Important takeaways from recent studies and reports

Strategies to reduce costs and risks of musculoskeletal disorders

A report by the Northeast Business Group on Health (NEBGH) urges employers to look at their own experiences with claims, disability, workers’ compensation and health risk assessment data to best prioritize program selection and implementation to better manage MSDs. It addresses several strategies to mitigate cost and health issues and suggests using onsite ergonomics training, online courses on the subject and workplace redesigns. It also suggests new approaches to treatment, such as online pain education, direct access to physical therapy by bypassing physician referrals, and directing employees away from “unnecessary diagnostic imaging and expensive visits to specialists.” Finally, the report examined ways to ensure that if surgery is needed, that the care is performed in an efficient and cost-effective way.

Obesity and worker productivity by occupational class

The Journal of Occupational and Environmental Medicine has published a new study, “Impact of Obesity on Work Productivity in Different US Occupations: Analysis of the National Health and Wellness Survey 2014-2015”, which examines the impacts of obesity by different occupational classes on work productivity and indirect costs of missed work time.

BMI results were as follows:

  • Protective Services: 38% overweight, 39% obese
  • Transportation: 38% overweight, 36% obese
  • Manufacturing: 35% overweight, 30% obese
  • Education: 31% overweight, 30% obese
  • Healthcare: 31% overweight, 30% obese
  • Construction: 38% overweight, 29% obese
  • Hospitality: 32% overweight, 27% obese
  • Arts: 34% overweight, 26% obese
  • Finance: 36% overweight, 25% obese
  • Computer: 36% overweight, 25% obese
  • Legal: 38% overweight, 24% obese
  • Science: 37% overweight, 21% obese

The researchers concluded that there was a positive association between work productivity impairment and increases in BMI class that varied across occupations. Obesity had the greatest impact on work productivity in construction, followed by arts and hospitality, and health care occupations. Work impairment was least impacted by increases in BMI in Finance, Protective Services, Computers, Science, and Legal. It was estimated that the indirect costs associated with the highest BMI group in construction was $12,000 compared to $7,000 for those with normal BMI.

Would your floors pass the slip and fall test? 50% fail

Half of the floors tested for a slip-and-fall study failed to meet safety criteria, suggesting that many fall-prevention programs may overlook the effects of flooring selection and ongoing maintenance on slip resistance, according to a study by CNA Financial Corp.

Given the high frequency of slips and falls, these findings underscore the need for attention to floor safety and regular surface resistance testing to avoid fall accidents and related injuries.

Fatigue costs employers big bucks

Key findings from a recent study on fatigue by the National Safety Council (NSC) include:

  • More than 43 percent of all workers are sleep-deprived, and those most at risk work the night shift, long shifts or irregular shifts. As employees become tired, their safety performance decreases and their risk of accidental injury increases.
  • Missing out on sleep makes it three times as likely to be involved in an accident while driving. Also, missing as little as two hours of sleep is the equivalent of having three beers.
  • Employers can see lost productivity costs of between $1,200 to $3,100 per employee per year.
  • The construction industry has the highest number of on-the-job deaths annually. In a 1,000-employee national construction company, more than 250 are likely to have a sleep disorder, which increases the risk of being killed or hurt on the job.
  • A single employee with obstructive sleep apnea can cost an employer more than $3,000 in excess healthcare costs each year.
  • An employee with untreated insomnia is present but not productive for more than 10 full days of work annually, and accounts for at least $2,000 in excess healthcare costs each year.

Experts say employers can help combat fatigue by offering breaks, scheduling work when employees are most alert, and promoting the importance of sleep.

Workers welcome employers’ help in dealing with stress

Workers want their employers to offer assistance in coping with work-related stress, according to a new report from the American Heart Association’s CEO Roundtable.

The report also concludes that employees think more highly of employers offering resiliency programs. Valued programs include methods for dealing with difficult people, improving physical health, remaining calm under pressure, coping with work-related stress and accurately identifying the causes of work-related problems. It also includes actionable strategies for effective workplace resilience programs.

Supportive communication and work accommodation help older workers return to work

While early supportive contact with injured workers and offers of work accommodation are important to all injured workers, a recent webinar hosted by the Disability Management Employer Coalition (DMEC) and presented by Dr. Glenn Pransky, founder of the highly acclaimed, but now-defunct Center for Disability Research within the Liberty Mutual Research Institute for Safety, noted that these two strategies are particularly effective with older workers.

