When Anger Erupts (Violence in the Workplace)

LarochellePosted by Greg LaRochelle, WCP

Any act in which one person seeks to hurt or intimidate another through the use of physical contact, verbal harassment, or manipulation, can be defined as workplace violence and is a risk common to all employers.  Violence in any form is always offensive and in the extreme is tragic and costly.  According to the Bureau of Labor Statistics, nearly five percent of 7.1 million private businesses experienced an incident of workplace violence in the previous year.  The National Safe Workplace Institute reports that each act of workplace violence costs $250,000 on average, factoring in legal expenses, lost work time, and decreased productivity associated with a decline in employee morale.  Nationally, this adds up to an estimated annual cost exceeding a billion dollars and includes increased costs for workers’ compensation insurance.   

Employers also face legal liability with OSHA’s General Duty Clause that states that each employer shall furnish a place of employment free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees.  OSHA’s website contains a workplace violence overview section with information on risk factors, prevention programs, training resources, and enforcement letters of interpretation.  Employers need to address the threat of workplace violence through the following measures.  

Establish a Workplace Violence Policy – Incorporate a workplace violence policy in an employee handbook which defines violence and states that all concerns will be investigated with appropriate action taken (up to and including dismissal).  An acknowledgement form should be used for employee signature attesting they have reviewed, understand, and will comply with the policy.

Applicant Screening – The application process should include contact with all listed references on the application form, an extensive interview, and a criminal background and motor vehicle record check.  A zero-tolerance stance on workplace violence should be reiterated upon hire. 

Employee Education – Provide awareness training on workplace violence with an emphasis on the early reporting of potential concerns of violence.  Involve all employees and hold managers and supervisors responsible for instructing their assigned employees on reporting procedures and emergency response. The MEMIC Safety Director contains a wide array of training resources on violence in the workplace.

Employee Counseling – Establish an Employee Assistance Program for employee access to qualified professionals trained to provide support, assistance, and resolution in a confidential manner. 

Enhance Security – Install video surveillance equipment, provide ID badges to employees, have all visitors sign in and out of the building, discourage employees from working alone, and ensure parking lot lighting is adequate.

Response Planning – Establish a plan for emergency response in the event of an escalating situation or actual incident and review the plan with employees at least annually.

Program Evaluation – Conduct an evaluation of any incident response for improvement opportunity including the threat assessment protocol and methods of communication to local and state authorities.

Take prudent action now to reduce the danger of anger erupting in your workplace so no one is left saying, “If only I had done something sooner!” 


Caregivers: First Do No Harm To Yourselves

WrightPosted by Laurette Wright, RN, MPH, COHN-S, CSPHP

Caregivers often put the needs of others before their own regardless of what exposures they may face while doing their nurturing tasks. One of the most important tips to give both informal and professional caregivers is to ensure that THEIR SAFETY COMES FIRST so they can support their residents, patients, and loved ones.   

When you fly on an airplane, the flight attendant instructs everyone to put on your oxygen mask first before you assist others. If caregivers don’t take care of themselves first, they may experience work related injuries and illnesses.  These can contribute to lost work days, reduced income, physical limitations impacting their family and work life, or job dissatisfaction.  Without being able to function as caregivers, who will be around to provide the nurturing support they desire for their care recipients?

If there’s any doubt about the injury potential in the health care industry, just take a look at the U.S. Department of Labor 2015 statistics below.  Over 20% of all recordable injuries in the private sector occurred in health care (more than any industry at over 562,000), and the 4.0 incident rate is near the top of all industries.

Hc chart

While healthcare workers, regardless of their setting, are exposed to numerous risks, caregivers in home environments face heightened challenges as a result of uncontrolled and non-regulated conditions.  Home health caregiver exposures can include poorly designed bathrooms, non-adjustable furniture/beds, slippery walkways that aren’t maintained, unsanitary conditions, dangerous pets, motor vehicle dangers, exposure to poor air quality, and the threat of violence. Another big concern for caregivers working in home care environments is the lack of staff support. Often home care assistance is provided by one caregiver, therefore in the event of a conflict or emergency, there is no one else to help.

