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Work, Stress, and Health: Help Us Plan the Next 25 Years

Categories: Stress, Total Worker Health

 

In May, NIOSH, the American Psychological Association (APA), and the Society for Occupational Health Psychology (SOHP) hosted the 11th International Conference on Occupational Stress and Health. “Work, Stress, and Health 2015: Sustainable Work, Sustainable Health, Sustainable Organizations” marks 25 years of efforts to advance research and intervention on work-related stress  through the conference series. Planning for the 12th International Conference on Occupational Stress and Health—“Work, Stress, and Health 2017: Contemporary Challenges and Opportunities”—is already underway.

N95 Respirator Use During Pregnancy – Findings from Recent NIOSH Research

Categories: Personal Protective Equipment, Reproductive Health, Respirators, Respiratory Health, Women

 

Recent NIOSH research has shed some light on the topic of the safety of N95 filtering facepiece respirators (FFR) use by pregnant workers. Women make up approximately one-half of the US work force. At any given time, about 10% of those female workers of child-bearing age (15–44 years of age) will be pregnant. Because many women are employed in occupations that require the use of protective facemasks, such as medical/surgical masks and FFR, NIOSH conducted research into the safety of FFR use while pregnant. The most frequently used FFR in the US is the N95 FFR (commonly referred to as “N95 mask”), but little information was previously available about the safety of N95 FFR use during pregnancy. Some individuals complain of difficulty breathing when wearing an N95 FFR or other protective facemasks, and many pregnant women find that they become somewhat shorter of breath as their pregnancy progresses, causing concern that use of N95 FFRs during pregnancy might make breathing even more difficult and possibly harm the woman and her fetus. Beyond the issue of use by pregnant working women on the job, the question also has implications for pregnant women outside the workplace. People sometimes use N95 FFRs as a matter of personal choice during infectious disease outbreaks, during environmental disasters that pollute the air, and even in more common recreational activities that may expose them to airborne allergens, such as gardening and woodworking.

Addressing the Hazards of Temporary Employment

Categories: Manufacturing, Service Sector

A Joint Session of the NORA Manufacturing Sector

and Services Sector Councils

Factors such as fluctuations in the economy, changing social habits and access to technology have boosted a rapid growth in temporary work arrangements [Luo,T]. Under many names– temporary workers, contingent workers, contract workers, long-term temps, workers in dual employer situations, on-demand freelance–these workers seem to be ubiquitous in most industrial sectors. These arrangements are impacting work organization, career paths, and health and safety. According to various reports, there were an estimated 17 million workers engaged in some type of temporary employment in the United States in 2013, the most in the nation’s history. [MBO Partners] There is also evidence that this upward trend will continue. Complexities of temporary employment arrangements have created some ambiguity over the responsibility for complying with health and safety standards, which can result in increased health and safety risks in the workplace. A growing body of research demonstrates that temporary workers have higher rates of workplace injury [OSHA, 2013; Fabiano, 2008]. According to ProPublica research, temporary workers have double the risk of suffering severe injuries on the job, including crushing incidents, lacerations, punctures and fractures. [Luo,T]

chart

Figure 1. Staffing Employees by Sector Source: American Staffing Association, 2014 Staffing Employee Survey

Guidelines and policy have not kept pace with the growth in the temporary workforce. One segment of the temporary workforce–those individuals who are employed by temporary employment agencies and sent to work for a different, or host, employer–were the focus of a recent meeting co-hosted by the National Occupational Research Agenda Manufacturing Sector Council and Services Sector Council. Workers employed by temporary employment agencies (NAICCS code 5613) are considered to be service workers, raising images of the temporary office assistant. However, a 2014 survey showed that only 28% of temporary agency employees work in offices. The largest segment of this worker population is physically located in manufacturing (37%) and other hazardous industries (Figure 1).

Presenters from NIOSH and partner organizations covered a variety of topics ranging from descriptions of the extent of the health and safety problems in workplaces that hire from temporary employment agencies, to strategies and recommendations to prevent injuries and illness in this vulnerable workforce. A summary of the presentations follows. Please provide your input at the end of the blog on resources you or your company use to prevent workplace injury and illness among temporary workers.