His research involved workers’ comp cases in New Hampshire related to low back and upper extremity problems. Negative responses, including lack of support, anger, disbelief, blaming the worker, or discouraging the worker from filing a claim resulted in significantly longer disability, and the effect was especially strong among older workers.

Click to hear the DMEC webinar

Loss control rep visits cut lost-time injuries in construction

Visits by insurance loss prevention representatives to construction job sites can lead to fewer workplace injuries, according to a study by a Center for Construction Research and Training supported research team at the University of Minnesota. One contact was associated with a 27% reduction of risk of lost-time injury, two contacts with a 41% reduction of risk, and three or more contacts with a 28% reduction of risk, according to the study. The study also found that these visits are often low cost and that the reduction in lost-time injuries reduced workers’ comp costs.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Things you should know

Attention motor carriers: “Roadcheck” annual event – June 6 – 8

Nearly three times more roadside inspections take place during the 72 hours on June 6 – 8 than on any other time of the year. Sponsored by the Commercial Vehicle Safety Alliance (CVSA), the intensive annual “Roadcheck” is a good opportunity for those in the motor carrier industry to improve their Compliance, Safety, Accountability (CSA) scores. In 2016, 62,796 truck and bus inspections were completed throughout the United States, Canada, and Mexico.

Top construction risks: geopolitical instability, workforce management issues

In a survey of executives in the construction sector, Willis Towers Watson P.L.C. found geopolitical instability and workforce management issues as the biggest challenges facing the industry. Geopolitical issues included uncertainty of government support and financing, postponement and delays, changes in strategy, and commitment to project pipelines. Workforce management issues include increasing need for digital skills, a global employee network, disparate labor laws, difficulty to attract talent, and an aging population. The Construction Risk Index report can be downloaded here.

New pamphlet spotlights Hypothenar Hammer Syndrome

Scientific research organization IRSST has released a pamphlet intended to help workers recognize Hypothenar Hammer Syndrome. Aimed at workers who use vibrating tools or frequently strike, press or twist objects with the palms of their hands, the free pamphlet outlines syndrome warning signs and prevention methods.

Mayo Clinic study: second opinion leads to new or refined diagnosis for 88% of patients

Many patients come to Mayo Clinic for a second opinion or diagnosis confirmation before treatment for a complex condition. In a new study, Mayo Clinic reports that as many as 88 percent of those patients go home with a new or refined diagnosis – changing their care plan and potentially their lives. Conversely, only 12 percent receive confirmation that the original diagnosis was complete and correct.

These findings were published online in the Journal of Evaluation in Clinical Practice.

Study links participation in weight-loss programs to reduced absenteeism

Obese workers who took part in a structured weight-loss program reported fewer hours missed on the job after six months, a recent University of Michigan study shows.

Researchers surveyed 92 people who had an average body mass index of 40 and worked in various occupations. Before entering the program, participants stated in a self-evaluation that they worked an average of 5.2 fewer hours a month than their employers expected. After six months and an average of 41 pounds shed, participants reported working 6.4 more hours a month than expected.

WCRI’s CompScope™ Benchmark 2017

The 17th edition of CompScope™ Benchmarks Report is available from the Workers’ Compensation Research Institute (WCRI). The report looks at the impact of state workers’ compensation reforms on things like claim costs, rate of litigation, and disability duration and included 18 states: California, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia and Wisconsin. In California and North Carolina, the total costs per claim have been steady between 2010 and 2013. Illinois saw total costs per claim decrease by 6.4 percent since 2010, which researchers attribute to a 30 percent reduction in fee schedule rates for their medical services. Indiana’s total costs per claim decreased by 4 percent from 2014 to 2015, a product of a 10 percent decrease in medical payments, but a 5 percent increase in indemnity benefits per claim. In Florida, total costs per claim increased between 2010 and 2015, but there were decisions last year from the Florida Supreme Court that may slow or stop those increases in costs.

Rising pedestrian death toll

The latest report on U.S. pedestrian deaths, from the Governors Highway Safety Association, estimates that last year’s total rose 11.6 percent to nearly 6,000, or more than 16 fatalities a day. If that projection proves accurate – it is based on fatality records from only the first half of 2016 – it would mark the sharpest yearlong increase since records have been kept.