It is important that caregivers ensure they have the right tools, devices, and equipment to support the needs of themselves and their care recipients in a safe and healthful manner. For professional caregivers working with an employer, reach out to that employer for the proper equipment and education on how to safely perform the tasks at hand.  For informal caregivers taking care of loved ones, resources such as durable medical equipment suppliers, trusted internet sources, and local social assistance agencies may be able to provide the support necessary to ensure a safer working environment. If you find yourself in a situation where you feel alone, unprepared or in over your head, you must ask for help. There are no short-cuts to ensuring a safe and healthful environment for care givers and recipients. Caregivers working more safely is a win-win for themselves and their patients/residents/loved ones.

Find more information on the top risks caregivers and healthcare workers are exposed to in the MEMIC Safety Director or the MEMIC Safety Net Blog, like slips, trips, and falls; lifting and moving patients/residents/loved ones; and agitated or combative patients/residents/loved ones.   

Additional resources are available from the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA).  




OSHA Delays Online Injury Reporting Rule

DarnleyPosted by David Darnley, MS, CHSP

On May 17, OSHA announced that employers will not have to electronically file injury and illness information by July 1, as the rule had stated. As of the date of this announcement, OSHA still had not opened the online portal for employers to file their injury data from the previous calendar year.  OSHA did not offer a reason for the postponement and has delayed other standards this year including a standard on beryllium and a standard on silica dust which our Manager of Industrial Hygiene, Luis Pieretti, has written about. 

The rule is currently being challenged in federal court by the U.S. Chamber of Commerce, among others. Several unions and worker advocacy groups, including the AFL-CIO and the American Public Health Association, have asked to intervene and defend the rule, as reported by Bruce Rolfsen, Occupational Safety & Health Reporter, Bloomberg BNA.

For more information on all aspects of OSHA injury reporting and regular updates to the new electronic submission rule, check out OSHA’s electronic recordkeeping webpage.  MEMIC policyholders can view in the Safety Director a webinar I presented earlier this year titled OSHA & Healthcare Update 2017 which features information on OSHA’s new Online Injury Reporting RuleYou can also review the details of the proposed rule on OSHA’s site or Adam Levesque’s February post on the electronic recordkeeping rule.

Risk Compensation & The Peltzman Effect

JonesPosted by Anthony G. Jones, R.N., COHN

While watching television several months ago I came across an author promoting his book.  As a safety person, I immediately took note as he was directly speaking about safety.  The author was Greg Ip, and the title of the book was “FOOLPROOF: Why Safety Can Be Dangerous and How Danger Makes Us Safe.” I was so intrigued by the subject matter I immediately ordered the book.    

In the discussion and subsequent reading of his book, the concept of risk compensation was set forth. For the sake of brevity, I went to the internet for a more concise description.  Sometimes we focus on, and address, the “hard science” of safety such as rules, regulations, and procedures. But that can lead to neglecting the “soft science” of safety - human behavior.  After all, safety is a “people problem.”  Unsafe acts are a more common injury cause than unsafe conditions.

According to Wikipedia:

Risk compensation is a theory which suggests that people typically adjust their behavior in response to the perceived level of risk, becoming more careful where they sense greater risk and less careful if they feel more protected. Although usually small in comparison to the fundamental benefits of safety interventions, it may result in a lower net benefit than expected.

The reduction of predicted benefit from regulations that intend to increase safety is sometimes referred to as the Peltzman Effect in recognition of Sam Peltzman, a professor of economics at the University of Chicago Booth School of Business.

“People feel safe, and the feeling of safety allowed danger to reemerge, often hidden from view… The more vivid our sense of danger the greater care we take,” says Greg Ip.

Clearly, we can’t afford to let our guard down simply because we have made things “safer.” As we focus in on better safety equipment, procedures, engineering controls, and personal protective equipment we cannot lose sight of the human behavioral aspect.  Ask yourself, are my employees using equipment correctly and following procedures effectively?  Is proper use allowing safety equipment, procedures, and PPE to work as intended to eliminate accidents?

