Archive for October, 2010

Teens Likely to Lie About Drug Use

Friday, October 29th, 2010

In a recent study reported in Pediatrics, the official journal of the American Academy of Pediatrics, both teens and parents substantially underreported recent teen cocaine and opiate use. However, compared with parents, teens were more likely to deny verified cocaine use.
Results of hair analysis for cocaine, opiates and marijuana were compared to confidential teen self- and parent-reported teen drug use in more than 400 high-risk urban teens and parents. Teen specimens (hair) were 52 times more likely to identify cocaine use compared with self-report. Parent hair analyses for cocaine and opiate use were 6.5 times and 5.5 times, respectively, more likely to indicate drug use than were parental self-report.

President Signs Safe Drug Disposal Act of 2010

Friday, October 29th, 2010

President Barack Obama signed the Secure and Responsible Drug Disposal Act of 2010 (S. 3397) into law. This law will allow patients who lawfully obtain controlled substances to transfer them to a government or private entity for disposal.

Under the provisions of the new law, the U.S. Attorney General will issue regulations governing the transfer of controlled substances for disposal to prevent diversion. Long-term care facilities will also be permitted to dispose of controlled substances on behalf of their patients or former patients. The Attorney General may not require any entity to establish disposal programs.

Michele Leonhart, DEA Acting Administrator, called the bill “an important step in addressing the alarming rise in prescription drug abuse” in a news release. “This bill will help reduce the diversion of prescription drugs that often sit in our own medicine cabinets far too long,” she commented.

This act would amend the Controlled Substances Act to ease restrictions on individuals that collect unwanted or unused pharmaceuticals for safe disposal.

Current restrictions by the Drug Enforcement Agency require that certain unused, expired or unwanted medications be relinquished only to an individual authorized by the DEA. This caveat has made take-back and disposal programs extremely difficult. Without access to an alternative disposal option, many unwanted drugs are disposed of via flushing, which has concerned many in the wastewater community that facilities are not equipped to treat this type of substance and thus it ends up in the water supply.

The legislation would ease these restrictions and make it easier to operate local take-back programs. Each state’s Attorney General would have the authority to authorize groups to run take-back or mail-in programs. Additionally the House legislation would require EPA and DEA to work together on a public education and outreach program and would require EPA to initiate a study analyzing the environmental impacts of medications in the water supply.

Taking home toxins

Wednesday, October 27th, 2010
Are your workers putting their families at risk?

Unfortunately, workers can carry hazardous substances home from work on their clothes, their bodies, their tools, and other items. That means they could unknowingly expose their families to these substances, causing various health effects such as respiratory problems, neurologic disorders, and fatal poisonings. These kinds of exposures can also occur when the home and workplace are not separated, such as on farms.

Contaminants

Some hazardous substances that cause health effects among workers’ families include: beryllium, asbestos, lead, mercury, arsenic, cadmium, pesticides, caustic farm products, chlorinated hydrocarbons, estrogenic substances, allergens, fibrous glass, and infectious agents like scabies and Q fever.

Routes of exposure

Hazardous substances like those just mentioned can reach workers’ homes and family members through a number of methods. These “routes of exposure” include:

  • Work clothing, even washing machines and dryers;
  • Tools and equipment;
  • Bags, rags, metal drums, scrap lumber, and other items taken home from work;
  • The worker’s body, especially hands;
  • Homes where the work was done;
  • Farming; and
  • Family visits to the workplace.

Preventive measures

The good news is hazardous substances don’t have to reach the home. There are a number of simple things you can train your workers to do to avoid taking these substances home:

  • Use good safety practices to reduce exposure;
  • Wear proper personal protective equipment;
  • Store hazardous substances properly;
  • Dispose of dangerous materials properly;
  • Leave soiled clothes at work;
  • Change clothes before leaving work;
  • Store non-work clothes away from work clothes;
  • Shower before leaving work;
  • Don’t take tools, scrap, packaging, and similar items home;
  • Launder work clothes separately; and
  • Prevent family members from visiting the work area.