Analysts are putting much of the blame on drivers and walkers who are looking at their smartphones instead of watching where they are going. Tipsy walking also is part of the problem, with one in three victims legally drunk when they were struck and killed.

Workplace death rate hits a 10-year high in Massachusetts

Seventy Massachusetts workers lost their lives last year, marking a 10-year high in the rate of workplace-related fatalities, according to the Massachusetts Coalition for Occupational Safety and Health, known as MassCOSH. Sixty-two of those workers were killed on the job, many in construction; the rest were firefighters who died from occupational illnesses, such as lung cancer and heart disease.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

Things you should know

Opioid abuse rises with length of prescription

According to a study by the U.S. Centers for Disease Control and Prevention, the risk of opioid abuse rises with lengthy prescriptions. If received a one-day prescription, 6% were still on opioids a year later; when prescribed for 8 days or more, this rises to 13.5%; when prescribed for 31 days or more, it increases to 29.9%.

Blacklisting rule repealed

President Trump repealed the so-called “blacklisting rule” that required federal contractors to disclose labor violations. The executive order had required employers bidding for federal contracts worth at least $500,000 to disclose any of 14 violations of workplace protections during the previous three years.

FMCSA will not reinstate overnight rest regulations for commercial drivers

The Federal Motor Carrier Safety Administration’s (FMCSA) regulation that required CMV (Commercial Motor Vehicle) drivers to take breaks in the hopes of preventing driver fatigue has been suspended since 2014 so that further research could be done to understand the efficacy of the program. A study from the Department of Transportation found that stricter mandated breaks did not do much to reduce driver fatigue or improve safety. Thus, the rule will not come out of suspension.

Study reveals occupations with sleep deprived workers

If your industry is health care, food service, or transportation, your workers are probably not getting adequate sleep, according to a study published March 3 in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. Workers who averaged fewer than seven hours of sleep per night were classified as having short sleep durations. Occupation groups that failed to average seven hours of sleep included:

  • Communications equipment operators: 58 percent
  • Rail transportation workers: 53 percent
  • Printing workers: 51 percent
  • Plant and system operators: 50 percent
  • Supervisors, food preparation and serving workers: 49 percent
  • Extraction workers: 45 percent
  • Nursing, psychiatric and home health aides: 43 %

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults 18 to 60 years old get at least seven hours of sleep every day. A lack of sleep can contribute to cardiovascular disease, obesity, diabetes, depression, and other health issues, as well as contribute to more injuries on the job.

NIOSH announces free health screenings for coal miners

A series of free, confidential health screenings will be available for coal miners as part of the NIOSH Coal Workers’ Health Surveillance Program. The first set of screenings will take place from March 26 to April 15 in coal mining regions throughout Alabama. The second set will occur from May 10 to May 31 throughout Indiana and Illinois. Finally, testing will take place from July 30 to Aug. 26 throughout Eastern Kentucky.

NIOSH updates mine hazard assessment software

Mine operators and workers now have access to updated hazard assessment software from NIOSH. According to the agency, EVADE 2.0 – short for Enhanced Video Analysis of Dust Exposures – offers a more comprehensive assessment of the hazards miners face by pulling together video footage and exposure data on dust, diesel and other gases, as well as sound levels.

Study: PT as effective as surgery for carpal tunnel

Physical therapy is as effective as surgery in treating carpal tunnel syndrome, according to a new study published in the Journal of Orthopaedic & Sports Physical Therapy. Researchers in Spain and the United States report that one year following treatment, patients with carpal tunnel syndrome who received physical therapy achieved results comparable to outcomes for patients who had surgery. Further, physical therapy patients saw faster improvements at the one-month mark than did patients treated surgically.

When hospital inspectors are watching, fewer patients die

A recent report in the New York Times cited a study in JAMA Internal Medicine which found death rates dropped when inspectors were onsite. In the non-inspection weeks, the average 30-day death rate was 7.21 percent. But during inspections, the rate fell to 7.03 percent. The difference was greater in teaching hospitals – 6.41 percent when the inspectors were absent, and 5.93 percent during survey weeks. While the difference may seem low, an absolute reduction of only 0.39 percent in the death rate would mean more than 3,500 fewer deaths per year.

Although the reasons for the effect are unclear, it was suggested when docs are being monitored, diligence ramps up.