The real danger appears to be complacency.  If a worker senses no danger, then unnecessary risks may be taken.  Often this theory is used as an excuse to limit safety steps or equipment.  But that is counterproductive.  Safety initiatives are beneficial and do provide protection for those employees who have become complacent.  Left unchecked, complacency will set in regardless of any other safety elements present.  So it is far better to address hazards and implement controls than to hope the employees will be more careful if there is more hazard.  Here are some suggestions to avoid complacency:

  • Remind staff during training and tool box talks the possible consequences of pushing the envelope, or walking too close to the edge, so to speak.
  • Attempt to change a person’s behavior to further enhance safety performance, rather than solely relying on equipment and procedures.
  • Observe employees doing their jobs. Are they demonstrating safe behaviors, with safety equipment and procedures in place? Do not assume because all guards and other controls are in place that they are being used correctly.
  • Are effective accountability policies in place?

Focusing safety efforts on behavior will lead to fewer unsafe acts, fewer injuries, and more productive workplaces.  Risk compensation is real, but with proper supervision the compensation and complacency can be kept to a minimum and safety systems will work as designed.   

National CPR and AED Awareness Week

KlattPosted by Randy Klatt, WCP®

Each year, June 1-7 is designated National CPR and AED Awareness Week.  This is a collaborative effort between the American Red Cross, American Heart Association, and the National Safety Council.  This is an important campaign for public safety, workplace safety, and personal safety and health.  MEMIC urges all employers to get involved by installing AED’s (automated external defibrillator) in common spaces, encouraging employees to learn how to perform CPR (Cardiopulmonary Resuscitation), and to get involved with local efforts to raise awareness of these life saving techniques and devices. Join us for a day of AED & CPR awareness on June 8.

Each year more than 350,000 people in the U.S. suffer out-of-hospital cardiac arrest.  This disruption of the heart’s electrical system is a leading cause of death.  Calling 911 for a person suffering cardiac arrest is the first step, but that alone will not likely save a life.  Immediate intervention is needed to provide blood flow to the vital organs and every second counts.  Providing CPR can temporarily circulate that much needed blood, while using an AED can restore the normal heart rhythm.  Unfortunately, only about 46% of people who experience out-of-hospital cardiac arrest get the immediate help needed before emergency medical personnel arrive. 

CPR was first developed for medical professionals in the early 1960s.  The first mass citizen training occurred in the Seattle area in the early 1970s.  The 1980s saw emergency dispatchers beginning to provide CPR instructions by telephone while emergency personnel responded to calls for help.  Early public access defibrillators were developed in the 1990s; these have now become the modern day AEDs.  Much has occurred over the last 58 years or so, but the fundamental principle remains:  early intervention is critical to saving lives.    

CPR courses are available from many entities including fire departments, ambulance services, hospitals, organizations such as the American Heart Association, National Safety Council, American Red Cross, and by many other consultants and health care professionals.  The basic techniques are easy to learn and remember.  Over the years the methodology has changed.  CPR is no longer complicated or intimidating.  It is a simple technique that could very well save the life of another human being.  It might even be someone you love. 

With improved technology and lower costs, AEDs have become ubiquitous in our society.  They are now available for around $1,000 and found in many airports, shopping malls, and schools.  Does your business have one?  Do you know where it is located?  Do you know how to use it?  The equipment is simple to use, it even talks you through every step.  But someone has to take the initiative, find the AED, and use it to save someone’s life.  The AED won’t help anyone if it isn’t used! 

We hope you will join us in a day of CPR & AED awareness and education for your coworkers.  It only takes a minute to watch a Hands-Only CPR video at www.handsonlycpr.orgClick here for more info on AEDs and check out these resources from the American Heart Association, American Red Cross, and the National Safety Council. 


Safe Golf Cart Operations

HawkerPosted by Tonya Hawker

Golf carts have become quite a popular commodity these days, and not just for playing golf.  In fact, golf carts are used not only in country clubs, but also on automotive dealership lots, large manufacturing facilities, and even between buildings on large properties like schools, hospitals, hotels, and entertainment venues.  So yes, golf carts have become a fast, cheap, maintenance free way to get around a large foot-print.  However, driving a small, silent vehicle around a bustling facility can also present significant hazards.  A quick search of the OSHA website revealed over 120 incidents resulting in citations, injuries, and fatalities related to golf cart use.