Decontamination

While prevention is the best approach, you may be considering a decontamination method. However, the results of decontamination depend on the cleaning methods used, the material to be removed, and the surface to be cleaned. Moreover, decontamination is difficult and may not even be effective.

Decontamination options include air showers, laundering, dry cleaning, shampooing, airing, vacuuming, and other surface cleaning methods. Soft materials such as carpet and clothing are the hardest to clean. Lead, asbestos, pesticides, and beryllium can be especially difficult to remove. What’s more, normal laundering usually does not succeed, and, sometimes, even the strongest decontamination methods fail. Decontamination, itself, may even increase the hazard to people in the home by stirring materials into the air.


Job offers are often more than 25 percent below previous salary

Wednesday, October 27th, 2010
Insufficient pay is main reason unemployed workers reject a job opportunity

According to Personified, a talent consulting division of CareerBuilder, a new survey showed that 17 percent of unemployed workers have received at least one job offer since they have become unemployed. Of these workers, 92 percent rejected the offer. Fifty-four percent reported the pay was more than 25 percent below the salary they earned in their most recent position.

Unemployed women were less likely to receive a job offer, and fourteen percent stated they had been offered at least one position during their unemployment compared to 20 percent of unemployed men.

Unemployed men reported a higher incidence of offers falling short of salary expectations. Fifty-six percent of men stated the pay offered was more than 25 percent below their previous salary compared to 49 percent of women.

Although insufficient pay was the number one reason unemployed workers turned down a job opportunity, other factors included a long commute, a lower title, the position being outside of their field, little room for career advancement and a poor hiring process.

Termination of health benefits is one of the main concerns of unemployed workers. Forty-nine percent of all unemployed workers reported that they do not have health insurance. Among workers who have been unemployed for more than a year, the number is 55 percent.


Health care costs projected to increase in 2011

Wednesday, October 27th, 2010
Employers shift plan designs to pass cost increases to participants
According to an analysis by Hewitt Associates, employers can expect 2011 health care cost increases to be at their highest levels in five years. Much of this is a result of recent higher medical claim costs, an aging population, and changes brought about by health care reform. Next year, Hewitt projects an 8.8 percent average premium increase for employers, compared to 6.9 percent in 2010 and 6.0 percent in 2009.

In 2010, Hewitt saw average cost increases of 7.8 percent for health maintenance organizations (HMOs), 6.9 percent for point-of-service (POS) plans and 6.3 percent for preferred provider organizations (PPOs). For 2011, Hewitt forecasts that companies will have average cost increases of 8.5 percent for PPOs and POS plans. Companies will see an average cost increase of 9.4 percent for HMOs.

By shifting plan designs from fixed dollar copayments to coinsurance models (where employees pay a percentage of the out-of-pocket costs for each health care service), and increasing deductibles, out of pocket limits, and cost sharing for use of non-network providers, employers are able to pass some of the cost increases to participants.

Disease management and health improvement programs continue to remain a top priority for employers.


“Randomly” schedule drug testing

Wednesday, October 27th, 2010
Sometimes, the best laid plans are random.

Usually, the sign of a well run program is evident by how well the manager is organized and how consistent they are in meeting their minimum requirements and goals. This type of a structured program takes the guess work out of the equation and allows the employees to act in a predictable manner that produces the desired results. However, this should not be the blueprint for a random drug testing program.

The whole concept of “random” is an activity without an identifiable pattern, plan, system, or connection. Ironically, a random drug testing program should be a well thought out plan and system which tests at least 50 percent of the average number of drivers operating a commercial motor vehicle for controlled substances and 10 percent of the average number of drivers for alcohol.

Who gets tested among this 50 and 10 percent of CDL drivers must be a random method and often times is generated by a computer program that matches a number associated to a driver. This number can be the driver’s social security number, driver’s license number, employee ID number, or any other numbering system that identifies the driver. Each driver must have an equal chance to be tested each time the testing cycle occurs, even if the same driver is selected in previous cycles.