Wearing eye protection can prevent 90 percent of work-related eye injuries, experts suggest

Ninety percent of on-the-job eye injuries could be avoided if workers wore eye protection, according to the American Academy of Ophthalmology (AAO). AAO offers the following tips for avoiding workplace eyestrain or injury:

  • Wear protective eyewear appropriate for the type of hazard you may encounter
  • Position your computer monitor 25 inches away
  • Follow the 20-20-20 rule: Every 20 minutes, take a break by looking at an object 20 feet away for 20 seconds
  • Reduce glare on your cell phone or digital device
  • Adjust environmental lighting near your workstation

 

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

Top 10 Workplace Trends in 2017

Performance Management tops the list

The Society for Industrial and Organizational Psychology (SIOP) asked its members – who study workplace issues of critical relevance to business, like talent management, coaching, training, organizational development, and work-life balance – about their predictions for 2017. Topping the list of top ten is the changing nature of performance management.

While much has been written about companies ending annual performance reviews and ratings, it’s unclear what will take its place. The group predicts, “Organizations can expect to rely less on once-a-year performance appraisals and more on frequent feedback and coaching to put the focus on improving performance. Strategies, such as continuous performance management, will lead to a greater emphasis on real-time feedback, daily manager-employee relationships and an increased need for managers to acquire the skills to coach and deliver timely feedback to employees.”

For the Top 10 Workplace Trends for 2017

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

Truckers’ medical conditions can increase crash risk

Commercial truck drivers who have at least three health issues can quadruple their crash risk compared to healthier drivers, according to a study from the University of Utah School of Medicine. Researchers examined medical records for nearly 50,000 commercial truck drivers, 34 percent of whom had signs of one or more health issues associated with poor driving performance, such as heart disease, low back pain and diabetes.

The crash rate involving injury among all drivers was 29 per 100 million miles traveled. The rate rose to 93 per 100 million miles traveled for drivers with at least three ailments. Researchers took into account other factors that can impact driving abilities, such as age and amount of commercial driving experience.

The study was published online Jan. 10 in the Journal of Occupational and Environmental Medicine.

Employee takeaway: It is well documented that truck drivers often have difficulty staying healthy because they tend to sit for long periods of time and sleep and eat poorly. With the industry facing a critical shortage of drivers, employers need to do all they can to keep their drivers healthy. There are a host of tools available to help drivers, including smart phone apps with guidance about nutrition and exercise on the road, customized in-house wellness programs, bio-screenings, coaching, sleep apnea testing and treatment, encouraging brown bagging and walking or bicycling during breaks, and so on. Some companies are ramping up their new-hire pain diagnostics, so they have a baseline for whether a new driver has pre-existing muscle pain. In an industry of high turnover and high claims, this puts the driver on notice and effectively deters claims.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

Pressure to meet earnings expectations negatively impacts worker safety

New research in the Journal of Accounting and Economics, “Earnings expectations and employee safety” examined the relation between workplace safety and managers’ attempts to meet earnings expectations. The finding: significantly higher injury/illness rates in firms that meet or just beat analyst forecasts compared to firms that miss or comfortably beat analyst forecasts.

Changes in operations or production, specifically increased workloads and abnormal reductions of discretionary expenses, that are meant to increase earnings impacted the number of workplace injuries. The relation between benchmark beating and workplace injuries is stronger when there is less union presence, when workers’ compensation premiums are less sensitive to injury claims, and among firms with less government business.

Employer takeaway: When pressure is applied on managers to meet earning expectations, they can detract from safety by increasing workloads, hours, speed of workflow or cutting corners. Contrast these findings to a study published in the January 2016 issue of the Journal of Occupational and Environmental Medicine (JOEM), that found 17 publicly held companies with strong health and/or safety programs significantly outperformed other companies in the stock market. Two additional studies also found that financially sound, high-performing companies invest in employee health and safety. Rather than deviate from normal business practices to meet earnings expectations in the short-term, these companies have an ongoing, long-term commitment to a healthy and safe workforce that tangibly contributes to the bottom line.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

New report weighs in on marijuana’s health benefits – nearly 100 conclusions

A new report from the National Academies of Sciences, Engineering, and Medicine offers a rigorous review of scientific research published since 1999 about the health impacts of cannabis and cannabis-derived products – such as marijuana. It lays out substantial evidence that associates the use of cannabis with the development of psychoses and schizophrenia, but also provides studies that show its potential benefits, such as relief of chronic pain and chemotherapy-induced nausea. Other benefits include: improvement of multiple sclerosis spasticity, improvement of short-term sleep in patients with obstructive sleep apnea, fibromyalgia, chronic pain, and multiple sclerosis, potential improvement of anxiety symptoms, and increasing appetite and decreasing weight loss in patients with HIV and AIDS.