Golf CArt

Here are a few hints to help reduce this exposure…

  • Controlled Access: Allow only specific employees to access or use the vehicle.  Controlling access can limit horseplay and unnecessary use.
  • Safety Rules: Require users to read and sign a copy of the company’s safety rules for the vehicle.
  • Identification: Assign a designated traffic route for use by the golf cart that doesn’t interfere with pedestrian or other vehicular traffic.  Consider highlighting the traffic patterns with marking paint to inform others of the traffic routine.
  • Enforcement: Administer strict disciplinary action for improper use or behavior by revoking privileges or terminating employment.  Safety compliance is critical!
  • Battery Charging: Charging should only be done in areas designed for that purpose. The area should be well ventilated and have spill response materials available to clean-up electrolyte spills.  Charging devices should be equipped with automatic shut-off devices.

Also consider clearly posting golf cart operating rules on all carts and don’t forget about training.  Golf Cart Operating Rules should be reviewed with designated drivers at hire and annual refresher training completed to reinforce the expected behaviors.  See sample rules below:


Golf Cart Safety Rules

  • Golf carts should be operated on clearly identified paths or perimeter roadways. Sidewalks should be used only where roadways &/or parking lots are not available, and then, only to the nearest adjacent street or parking lot.
  • Keys to unused golf carts should be controlled to prevent unauthorized use.
  • When operating the cart, always stay to the far right side of the lane to allow other vehicles to pass.
  • Always obey traffic rules and regulations.
  • Use extreme caution near building entrances. Park the vehicle away from doors, walkways, or covered areas.
  • Golf carts should be operated at a safe speed. The speed should be no faster than a well-paced walk.  Speed may also be subject to terrain, weather conditions, and total weight of the golf cart… So be cautious of your environment.
  • All occupants MUST keep hands, arms, legs, and feet inside the golf cart while it is moving.
  • No golf carts should be operated with more passengers than the seating provides. All passengers MUST be seated while cart is in motion.
  • Never back up without making sure there are no people or obstructions blocking the travel route.
  • Pedestrians always have the “right of way”.
  • Approach sharp or blind corners with caution and reduce speed.
  • NEVER operate golf cart on steep hills or severely sloped terrain. Stay on flat areas.
  • Never leave keys in a golf cart unattended.
  • When the golf cart is not in motion, the control lever should be placed in PARK (or neutral position) with the PARKING BRAKE SET. Then remove the key.



Additional information can be found at Golf Cart Safety.com, and from EHS Daily Advisor


Bunk Beds De-bunked!

KochPosted by Peter Koch

Housekeepers unite! It’s time we de-bunked. While bunk beds are common in many segments of the hospitality industry and serve to increase the occupancy of a room, they can be a real pain in a housekeeper’s day.  This becomes even more important as summer camps open and more bunk beds are in use.  Ask any housekeeper, “Which would you rather do, clean a bathroom or make up a bunk bed?”  Inevitably, they will choose bathroom duty. 

Bunk beds come in many shapes and sizes, but all have the same basic hazards:

These exposures increase the force it takes to do the same tasks as a regular bed, no matter the size.  Using proper technique as allowed by the bed configuration, lifting the edge of a twin mattress on a top bunk can put more strain on the shoulder and back than lifting the edge of a king mattress on a bed positioned at the housekeepers waist.  Pic 1 5 19

While there are no national statistics on bunk bed injuries among housekeeping staff, their design alone places limitations on the controls that can be implemented.  The best practice is transitioning to a “no bunk bed environment”.  However, this is usually beyond the scope of most housekeeping teams, so here are a few quick tips to tame bunk bed tasks:

  • Create space
    1. Move the bunk away from the wall so the team can work on both sides of the bed.
    2. No Bunk Monkeys - Assigning the smallest person to climb to the top bunk and do the work that can’t be reached from the open side is a widely used practice. However, this brings on its own set of exposures and is not recommended.

Pic 2 5 19

  • Work as a team
    1. Two housekeepers are recommended to tackle the bunk bed tasks. Working together they can share the load and reduce the forces required.
  • Remove the rails or work between them
    1. If the bunk has removable rails, take them down. This will allow the team to work without having to reach over it.
    2. If the rails can’t be removed, work between or under them when possible. This will also limit awkward postures.