Occupational Health and Safety of Temporary Workers in Washington State

Michael Foley, Services Sector Council Member, WA State Dept. of Labor & Industries

This presenter reported on previously published information using data from the Washington State workers’ compensation database that shows that temporary workers have higher claim rates in certain industries compared to permanent workers. Differences in machine operations, vehicle operations and construction were most notable. The presenter also described a survey of injured workers, conducted as an innovative method of occupational health and safety surveillance of the temporary help supply industry. Temporary workers were more likely to rate their job as less hazardous than permanent employees in similar industries, possibly indicating a lower ability to accurately assess hazards. Temporary workers were less likely to have had pre-assignment screening, safety training, or safety equipment. About 28% of temporary workers interviewed had experienced a significant change of job assignment upon arrival at the job site. No significant differences were found for physical/mental exhaustion, current health, frequency of overtime and knowledge about the workers’ compensation system.

Workers’ Compensation and Injury among Temporary Workers in Manufacturing

Steve Wurzelbacher and Chia Wei, NIOSH Center for Workers’ Compensation Studies (CWCS)

This presentation provided an overview of the use of workers’ compensation claims data to understand risks in temporary help services. Specific examples focused on data from the Ohio Bureau of Workers’ Compensation, and depicted trends by the type of temporary work being performed, cause and diagnoses of injury and injured worker age. The industry groups with the most claims (in the 56132 NAICS code) were: manufacturing (60%), commercial (14%) and services (13%). The top injury categories were open wounds, contusion and sprains. Young workers were more likely to have had traumatic injuries compared to other types of injuries such as slip/trip/falls, and ergonomic related injuries (due to repetitive motion, awkward postures, and/or overexertion).

Issues Facing Temporary Employment Agencies

Cheri R. Duggan, Sr. Regional Safety, Health & Environmental Manager, Kelly Services

The presenter emphasized the need for clarity regarding an understanding of the roles and responsibilities of a staffing company and how they differ from those of an independent contractor, the host employer, and the primary employer. This is particularly relevant to safety issues, recordkeeping and training. The temporary agency often provides general training whereas the host employer provides specific training. Interpretations of seemingly straightforward responsibilities can be challenging as they are handled differently by state and federal entities. Standardization of definitions and interpretations would enable each party to understand their responsibilities and better protect the worker.

Protecting Contingent Employees through a Collaborative Culture of Safety

Kristen Schweizer, The York Companies, Inc.

The presenter discussed the unique risks and challenges that staffing agencies face in their efforts to promote the health and well-being of contingent employees. The York Companies developed best practices and initiatives for building a collaborative culture of safety. Some best practices to enhance the work environment for contingent employees and minimize risks and exposures include:

  • Safety must be a priority of senior management
  • Continual training at all levels
  • Participate in “Captive insurance” for workers’ compensation, which is an arrangement under some state’s workers’ compensation system, where a group of staffing agencies share risk and assist others towards best practices
  • Partner with client companies to clearly delineate co-employment of workers
  • Pre-agreement and quarterly safety evaluations of client companies and contingent employee job functions.
  • In-depth analysis of every incident and accident

Guidelines to Protect Temporary Workers

Ken Rosenman, Michigan State University

Temporary workers in Michigan represent approximately 3% of its workforce. The results of a needs assessment conducted of the 304 temporary service agencies in Michigan were presented. Most respondents provide staffing for manufacturing, office and professional services companies.

  • More than half of the respondent agencies provided training on general procedures, ergonomics, hazard communication, lockout/tagout and personal protective equipment.
  • More than half of the respondent agencies also indicated that they had a contract with the host employer specifying safety and health responsibilities.
  • 90% said they visit the worksite prior to placement of temporary employees at a company.

Lastly, the speaker shared information on several resources developed by the Michigan state-based occupational health program for staffing agencies and host employers including:

http://www.oem.msu.edu/userfiles/file/Resources/ResourcesTemporaryStaffingAgencies.pdf

http://www.oem.msu.edu/userfiles/file/Resources/TempAgencySafetyResponsibilityFinal.pdf

http://www.oem.msu.edu/userfiles/file/Resources/TemporaryWorkerHA17.pdf

The OSHA and NIOSH Joint 2014 Publication: Recommended Practices for Protecting Temporary Workers

Kathy Fagan, Service Sector Council Member, Occupational Safety and Health Administration (OSHA), and Terri Schnorr, NORA, Services Sector Council Manager

Presenters shared information available on OSHA’s Temporary Worker Initiative (TWI) webpage and guidance materials:

Additionally, OSHA inspections regarding temporary workers resulted in 687 inspections where the host employer was cited and 66 inspections where the staffing agency was cited and 24 with both being cited (FY2014) showing that both can be responsible for the wellbeing of the temporary worker.  The presenters’ main point was that the staffing agencies and the host employers have joint responsibility to keep workers safe and healthy.  Future plans include working with the American Staffing Association Alliance and targeting temporary workers in Susan Harwood training grants.