The Federal Motor Carrier Safety Administration (FMCSA) does not address the number of testing cycles a motor carrier must perform. It is up to the carrier’s discretion to determine if this should be a monthly, bi-monthly, or quarterly event, so long as the year is evenly broken up among the proper number of drivers required to be tested.

Where the term “random” should definitely not be an identifiable pattern is in the scheduling of these tests. If a carrier is testing on a monthly basis, and the selected drivers are sent for testing during the first week of every month, the element of surprise is partially eliminated. Once a pattern is established, drivers will be able to time a series of events and adjust their activities around them. For random drug testing purposes, this predictability could skew the results and allow the non-tested driver an opportunity to engage in prohibited activity thinking they were safe until the same time next month.

If monthly random testing is the cycle used to satisfy FMCSA requirements, the motor carrier must make sure the testing days are varied throughout each individual month so that no deliberate and identifiable pattern can be determined.

Therefore, a random system of unscheduled events can prove to be a well managed program!


Texting rule is official

Wednesday, October 27th, 2010
FMCSA ready to impose penalties and disqualifications to those who violate rule

In a final rule published in the Federal Register on September 27, 2010, the Federal Motor Carrier Safety Administration (FMCSA) prohibits texting by commercial motor vehicle (CMV) drivers while operating in interstate commerce and imposes sanctions, including civil penalties and disqualification from operating CMVs in interstate commerce, for drivers who fail to comply with this rule.

Additionally, motor carriers are prohibited from requiring or allowing their drivers to engage in texting while driving. FMCSA amended its commercial driver’s license (CDL) regulations to add to the list of disqualifying offenses a conviction under state or local traffic laws or ordinances that prohibit texting by CDL drivers while operating a CMV, including school bus drivers. Recent research commissioned by FMCSA shows that the odds of being involved in a safety-critical event (e.g., crash, near-crash, unintentional lane deviation) is 23.2 times greater for CMV drivers who engage in texting while driving than for those who do not.

According to the agency, this rulemaking increases safety on the nation’s highways by reducing the prevalence of or preventing certain truck- and bus-related crashes, fatalities, and injuries associated with distracted driving.


Oh, my aching back!

Wednesday, October 27th, 2010
Preventing a back injury is easier than treating one. Your workers’ ability to sit, stand, walk, and run depend on the health of their backs. October is National Chiropractic Health Month — a good time to train them in the basics of keeping their backs in good shape.

Common back hazards

Many people think that back injuries come from lifting heavy or awkward objects one time. Lots of back injuries, however, result not from a single lift, but from relatively minor strains that occur over time. Back disorders are frequently caused by excessive or repetitive twisting, bending, and reaching; carrying, moving, or lifting loads that are too heavy or too big; staying in one position for too long; poor physical condition; and poor posture. When back muscles or ligaments are injured from these repetitive pulling and straining activities, the back muscles, discs, and ligaments can become scarred and weakened and lose their ability to support the back, making additional injuries more likely. Other factors contributing to back injuries include: aging, stress, vibration (such as from driving), inactivity both at home and at work, and recreation done without physical conditioning.

Proper care

The question remains, what is a realistic solution? Doctors are finding that preventing back injury involves a combination of things:

Proper task design — Tasks may be designed to fit a worker better (i.e., using the correct table or chair height) and to eliminate the need to lift (i.e., providing carts or breaking loads into smaller ones). Tasks may also be managed to allow for breaks, job rotation, or lifting with a buddy.

Proper diet — To prevent injury and stiffness, workers should drink plenty of water. Because injuries can occur when workers are mentally and physically tired, they should eat a well-balanced diet to keep up their energy. They should also avoid caffeine, which increases sensitivity to pain.

Proper exercise — Stretching can make a back stronger, more flexible, and more resistant to injury. Workers should focus on these muscles: back, thighs, buttocks, and hamstrings.

Proper weight — Excessive weight exerts force and strain on a back, especially the lower back muscles. Reaching or maintaining a proper weight can reduce the strain on a worker’s back.