But it also points out potential risks: worsening of respiratory symptoms and more frequent bronchitis with long-term smoking, increase in motor vehicle accidents, low birth weight in offspring of maternal smoker, and higher risk of cannabis overdose in children in states where cannabis is legal.

The report also acknowledges that it has been difficult for researchers to do rigorous research on marijuana, partly because of the federal classification of it as a Schedule 1 substance.

Employer takeaway: This report demonstrates how much more needs to be done – many health questions remain to be answered by better research. The increased legal availability of cannabis products in many states and the uncertain legal landscape has complicated workplace policies. It’s prudent for employers to establish a clear policy and communicate it effectively to employees as well as stay abreast of all legal decisions and regulations in the states where they do business.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

HR Tip: Incivility at work begets incivility to co-workers: study

Lack of civil behavior in the workplace can cause employees to experience mental fatigue and strike back, with negative consequences for employees’ well-being and companies’ bottom-lines, according to a study from Michigan State University. Researchers tested how experiencing incivility precipitates instigating incivility towards others at work via reduced self-control.

People who are recipients of incivility at work feel mentally fatigued and lack the energy to suppress terse or impatient responses to colleagues. It is primarily a problem in work environments that are perceived to be political, when intentions and motives are less clear.

To combat incivility spirals, which can cost employers an estimated $14,000 per worker annually in lost workdays and lost productivity, researchers said employers should provide clear feedback about appropriate workplace behaviors. This can be accomplished informally by enhancing the quality of feedback provided during day-to-day interactions, as well as formally through the performance management process.

The findings also may have ramifications for worker safety. According to NIOSH documents, although more research is needed, “there is a growing concern that stressful working conditions interfere with safe work practices and set the stage for injuries at work.”

The study was published in June in the Journal of Applied Psychology.

For Cutting-Edge Strategies on slashing Workers’ Compensation Costs visit www.PremiumReductionCenter.com

New studies and surveys

Experience, risk-taking major factors in industrial accidents

Although industrial accidents have declined sharply over the past 20 years, a recent survey by The Golden Triangle Business Roundtable, a Texas trade association, found “risk-taking” continues to be a factor in deaths and injuries. Among workers involved in the incidents, 43 percent had fewer than five years in their crafts and 34 percent had between five and 10 years of experience.

Where incidents have occurred in the 20 years of surveys, 42 percent were at refineries and 21 percent were at chemical plants. Men accounted for 96 percent of the incidents, and two-thirds of them involved men aged 18 to 40 years old. Pipe fitters and laborers accounted for 30 percent of the accidents and 77 percent were in their craft for fewer than 10 years.

Takeaway: While an intensive training program for new and young workers is critical, it is not enough. An on-going mentoring program that emphasizes awareness of the surrounding physical hazards, potential dangers, and good decision-making is key, particularly for less experienced workers who are prone to risk-taking.


Emerging trends and challenges: National Safety Survey

Every year, EHS Today surveys its readers to discover emerging trends and challenges. The major findings of the survey of the nearly 1,000 EHS (environment, health and safety) professionals include:

Leading indicators

Leading indicators are where’s it at in 2016 and those that are most tracked include:

  • Near misses (85.66%)
  • Employee audits/observations (82.87%)
  • Participation in safety training (80.88%)
  • Inspections and their results (79.58%)
  • Participation in safety meetings (69.72%)
  • Facility housekeeping (64.54%)

Others included: participation in safety committees (64.14%), overall employee engagement in safety (60.56%), safety action plans execution (58.17%), equipment/machinery maintenance (51.79%), safety perception surveys and follow up (37.85%), and permit deviation (21.91%).

Top injuries

Cuts, lacerations, and punctures topped the list of most common type of injuries – 53.74%. This was followed by strains, sprains, and tears (52.04%), slips, trips, and falls (47.96%), back injuries (26.53%) and repetitive stress and musculoskeletal injuries (23.47%).

