Exclusions, barriers, bans and hurdles describe many injured workers’ experiences with workers’ compensation. A system that was supposed to assist them and provide streamlined procedures to recoup medical costs and lost wages has become a nightmare for individuals who’ve been injured on-the-job. A new policy brief by the National Economic & Social Rights Initiative (NESRI) describes seven destructive trends in workers’ compensation laws which reflect the attitude of many in state legislatures who “see workers’ comp as an unnecessary cost for business rather than a critical health care and social insurance program.” NESRI’s list them as the following:
- More workers’ health conditions are excluded from coverage (e.g., some state laws explicitly disallow claims for hearing loss, repetitive motion injuries and back disease.)
- Increased procedural barriers to workers claims (i.e., originally designed to be a “no fault” system, most workers have to retain lawyers and their own medical experts to support their claims.)
- Reduced income support for disabled workers (e.g., a fixed number of weeks of pay for disabled workers, regardless of the individual’s condition or advice from a physician.)
- More employer control over workers’ medical treatment (e.g., workers are forced to use physicians selected by the employer or insurer who have a vested interest in saving money.)
- End to universal mandates that employers carry workers’ compensation insurance (e.g., in 2013, Oklahoma joined Texas in allowing employers to “opt out” of carrying work comp insurance.)
- Bans on workers suing insurers for dishonest and misleading practices by insurers.
- Reduced access to attorneys (e.g., cutting the fees that an attorney can charge for handling a worker’s case.)
None of this is new to public health researchers and organizations who’ve studied workers’ experiences with the workers’ compensation system (e.g., here, here, here, here, here, here.) As Les Boden, PhD wrote in a 2012 article in the American Journal of Industrial Medicine:
“The sorry and declining state of workers’ compensation in the U.S. is largely the consequence of the political power of employers and insurers, bolstered by their ability to frame the political debate. Employer costs per $100 of covered wages declined from $2.18 in 1989 to $1.33 in 2009, reflecting both legal restrictions on workers’ compensation and declining reported injury rates. Yet even today the debate in the states is about excessive employer costs and employers’ threats to move to states (or countries) with lower workers’ compensation costs. The simplest way to reduce costs is to reduce the amount of benefits paid to workers, through raising barriers to approval of claims or reducing the benefits in claims that are approved.”
The impact of the destructive trends described in NESRI’s brief are made real through the voices of injured workers. Robert Hudson, 61, was working for the school district in Addison, New York when he was exposed to muriatic acid while cleaning a swimming pool. He’d never cleaned a pool before and wasn’t trained on how to do it safely. “I was a company man and I wanted to get the job done,” explained Hudson.
Injuries to his respiratory system were severe. Hudson wanted to continue working, but could no longer climb ladders or the other physical work required by the job. His doctor says he is permanently disabled. He used his paid sick leave and personal leave for three months while waiting for the workers compensation system to make a decision about his case. It was seven months later when he received his first payment from work comp for lost wages. His weekly payment was $202.36 compared to the $400 he used to earn. In a report prepared by the New York Committee for Occupational Safety and Health (NYCOSH), Hudson describes his frustration with the workers’ comp system:
“They keep sending me to independent medical examiners to prove my condition is not what my doctors are saying it is. I am being badgered. The procedures are flawed. My life as it was is ended now. I can never work again. I am tired of being screwed by all these people. They don’t have to live with the constant worry, and coughing their brains out all night long…”
In 2009, the American Public Health Association (APHA) adopted a policy statement calling for reforms to the workers’ compensation system. Not the pro-business “reforms” that create hurdles for injured workers, but improvements to create a safety net for workers and their families. Among others, APHA proposes a national system with
- uniform coverage of health care and adequate loss-of-earnings benefits for all occupational injuries and illnesses;
- health care for injured workers provided by providers independent of employer involvement and insurance industry control;
- health care providers removed from the responsibility of determining eligibility for benefits;
- an emphasis on prevention of injury and illness, and rehabilitation of those unable to return to work, and
- mandatory root cause investigation requirements for all occupational injuries and illnesses.