Proper posture — When sitting, a worker should keep his/her head directly over the shoulders, ensure his/her chair supports the lower back, and keep his/her knees at the same level as the hips. When standing, it’s good practice to tuck in the chin, keep feet a foot apart, and move about whenever possible. Workers should try standing with one foot on a small stool and switch feet. When driving, it may help to rest the back against the seat and bring the wheel close enough to allow the knees to bend a bit higher than the hips. When sleeping, workers should sleep on their sides and bend their knees, or they might sleep on their back and tuck a small pillow under their knees.

Proper lifting — Finally, workers might try this basic lifting procedure:

    1. Plan the lift and size up the load.

    2. Be sure the path is clear.

    3. Get centered over the load, then bend the knees and get a good handhold.

    4. Lift straight up and don’t bend at the waist.

    5. Don’t twist or turn the body (use the feet to turn) and keep the load close.

    6. Set the load down by bending the knees.


May the Medical Review Officers verify a drug test as negative based upon information that a physician recommended that the employee use “medical marijuana?”

Wednesday, October 27th, 2010

No. The MRO may not verify a test negative based on information that a physician recommended that the employee use a drug listed in Schedule I of the Controlled Substances Act. Marijuana remains a drug listed in Schedule I of the Controlled Substances Act. It remains unacceptable for any safety‐sensitive employee subject to drug testing under the Department of Transportation’s drug testing regulations to use marijuana.

Army Coping With Synthetic Marijuana

Wednesday, October 27th, 2010

According to an article in The Army Times, the Army has launched a crackdown on the drug spice at least nine commands in response to a spike in usage among soldiers.

A designer drug that mimics marijuana, spice is legal in most states, and is available for sale in smoke shops and online for around $50 for three ounces.

What’s more, spice is undetectable by most urinalyses.

Spice is also known as K2 or by any number of colorful brand names — “Red Ball,” “Blowout,” “Cahoots,” “Chill” or “Spike 99,” to name a few — and is sold in foil packets or plastic canisters. Brands often bear a warning label that state that contents are an incense and are not to be smoked, which is disingenuous at best, say law enforcement sources.

Spice has been outlawed in 13 states, including Georgia, Kentucky, Tennessee and, as of July, Hawaii, according to the National Conference on State Legislatures. Several variants of spice are illegal in Germany and some other European nations.

Although Army officials have said that spice use is rising, it is unclear exactly how widespread it has become. The Army is not tracking the number of soldiers who have been disciplined in connection with spice, according to Army spokesman George Wright.

Medical researchers and drug companies had developed dozens of synthetic cannabinoids to explore their potentially pain-relieving effects. And makers of spice have taken advantage, continuously switching between the types of synthetic cannabinoids to stay ahead of the law.

Although detection is tricky for law enforcement because data on many of the types are scarce, a handful of private labs say they have urinalyses that detect at least a few of them, and according to Fadness, forensic scientists continuously share data on new types via Internet message boards to aid evidence analyses. 

Because spice is not manufactured using any single compound or common method, its effects can be unpredictable or dangerous. Though there have been no human studies of synthetic cannabinoids, a European Union study says they are potentially very harmful. It notes that THC is only a partial cannabinoid; synthetic cannabinoids may prove stronger and carry a heavier risk of dependence and overdose. The American Association of Poison Control Centers has logged 1,340 spice-related calls to poison control centers nationwide this year. Many emergency room patients admitted for spice intoxication show life-threatening symptoms, such as racing heart rates and spiking blood pressure.

The drug seems to be most popular among young people and those who are worried about regular drug tests, according to Dr. Marilyn A. Huestis, of the National Institutes of Health. “It’s anecdotal, but … a lot of police, firemen and military consume it,” she said. “But there is still no good epidemiological data to track that.”

Federal regulations will likely catch up with spice, but that could take two years or more, said Gary Boggs, a spokesman for the Drug Enforcement Administration’s diversion department.