PPE purchases

The two factors most considered when purchasing PPE are certification levels/ratings (55.18%) and price (47.83%). This was closely followed by employee recommendations (41.47%). Hand protection dominates the PPE market, accounting for over 23 percent of the overall protective equipment revenue in 2015.

 

Untreated sleep apnea deadly for commercial drivers

Research from the National Transportation Safety Board revealed that fatigue was the most frequently cited cause of heavy truck accidents, accounting for 30-40 percent, and was also the cause of 31 percent of the 182 fatal-to-the-truck-driver accidents studied.

Sedentary lifestyles and a tendency toward a high body mass index (BMI) put commercial drivers at a greater risk than non-commercial drivers of developing dangerous sleep disorders. While commercial truck drivers are required by the Federal Motor Carrier Safety Administration to undergo regular medical exams to spot dangerous medical conditions, many sleep disorders still go undiagnosed, or worse, ignored.

When the human body is deprived of sleep, cognitive performance begins to suffer almost immediately. Sleep deprivation problems can include a decrease in alertness and an inability to perform; cognitive as well as memory difficulties; and an increased risk of involvement in a motor vehicle or workplace accident.

While individuals of all ages can develop sleep apnea, common sleep apnea risk factors include:

  • Obesity/high BMI
  • Heavy snoring
  • Large neck circumference
  • High blood pressure
  • Diabetes
  • Male
  • Middle to older age
  • Smoking
  • Alcohol or sedative use
  • Difficulty breathing through the nose

 

Tractor-trailer truck drivers at increased risk of injury, death

According to a recent blog post from the Department of Labor (DOL), one out of six U.S. American workers killed on the job is a tractor-trailer truck driver. A total of 761 tractor-trailer truck drivers were killed in 2014.

Tractor-trailer truck drivers are three times more likely than the typical American worker to have an injury or illness that required days off from work. Injuries from slips, trips and falls were the most common cause of missed workdays, followed by overexertion injuries caused by tasks such as loading and unloading cargo, pushing and pulling containers, and entering and exiting the vehicle.

When truck drivers get hurt on the job it takes them longer to recover. Approximately half of all truck drivers needed at least 20 days away from work to recover from an incident; 42 percent of tractor-trailer drivers required at least 31 days.

 

Obstructed breathing more common in certain jobs

Airway obstruction, which can signify lung diseases such as asthma or chronic obstructive pulmonary disease (COPD), was more common among workers in construction and oil and gas extraction than in other industry, investigators at the National Institute for Occupational Safety and Health (NIOSH) reported after analyzing results from a nationwide survey. These findings underscore the importance of monitoring the lung function of workers in high-risk jobs. Investigators found that the highest rates of airway obstruction were in jobs related to installation, maintenance, and repair; construction; and oil and gas extraction. More than one-fifth of study participants in these jobs had airway obstruction. In other findings, cigarette smoking, even prior to the study, also correlated with a high risk of airway obstruction.

 

Michigan survey suggests medical marijuana can aid in decreasing opioid use to treat chronic pain

In “Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain,” published in the June 2016 issue of The Journal of Pain, researchers from the University of Michigan surveyed users of medical marijuana looking for some insight into the relationship between medical marijuana use and alternatives such as opioids for chronic pain management. While researchers acknowledge limitations of the study and need for more research, their findings suggest that using medical cannabis for chronic pain treatment may benefit some patients with improvement in quality of life, better side effect profile, and decreased opioid use.

 

Study finds nearly 30 pesticides that make farmers wheeze

More than two dozen pesticides – including the most commonly used herbicide – are associated with respiratory wheeze among male farmers, according to a recent study from North Carolina State University. For the study, researchers defined allergic wheeze as cases in which farmers reported wheezing along with doctor-diagnosed hay fever and non-allergic wheeze as cases in which wheezing with no hay fever was reported. Wheezing indicates airway problems and can lead to more serious health issues.

Among the 78 pesticides listed were 45 herbicides and plant growth regulators and 25 insecticides. Twenty-nine pesticides were associated with at least one type of wheeze, and 11 were associated with both types, including Glyphosate, the world’s most popular herbicide.