The US workers’ compensation system—dating back to Wisconsin’s law in 1911—stems from a bargain between workers and employers. Workers who are injured or made ill from hazards at work would receive medical care and payment of lost wages while they recover. In exchange, employers could not be sued by workers for the harm the employer caused. The destructive trends profiled by NESRI, however, illustrate that decades of “reforms” make the bargain no longer a good deal for injured workers.
Land managers in the eastern U.S. and Canada have spent countless man-hours and millions of dollars trying to tame a pernicious, invasive reed known as Phragmites australis. Toxic herbicides, controlled burns, and even bulldozers have been the go-to solutions to the problem. But recent research out of Duke University suggests another, less aggressive fix: goats. The approach is finding practical applications, including in New York City, where officials deployed a herd of goats at Staten Island’s Freshkills Park.
In an amazing three-part investigation, Seattle Times reporters Christine Willmsen, Lewis Kamb and Justin Mayo bring to light an occupational hazard not often heard about: the risk of lead poisoning at the nation’s gun ranges. They write that thousands of people, many of them gun range employees, have been contaminated due to poor ventilation and contact with lead-coated surfaces. Legally, gun range owners are responsible for protecting employees, but the investigation found that officials do little to enforce regulations. The investigative series offers a “first-of-its-kind analysis of occupational lead-monitoring data,” finding “reckless shooting-range owners who’ve repeatedly violated workplace-safety laws with no regard for workers who became sick. Other owners and operators were ignorant of the dangers posed by lead.”
Throughout the series, the reporters interview the victims of lead poisoning, such as James Maddox, a former gun range manager in Kentucky. They write:
Like many shooting-range workers, Maddox knew little about lead and its damaging capabilities. Daily, he inhaled airborne lead while managing the range and gun shop. Nightly, he swept up casings from spent ammunition in the 12 firing lanes, pushing a broom and kicking up more lead dust. The toxin landed on his skin and sank into his pores. Every breath pushed the poison further into his lungs, blood and bones.
He complained to owner Winfield Underwood that catch bins at the end of shooting lanes were overflowing with spent lead bullets, the ventilation system didn’t work and workers needed protective gear. Inspectors later discovered the air vents didn’t even have filters.
“It was just circulating the lead air,” said Maddox, who earned $9 an hour.
After working at the Louisville range about six months, Maddox, a hefty 38-year-old man, dropped 180 pounds. He also lost sensation in his fingers and toes. His head throbbed, his thinking slowed and he couldn’t remember birthdays.
Unfortunately, OSHA’s track record on inspections and enforcement seems severely lacking. The article notes that OSHA can’t determine just how many gun ranges have been inspected because they can’t track all the ranges in the first place. Apparently, many ranges register under categories such as “amusement and recreational industries” — one gun range even claimed to be a locksmith. And even when OSHA does take action, it may not stick. The reporters write:
In 2012, OSHA touted a crackdown at Illinois Gun Works, a firing range in Elmwood Park, a Chicago suburb. After federal inspectors found air inside the range contaminated with lead at 12 times allowable levels, the agency cited the range with 27 serious violations and hit it with $111,000 in fines. OSHA then hyped its enforcement in a widely distributed news release.
But since then, Illinois Gun Works has neither paid a dime nor fixed a single violation. Range owner Don Mastrianni, 59, a retired Chicago garbage collector, said he opted against making costly corrections after he learned his landlord was planning to demolish the building that housed his range.
Instead, Mastrianni kept the range operating for months before it was torn down in 2013 to make way for a new McDonald’s restaurant. Salvagers took no special precautions when hauling off the lead-caked debris.
In addition to telling the stories of gun range workers, the series also chronicles the effect of lead exposure on the families of workers. In the second part of the series, which investigates the nation’s worst known case of lead exposure at a gun range at Wade’s Eastside Guns and Bellevue Indoor Range in Washington, the reporters tell the story of construction worker Manny Romo:
An invisible assailant had invaded the bodies of Romo and his two kids, attacking their bones, brains and nerves.
They were contaminated with lead. And it came from an unexpected place.
In fall 2012, Romo had inhaled lead while helping erect a second story on Wade’s Eastside Guns and Bellevue Indoor Range. He was never warned about lead hazards from spent ammunition at the worksite and unknowingly tracked the poison home to his children.