Pic 3 5 19

  • Consider custom tools
    1. Using a pole or board placed under the mattress and between the rails can provide needed space and limit the length of time the mattress must be held manually.
  • Change positions to reduce sustained awkward postures
    1. Stand up to position the bedding.
    2. Kneel to spread, smooth and tuck.

Pic 4 5 19


Keep Lifts Between the Knees and Shoulders

BrownPosted by Allan Brown, PT 

How did this lifting range come into existence?  Some might say experience and logic got us here.  Actually, this guideline was developed through historical research done by the National Institute of Occupational Safety and Health (NIOSH) using mechanical models and understanding the mechanism of injury. 

The NIOSH lifting equation is used to predict the risk of injury based on the weight being lifted.  The equation uses a load constant of 51 pounds.  This was the starting load that 99% of male and 75% of female workers could handle safely in perfect conditions.  However, perfect conditions don’t exist in our manufacturing and manual lifting worlds. 

The equation accounts for these imperfections (such as reaching and vertical distance) and chisels away at the 51 pounds as risks increase.  Once all considerations are accounted for the final recommended weight limit is calculated.  This is often something less than 51 pounds.  The healthcare industries as well as some manufacturers are starting to use 35 pounds as a standard. It’s a basic recommendation that doesn’t account for all risks when lifting. 

Why knee and shoulder height? 

At shoulder height the dynamics and forces around the shoulder change and become poorer and weaker.  According to a review of literature by Rhode and Rhode titled Occupational Risk Factors of Shoulder Tendon Disorders 2015, when lifting an object to above shoulder height the core and stabilizer muscles become less efficient so we change our body mechanics and the risk of shoulder injury increases dramatically. 

Pic - Blog

The graphic above illustrates safe lift zones and appropriate weights in those zones.  The green area is the best zone often referred to as the power zone.  The red zone is the no lift zone and is appropriately above shoulder and below knee height.  Additionally, the further a worker reaches from the body the lesser the weight safely handled (yellow zone). You can see why 35 pounds became the healthcare industry standard and a good recommendation for all lifting environments.

At the lower end of a lift, moving below the knee increases the risk and exposure to the back, especially for the lumbar region.  Research completed by Al Nachemson  illustrated the changes in disc pressure with different activities.    Lifting activities greatly increase the disc pressure.  Better body mechanics reduces the force and keeping the load off the floor in an upright position reduces the force further. 

Here’s a fact that will make you pause before you lift from the floor. Bending at the waist and reaching to the floor with no weight in the hands increases the pressure in the lumbar disc to approximately 1000 inch pounds. 

NIOSH recommends limiting lumbar disc pressure to no greater than 770 inch pounds.  Forces beyond 770 inch pounds begin to physically change the health of the disc.  Lifting properly can reduce the force, but proper technique is a skill rarely mastered or used by people in a dynamic work environment.  

Through these studies we know the safest lift range is between standing knee and shoulder height.  This is a basic guideline not taking into consideration reaches and twists away from the body as well as coupling (grip).  Work environments outside these ranges increase the risks of shoulder and back injuries. 

Here are a few simple considerations:

  • Keep lifts between knee and shoulder height.
  • Limit weight to 35 pounds and consider lift assist devices such as vacuum lifts for greater loads.
  • Avoid placing work on the floor. Double up pallets to raise load platform.
  • Consider dynamic pallet lifts to keep the load in the best position.
  • Anything lifted manually over 35 pounds should be a two person lift.




Hand in Glove (Suitably Protected)

LarochellePosted by Greg LaRochelle, WCP

Soon in northern climes with the arrival of spring and the greening of the outdoors, we’ll be outside digging in the dirt starting our vegetable and flower gardens, pruning shrubs, cleaning up yard debris, and mowing the lawn.  To accomplish this, hand and power tools made of steel with honed edges, pointed ends, and sharp teeth will be used.  We’ll be spreading lime and fertilizer for a lush green landscape and maybe even applying herbicides and insecticides to control unwanted guests, orchestrating all of this with the use of our dexterous hands.  So it stands to reason, we should protect our “paws” and nimble fingers against cuts, chemical exposure, and the chance of infection from bacteria-laden earth.    