The study was published online July 8 in the journal, Environmental Health Perspectives

For Cutting-Edge Strategies on slashing Workers’ Compensation Costs visit www.PremiumReductionCenter.com

Costs shifting from group health plans to workers’ compensation

Medical services continue to drive workers’ compensation costs. These studies examine cost shifting from group health plans to workers’ compensation, perception and reality of opioid usage, and compound drugs and physician dispensing…

Costs shifting from group health plans to workers’ compensation

According to current research from Workers’ Compensation Research Institute (WCRI), a significant number of workers in capitated health plans (such as health maintenance organizations), are likely to see medical costs shifting from group health plans to workers’ compensation insurance. Under capitated group health plans, medical providers are paid a set annual fee per plan member, regardless of visits. Workers’ comp plans pay providers for services received; therefore, there is an incentive for providers to prefer workers’ comp payments. Capitated health plans, once declining, are now increasing under the Affordable Care Act (ACA). Accountable care organizations (ACO), networks of doctors and hospitals that share financial and medical responsibility for providing care for patients that ties outcomes to reimbursements, are a central part of the ACA.

Typically, the treating physician makes decisions about the work-relatedness of a condition. Reimbursement rates set under the ACA and specifically under ACOs tend to be significantly lower than reimbursement rates under workers’ compensation systems. In addition, cases that are workers’ comp and their outcomes are not factored into the ACO performance evaluation.

The study found that states with higher percentages of insured workers in capitated health care systems saw a significant (30%) shift in coverage to workers’ compensation for employees claiming soft tissue injuries. Such injuries often require longer, more costly treatment and it’s difficult to pin down an exact cause, so providers can easily make a case for a workplace injury. States with more than 25% of workers under capitated health plans include California, New York, Pennsylvania, Michigan and Massachusetts.

The study revealed this increase in cost shifting also occurs when the employee is covered under a large deductible plan for their group health. Another factor contributing to the costs shifting is health plans with high deductibles; workers trying to avoid paying the high deductible prefer a workers’ comp deductible-free claim.

Employer takeaway: WCRI’s study suggests that the ACA’s focus on ACOs could accelerate the trend to recover more claims under workers’ compensation systems. By their nature, capitated plans discourage physicians from long lasting treatment options. Therefore, it is important for employers to implement and monitor injury reporting guidelines meticulously, to have established relationships with physicians, and to report suspected cases of cost shifting to the claims adjusters.

Education lacking in opioid use by workers

Almost 9 out of 10 people who use opioid painkillers are not concerned about becoming addicted to the drugs, according to a recent survey from the National Safety Council. This is a stark contrast between public perception and the known potential dangers of opioid medication. The survey found people do not understand what drugs are opioids and also underestimate the dangers related to the use of opioid painkillers.

Employer takeaway: While strides are being made in controlling the use of opioids in workers’ comp cases, much remains to be done. Employers should be proactive and educate workers on opioids, the dangers of addiction, and alternative approaches to pain management. Working with physicians who take a conservative approach to the prescribing of opioids, training supervisors to understand the potential signs of abuse and impairment, and providing assistance to at risk employees are also critical.

Employers should lead scrutiny on compounded drugs, physician dispensing

Employers should work with brokers, claims administrators and pharmacy benefit managers (PBM) to control workers’ compensation medical costs related to compounded drugs and physician dispensing, according to a report, “Targeting Prescription Drugs to Decrease Workers Compensation Costs” by Marsh L.L.C.’s Workers’ Compensation Center of Excellence. Typically, compounding pharmacies raise the price of each ingredient included in a solution resulting in excessively high costs. The cost per compounded prescription in 2013 was nearly $1,300 – far higher than the cost per prescription for other top therapy classes. Moreover, without consistent protocols to prepare each drug, compounded drugs can have a greater batch-to-batch variability, posing significant safety concerns.

Drugs commonly dispensed by physicians cost 60% to 300% more than drugs dispensed at retail pharmacies, according to the report. While more states have taken steps to curb abuse through legislation, it remains a serious problem.

Employer takeaway: A strong relationship with occupational health care providers focused on outcomes is key. The report urges employers to ensure that their claims administrators, in concert with PBMs, have specific policies in place to limit both physician dispensing and prescriptions involving compounded drugs.

  For Cutting-Edge Strategies on slashing Workers’ Compensation Costs visit www.PremiumReductionCenter.com

David Leng, CPCU, CIC, CBWA, CWCA, CRM

Author | Speaker | Certified Risk Manager | Certified Work Comp Advisor