Shortly before Christmas 2012, the Romo family evacuated their Auburn home, fearing for their safety and leaving behind contaminated furniture and toys.
Romo was one of 46 people contaminated by lead during the Wade’s renovation — the worst known case of occupational lead exposure at an American shooting range, according to public-health officials.
In other news:
Buzzfeed: Reporter Chris Hamby chronicles the story of Steve Day, who worked in the coal mines of West Virginia for nearly 35 years. Even though half a dozen doctors diagnosed him with black lung disease, Day initially lost his case to gain the federal benefits guaranteed to him by law, thanks to the opinion of a unit of doctors at Johns Hopkins Medical Institutions. Unfortunately, Day died in July. Doctors who saw his autopsy report said he had one of the worst cases of black lung they’d ever seen. Hamby writes about Day’s life and story, the doctors who wrongly diagnosed him and countless other miners, and how Day’s willingness to speak out is helping others.
Wall Street Journal: Less than a day after the Centers for Disease Control and Prevention announced new safety procedures for workers treating Ebola patients, thousands of New York City health care workers participated in an exercise in the proper use of protective gear. Reporter Melanie Grayce West writes that the union-organized event was convened in response to worker concerns about inadequate training. West reports: “Patricia Kane, a 55-year-old nurse from Staten Island and leader of the New York Nurses Association, said that Tuesday’s ‘very informative’ training was a step in the right direction and encouraging. But, she added, repetitive training and lots of practice is needed, as is adequate staffing for patients.”
Salon: Cantare Davunt, a Wal-Mart employee from Apple Valley, Minnesota, writes about life making little more than minimum wage and explains why she joined fellow Wal-Mart workers in shutting down Manhattan’s Park Avenue while protesting in front of the luxury penthouse where Alice Walton, one of Wal-Mart’s owners, lives.
Forbes: The Huffington Post recently exposed a non-compete agreement that all Jimmy John’s workers are asked to sign, even those at the bottom of the wage ladder making sandwiches and deliveries. According to Huffington Post reporter Dave Jamieson, the “worker agrees not to work at one of the sandwich chain’s competitors for a period of two years following employment at Jimmy John’s. But the company’s definition of a ‘competitor’ goes far beyond the Subways and Potbellys of the world. It encompasses any business that’s near a Jimmy John’s location and that derives a mere 10 percent of its revenue from sandwiches.” Forbes writer Clare O’Connor asks if such an agreement has any legal legs to stand on. Fortunately, the legal expert she interviews doesn’t think any court would uphold it.
Buzzfeed: Imagine sending an email to your boss asking for a raise and copying 200,000 of your co-workers. That’s exactly what Wells Fargo employee Tyrel Oates did in an impressive email about income inequality.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
A few of the recent pieces I’ve liked:
Nancy Shute at NPR’s Shots blog: Nurses Want to Know How Safe is Safe Enough with Ebola
Maryn McKenna at Superbug: What Would Keep Ebola from Spreading in the US? Investing in Simple Research Years Ago. (Check out the last paragraph for links to other great recent pieces on the disease.)
Atul Gawande at Slate: No Risky Chances: The conversation that matters most
Catherine Rampell in the Washington Post: Is sex only for rich people?
Laurie Abraham in Elle: Abortion: Not easy, not sorry
Ta-Nehisi Coates at The Atlantic: To Raise, Love, and Lose a Black Child
At this point, it’s pretty clear that soda is bad for your health. But a new study has found that it may be even worse than we thought.
Published yesterday in the American Journal of Public Health, the study found that drinking sugar-sweetened beverages may be associated with cell aging. More specifically, researchers studied the effect that soda has on telomeres, which are the protective units of DNA that cap the ends of chromosomes inside human cells. Previously, the length of telomeres within white blood cells has been tied to shorter lifespans as well as the development of chronic diseases such as heart disease, diabetes and certain cancers. In this study, researchers found that telomeres within white blood cells were shorter among people who drank more soda.
“This is the first demonstration that soda is associated with telomere shortness,” said study lead author Elissa Epel, a professor of psychiatry at the University of California-San Francisco, in a news release. “This finding held regardless of age, race, income and education level. Telomere shortening starts long before disease onset. Further, although we only studied adults here, it is possible that soda consumption is associated with telomere shortening in children as well.”