Collaborating with Temporary Employment Agencies to Equip Workers with Foundational Workplace Safety and Health

Rebecca Guerin, Education and Information Division, NIOSH

The NIOSH Safe-Skilled-Ready Workforce Initiative (SSRWI) aims to ensure that all young workers and new hires obtain foundational, workplace safety and health skills before they enter the workforce or start a new job. By collaborating with NIOSH on the SSRWI, it is possible for a temporary services agency to identify and implement actions to provide foundational workplace safety and health training to young workers and new hires placed in host companies. NIOSH/SSRWI conducted in-depth interviews with leaders in key temporary services agencies to identify barriers and incentives to providing these skills. These were some common themes:

  • Intense price competition
  • High workers’ compensation costs
  • Compensation for pre-placement training
  • Definitional issues
  • Responding to OSHA/NIOSH Recommended Practices
  • Training of temporary workers is the joint responsibility of the staffing agency and host employer
  • Staffing agencies should provide general S&H training applicable to different occupational settings

NIOSH researchers are developing business cases for these agencies that support their integration of the foundational workplace safety and health competencies into their programs.

National Safety Council Strategy to Promote Safety for Temporary Workers

Jim Johnson, Manufacturing Sector Council Member; Workplace Safety Initiatives, National Safety Council (NSC)

The National Safety Council has taken the position that temporary and contract workers are at greater risk of workplace injury and encourages its members to adopt safety management systems to improve the well-being of all workers (http://www.nsc.org/learn/about/Pages/NSC-calls-on-employers-to-ensure-safety-of-temporary-and-contract-workers.aspx) . The NSC reiterated and supports the recommendations in the 2014 OSHA/NIOSH Recommended Practices document. The 2015 NSC Congress and Expo will have several sessions focusing on strategies to improve safety in complex organizations, management of temporary and contractor working arrangements and overall worker well-being. The Congress will be held September 26 to October 2, 2015, in Atlanta. As a member of the National Advisory Committee on Occupational Safety and Health (NACOSH), Johnson is chairing a workgroup on injury and illness prevention program best practices for temporary workers.  The NSC is also working with the American Staffing Association on a joint OSHA Alliance project on a best practice case study.

Discussion

The last hour of the session was reserved for discussion of actions needed to contribute to safe and healthy work conditions for dual-employment workers. The group attempted to identify research priorities, materials and outreach efforts that are most likely to yield a health gain for the worker. Several issues emerged and often there was agreement about research needs and priorities. We are reporting on key issues based on the time spent in their discussion, the level of detail in which they were addressed and the consensus reached. They are summarized in Table 1.

TABLE 1  Identified key needs for research and dissemination of recommended practices for dual-employment workers

Need to be addressed by research

Problems Specific needs Suggested action or resource
Overlapping vulnerabilities due to the demographics of temporary workers (age, ethnic background, language, gender, educational level, lack of long-term job stability, etc.) Investigations needed to distinguish the contributions of the different risk factors to injuries and illnesses and to identify appropriate preventive actions. Investigation of the contribution of lack of familiarity and experience with a particular job or worksite Incorporate questions on employment type into large national surveys. Gather input of all involved parties.
Lack of information or awareness of hazards Investigations needed to compare knowledge, beliefs and attitudes among temporary workers versus permanent workers. Investigations needed on access to safety training and health and safety programs. Investigations needed on access to avenues to inquire and/or communicate about hazards Investigate safety climate, awareness, risk tolerance (perceptions of susceptibility and severity of risk and health outcomes), as well as the benefits and barriers towards health and safety interventions.
Evidence-based strategies to address the problem Evaluations of intervention effectiveness on modes of intervention Gather input from all involved players: temporary agencies, host employers and workers.
Disseminate information on model programs with documented successful arrangements, as a benchmark for recommended practices.

Need to be addressed by outreach

Problem Existing materials Action needed
Clarifications over the responsibility for complying with health and safety standards. 2014 OSHA NIOSH Recommended Practices Protecting Temporary Workers “Assign Occupational Safety and Health Responsibilities and Define the Scope of Work in the Contract” OSHA and NIOSH have jointly recommended that explicit agreements are needed between the staffing agency and host employer, outlining roles and responsibilities related to worker training and protection, processes to identify and report hazards and compensation in cases of injury with no risk of retaliation. See Appendix A for a Sample Contract Language used by a Michigan Construction Company Jan 8, 2015 American Staffing Association “Model contract for staffing agencies and potential clients Model contract for staffing agencies and potential clients (existing or proposed) should be evaluated for completeness and accuracy and disseminated.
Evaluation of the host employer’s worksite prior to accepting a new host employer as a client, or a new project from a current client host employer 2014 OSHA NIOSH Recommended Practices Protecting Temporary Workers “Evaluate the Host Employer’s Worksite”  OSHA and NIOSH have jointly recommended that the staffing agency and host employer should jointly review all worksites to which the worker might be sent, with their corresponding task assignments and job hazard. Instrument to guide the evaluation of workplaces by staffing agencies (what hazards may be encountered, and how to best ensure protection for the temporary workers)Dissemination of information to small and medium-sized businesses on availability of third-party support for the evaluation (OSHA Consultation or workers’ compensation insurance providers)

