Occupational Medicine : Medical / Nursing Research Paper

Running Head: Occupational Medicine

Occupational Medicine
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Occupational Medicine

It is important for all employees to have emergency training. Once emergency medical treatment has been provided, the supervisor's job has just begun. The supervisor should investigate the accident immediately. Who and what was involved? Exactly where and when did it happen? Who saw it occur? Was the employee using required safety equipment? Was the employee performing his/her assigned tasks? If possible, the injured employee should describe the accident in his or her own words. Encourage the employee to be specific. The supervisor should take statements from all witnesses. If possible, the interviews and statements should be completed at the scene of the accident. Remember, the sooner accident information is gathered, the more accurate it will be. The next stop is processing a workers' compensation claim. Your insurance carrier must be notified when there has been a workplace accident involving lost time and/or medical expense other than first aid. The insurer will need the facts of the accident and information about the employee to begin processing the claim.

Once claim processing has begun, the supervisor should continue to investigate the claim. Ethyl acetate is used as a solvent for varnishes, coatings, plastics, lacquers, smokeless powders, nitrocellulose, organic synthesis and pharmaceuticals. It is also used in the manufacture of artificial silk and leather, perfumes and artificial fruit essences and photographic films. (R.J. Flanagan 2000) Ethyl acetate is present in cleaning textiles and is commonly used in manicuring preparations. The vapor is heavier than air and workplace handling procedures include recommendations for gloves, clothing and respirator. After exposure to ethyl acetate vapor irritation of the eyes, mucous membranes, gums, respiratory tract, nasal passages, throat and skin may occur. Other symptoms include gastrointestinal disturbances, nausea, headache and vomiting. Chronic exposure by inhalation can cause damage to the lungs and heart and can lead to renal or hepatic abnormalities. Exposure to high concentrations may cause drowsiness, sleepiness, unconsciousness, narcosis, stupor and central nervous system depression. In blood, rapid hydrolysis of ethyl acetate occurs by plasma esterases, resulting in ethanol and acetic acid. The threshold limit for ethyl acetate is 1400 mg/m3 in air. The indirect costs of an accident take into effect the sometimes immeasurable costs of lost production and efficiency on a company-wide basis. (R.P. Ryan, C.E. Terry, 1997) They include the following costs:

• Wages for lost time of uninjured co-workers. Workers adjacent to the accident scene who stop their work to watch or offer assistance or talk about the accident need to be considered when assessing the financial impact of an accident.

• Repair or replacement of damaged material or equipment. This includes the time to order, deliver, and test the new machine following the accident.

• Training replacement workers. Recruiting and training temporary or permanent workers-and all the costs incurred by administrative personnel-need to be considered.

• Overtime. Extra costs of employee overtime to make up lost production frequently occur after a workplace accident.

Other indirect costs of an accident also result in loss of productivity, including the following:

• Foreman's diverted activity. Supervisory wages for time attending to the accident must be assigned to the total costs of the accident.

• Wages spent on reduced production. The cost of wages for an injured worker's return to a job could also be a factor, if the worker's performance decreases.

• Clerical supervision and accident investigation. Filing accident and investigation reports to insurance company and regulatory agencies, and the expense of accident investigation and recommendations for preventive measures, are to be considered.

• Remedial and compliance costs for equipment safeguards. Following the event, response to regulatory hearings and equipment modifications for compliance can be costly, including special safety training, procedures, and monitoring of results as directly related to the accident.

The supervisor should review the accident statements taken from the employee and co-workers. Do they agree on the cause of the accident? Could the accident have been prevented? If necessary, form a safety team to study the cause of the accident and make recommendations as to how a similar accident may be prevented in the future. They could even videotape a re-enactment of the accident for future training proposes. It is also a good idea to investigate "near misses," or accident injuries where there was no serious injury. If you can come up with prevention measures for these incidents, you may be able to prevent more serious accident injuries in the future. A strong investigation policy gives employees the message that management is genuinely concerned about their welfare, and it also can be a deterrent to fraudulent or abusive claims. (D.J. Pounder, G.R. Jones, 1990) When it's time to report the accident to your insurance carrier or claims administrator, do your supervisors know what to do? Did your safety program include training supervisors on handling claims? To whom should the claim be reported -- a person in your human resources office or directly to the insurance carrier's claims office? Do your supervisors have the forms required by the insurance carrier? What part of the form should be completed by the employee, the supervisor, and the insurance carrier? (E. Browning, 1965) These too are basic questions -- but do you and your supervisors know the answers? In cases involving three or more days of lost work time, you will need to fill out a WKC-12 "First Report of Injury" form. This allows you to communicate the facts of your investigation to your insurer. Make sure the appropriate person completes the form and that the facts are accurately stated.