To conduct the study, researchers studied the association between drinking sugar-sweetened beverages, fruit juice and diet soda with telomere length among about 5,300 adults with no history of diabetes or heart disease and who were participating in the National Health and Nutrition Examination Survey. They found that each daily eight-ounce serving of sugar-sweetened sodas was linearly associated with shorter telomeres, which would roughly equal about 1.9 additional years of biological aging. (The average daily sugar-sweetened soda consumption among the study participants was 16.8 ounces.) A daily 20-ounce soda, which is a typical serving size, would translate into about 4.6 additional years of biological aging. Study authors Epel, Cindy Leung, Barbara Laraia, Belinda Needham, David Rehkopf, Nancy Adler, Jue Lin and Elizabeth Blackburn write:
Our hypothesis that consumption of (sugar-sweetened beverages) were related to shorter telomeres was derived from the known effects of (sugar-sweetened beverages) consumption on impaired fasting glucose and insulin resistance. (Sugar-sweetened beverages) have been known to increase oxidative stress and systemic inflammation, which are both processes that can influence telomere attrition. Telomere shortening in response to, and perhaps contributing to, these disease processes was reported, reflecting the overall burden of cardiometabolic disease. Our results suggested that another link between sugar-sweetened soda consumption and metabolic disease might be through shortened telomere length, a biomarker and mechanism of cellular aging.
While sugary sodas did seem to have an effect on telomere length, the study found that drinking 100 percent fruit juice was slightly associated with longer telomeres and no association was observed between telomere length and the consumption of diet sodas or noncarbonated sugar-sweetened beverages. The study noted that soda’s effect on telomere length was comparable to the negative effect of smoking or the positive effect of physical activity on cellular aging.
“Regular consumption of sugar-sweetened sodas might influence disease development, not only by straining the body’s metabolic control of sugars, but also through accelerated cellular aging of tissues,” Epel said.
However, the study authors cautioned that more research is needed, noting that the current study only examined participants at one point in time and that association does not equal causation. Currently, a new study is in the works in which Epel and colleagues will follow a group of study participants over a longer period of time and examine the effects of soda on cellular aging.
To read a full copy of the study, visit the American Journal of Public Health.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Not an “accident”: John Dunnivant, 57, suffers fatal work-related injury at Kia Motors plant in West Point, Georgia
John Dunnivant, 57, suffered fatal traumatic injuries on Tuesday, October 7, while working at a Kia Motors manufacturing plant. The facility is located in West Point, Georgia, off of I-85 near the Alabama-state line. WTVM provides some initial information on the worker’s death:
- Police and fire were called to the plant at 11:10 am local time.
- Dunnivant worked in maintenance and was crushed by a stamping machine.
- Kia management cancelled the remaining workshifts the day of Dunnivant’s death, but production began again the next day.
Ben Wright of the Ledger-Enquirer reports:
- Dunnivant was found in the steel press section of the facility.
- The county coroner reports that Dunnivant “was moving something very heavy and it fell on him.”
- The Korean automaker employs about 3,000 people at the West Point operation. The plant builds the Kia Sorento, Hyundai Santa Fe, and Kia Optima.
- In January 2008 when this Kia Motors plant was being constructed, a worker employed by Superior Rigging & Erecting Co. was struck by a beam and suffered fatal injuries.
The Ledger-Enquirer’s Wright also provides information on Dunnivant’s memorial, including his family’s request:
“Instead of flowers, donations may go to Native American orphanages or schools in his memory.”
Each year, dozens of workers in Georgia are fatally injured on-the-job. The Bureau of Labor Statistics reports 70 work-related fatal injuries in Georgia during 2013 (preliminary data, most recent available.) Nationwide, at least 4,405 workers suffered fatal traumatic injuries in 2013.
The AFL-CIO’s annual Death on the Job report notes:
- Federal OSHA has 49 inspectors in Georgia to cover more than 214,000 workplaces.
- The average penalty for a serious OSHA violation in Georgia is $2,061.
Federal OSHA has until early April 2015 to issue any citations and penalties related to the incident that stole John Dunnivant’s life. It’s likely they’ll determine that Dunnivant’s death was preventable. It was no “accident.”