 

We would like some feedback from you on the issues examined here and the key issues identified by our Councils. We are aware that we could not cover all aspects of this complex scenario. Do you have a suggestion on which aspect we should include in our future activities? Have you used any of the resources listed in this Blog? What did you like or dislike about them? Are you aware of other resources which we did not mention here? Your input will help the NORA Manufacturing and the Services Sector Councils determine what resources are needed and where we can contribute. Feel free to add other sources you use for ideas, solutions and other information on dual-employment arrangements.

Thank you for your assistance in identifying and improving the dissemination of resources that can help tackle health and safety problems among temporary workers.

 

Cheryl F. Estill is an Industrial Hygiene Supervisor in the NIOSH Division of Surveillance, Hazard Evaluation, and Field Studies and the Coordinator of the National Occupational Research Agenda (NORA) Services Sector Council.

Thais Morata is a Research Audiologist in the NIOSH Division of Applied Research and Technology and the Coordinator of the NORA Manufacturing Sector Council.

Terri Schnorr is the Division Director of the NIOSH Division of Surveillance, Hazard Evaluations, and Field Studies and the manager of the NORA Services Sector Council.

Barbara Materna is the Chief of the Occupational Health Branch, California Department of Public Health and NORA Services Sector Council Co-Chair.

Gregory Lotz, is the Division Director of the Division of Applied Research and Technology (DART) and the manager of the NORA Manufacturing Sector Council.

 

 

References

American Staffing Association. Staffing industry facts and data.

Fabiano, B, Currò, F, Reverberi, AP, Pastorino, R. (2008) A statistical study on temporary work and occupational accidents: Specific risk factors and risk management strategies. Safety Science, 46: 3, March 2008, 535–544.

Luo T, Mann A, Holden R. The expanding role of temporary help services from 1990 to 2008. Monthly Labor Review, August, 2010. http://www.bls.gov/opub/mlr/2010/08/art1full.pdf

MBO Partners. The State of Independence in America (2013). Accessed from: http://info.mbopartners.com/rs/mbo/images/2013-MBO_Partners_State_of_Independence_Report.pdf

OSHA (2013) Protecting the Safety and Health of Temporary Workers. Webinar presented by the Occupational Safety and Health Administration and the American Staffing Association. July 18, 2013. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=SPEECHES&p_id=2974

OSHA and NIOSH (2014) Recommended Practices. Protecting Temporary Workers. Available at https://www.osha.gov/Publications/OSHA3735.pdf

ProPublica. Temporary Work, Lasting Harm (2013). Accessed from: www.propublica.org/article/temporary-work-lasting-harm.

 

More Resources

In addition to the resources suggested by the Councils’ members mentioned above, we encourage the reader to attend this free Council of State and Territorial Epidemiologists’ webinar on Assessing and Responding to the Health and Safety Needs of Workers in the Temporary Services Industry , which was held on 2/27/2015 by the Occupational Health Subcommittee. The purpose of this webinar is to provide an overview of occupational health and safety issues for workers in the temporary services industry and to outline a basic public health response. References to products or services do not constitute an endorsement by NIOSH or the U.S. government.

Silicosis Update

Categories: Respiratory Health, Silica

 

Silicosis is a potentially fatal but preventable occupational lung disease caused by inhaling respirable particles containing crystalline silicon dioxide (silica). Quartz, a type of crystalline silica, is the second most abundant mineral in the earth’s crust and workers across a wide range of occupations and industries are exposed to silica-containing dusts. The risks, causes, and prevention of this avoidable disease have been known for decades. There is no cure for silicosis and only symptomatic treatment is available, including lung transplantation for the most severe cases.  New national data have become available since a prior report on silicosis surveillance was published earlier this year. The new data show that silicosis continues to cause or contribute to the deaths of about 100 Americans each year. There were 88, 103, and 111 such deaths in 2011, 2012, and 2013 respectively.

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