Clear and concise communication with your insurer is essential. Your insurer will need information regarding the employee and how the accident happened. At this time, the supervisor should indicate if the claim is legitimate or if there are any suspicious circumstances that may require additional investigation by the insurer. Supervisory follow-up with the injured employee after the accident and throughout the disability period is essential. The supervisor should explain in detail to the injured employee what workers' compensation benefits he or she will receive, and when disability payments will be received. (T. Richardson, 2000)

The employer or supervisor should meet with the employee's treating physician to discuss the demands of the employee's job, as well as the employee's capabilities with the current injury. As an employer, you have the option to set up an early return-to-work program. If you can assign the employee tight-or duties, the employee may return to work before he or she is able to perform the duties of the job held before the accident. (.A. Coopman, J.A. Cordonnier, D. Van Varenbergh and W. Goeteyn, 1998) Getting that injured employee back to the workplace is beneficial to your company and the employee. A flexible program providing light-duty work helps motivate the employee, will renew his/her self-esteem, and will relieve the worry over lost income. Precise investigation, prompt reporting, good communications with the insurance carrier, and follow-up with the employee will make the process of handling an accident a little easier for everyone involved. Investing in a safer workplace cuts the expense of treating injured workers and helps companies control insurance premiums and prevent workplace accidents. Equally important, effective safety standards in the workplace boost employee morale by conveying the message that the company cares enough about its people to protect their health and safety. (Y. Seto, 1994) Safety problems can be easily and inexpensively avoided by taking the following steps:

• Tighten up housekeeping. It sounds simple, but such activities as keeping floors swept and obstacles out of the way make a major contribution to reducing the number of accidents in both factories and offices. Pay special attention to seemingly harmless items that can easily become hazards-e.g., water spilled around a water cooler or pathways obstructed by wires or boxes.

• Conduct regular safety checks. Unless your company is large enough to hire a full- or part-time risk manager, consider retaining a safety consultant to inspect the premises once or twice a year. To find one, consult your insurance company. It may offer to do the inspections or suggest other specialists. The cost is typically $300 to $400 for one day--the time required to make a safety inspection at most small companies.

• Conduct regular fire drills. If you retain a safety consultant, ask for suggestions on the frequency of fire drills. As a rule, businesses need drills two or three times a year, but some types of companies handling flammable materials should hold drills more often.

• Train employees to be safety conscious. Alert workers to areas that pose potential safety risks, such as stairways and light fixtures. Many accidents can be avoided by orienting new employees to their environment or by reminding current workers of past accidents and procedures for avoiding them in the future.

• Continuously improve safety training. Few companies would let untrained employees operate heavy machinery, but a surprising number allow them to use everyday office equipment that can also cause injury. Training basics include instructing all employees in safe machine operation, stating safety procedures in employee handbooks, and supporting employees in first aid training offered by the Red Cross and other civic organizations.

Each of these suggestions can be implemented inexpensively and has reduced workplace injuries in organizations of all sizes.

D.J. Pounder and G.R. Jones, Postmortem drug redistribution – a toxicological nightmare, Foren. Sci. Int. 45 (1990), pp. 253–263.

E. Browning, Toxicity and Metabolism of Industrial Solvents, Elsevier (1965) pp. 522–525.

R.J. Flanagan, Inhalants, Encyclopedia of Forensic Science, Academic Press, New York (2000).

R.P. Ryan and C.E. Terry, Editors, Toxicology Desk Reference (4th ed.), Taylor & Francis, Washington, DC (1997), p. 1256.

T. Richardson, Pitfalls in forensic toxicology, Ann. Clin. Biochem. 37 (2000), pp. 20–44.

V.A. Coopman, J.A. Cordonnier, D. Van Varenbergh and W. Goeteyn, Tissue Distribution of Gasoline in a Forensic Case, Proceedings of the Joint SOFT/TIAFT International Meeting Albuquerque, New Mexico (1998), pp. 222–229.

V.A. Coopman, J.A. Cordonnier, E.A. De Letter and M.H. Piette, Tissue distribution of trichloroethylene in case of accidental acute intoxication by inhalation, Foren. Sci. Int. 134 (2003), pp. 115–119.

Y. Seto, Determination of volatile substances in biological samples by headspace gas chromatography, J. Chromatogr. A (1994), pp. 25–62.