The obvious safeguard is to don a pair of gloves; but the selection of the right glove for the job is less apparent when you consider all the hazards (at hand).  This is the same perplexing issue many employers are faced with when conducting a personal protective equipment (PPE) assessment specific for hand protection.  The appropriate glove for protection against sharp tools may be an all-purpose leather glove or one made of cut-resistant Kevlar but the answer is less clear for safeguarding against chemical use. 

Gloves intended for protection against chemicals are rated for their resistance to permeation and degradation.  Permeation is a process by which a chemical can pass through the molecules of the glove material and degradation is a reduction in the physical properties of the glove material when exposed to a chemical.  In sizing up the situation for selecting the right glove, the safety data sheet for the chemical product should be reviewed with regard to its chemical composition.  Typically, the major constituent in weight percent is evaluated for PPE use.  From this “ingredient” information, the proper glove can be determined by referencing a rating chart.  The glove manufacturer Ansell has an online chemical resistance guide for 163 chemicals from acetaldehyde to xylene/xylol.  For example, if a certain manufacturing process involves the use of the organic solvent acetone, the Ansell chart indicates a laminate film glove as well as neoprene and natural rubber to be appropriate glove selections while nitrile and polyvinyl chloride gloves are not recommended for use.    

So review this glove rating chart or contact your PPE supply vendor to ensure the “hand in glove” is suitably protected against the chemical products in use.  You’ll likely find this resource to be quite handy. 

Also, check out these previous springtime related MEMIC blog posts, Your Lawn Mower is More Dangerous Than You Think and Spring Clean Up: Chainsaw Awareness.  Have a safe and bountiful gardening season!





More than Love Handles

Beth-Stowell-lg2 Posted by Beth Stowell, BS, MPH, COHN‐S, CHSP

Emily Post’s book of etiquette indicates that a gentleman should put his hand under a women’s elbow as she steps off the curb to prevent any risk of falling. This courtesy may have started as early as the 1800’s with ladies’ large petticoats.  At the time, who would have thought about the potential damage this support could cause to the shoulder girdle?  In the 21st century this is a concern, particularly to caregivers in the healthcare industry.

The shoulder joint is a ball and socket held in place with ligaments.  Tendons then connect muscles to the skeletal structure.  As we age, this overused joint can be damaged by helpful loved ones and/or caregivers.  We may not only need help stepping off the curb, but rising out of a chair, moving onto a toilet, and getting into the car.

The shoulder girdle is not designed for the stress incurred when the arm is used as a “handle” to raise a person out of a seated posture.  This is hazardous to both the resident/patient and the caregiver.  MEMIC has long recognized the injury exposure “lifting” places on healthcare workers.  Preventing lifting injuries to both caregivers and patients starts with eliminating the act of “lifting”.

The traditional gait belt was used by physical therapists to help guide and assist patients when re-learning to ambulate. Over the years, caregivers have mutated its use into handles for assisting patients/residents to a standing posture.  In January 2016, MEMIC committed to provide our healthcare industry policyholders a different type of gait belt.  We call this product the Safe Assist Belt (SAB).  The SAB includes vertical handles on a wide padded belt with slip resistant material on the inside.  The padding makes it much more comfortable for the patient/resident, and the handles allow a more neutral wrist posture.  However, it is not just the vertical handles and padding that is significant.  The SAB is intended to replace the traditional gait belt, but also requires a new method to assist residents/patients. Now the mechanism to elevate a seated person is a push/pull using the legs and not a “lift” which required the use of the bicep and lower back. 

The new device requires training for all caregivers.  The training not only addresses the change in technique, but an explanation as to why this change will improve the safety of the caregiver and improve quality of care for patients/residents. Training the frontline caregivers is rewarding as they learn the technique and realize this new tool makes their job safer and easier. Changing the technique comes with challenges.  A new habit must be developed.  However, taking the lift out of the maneuver is imperative.  Below you can see the” right pull” and the “incorrect lift”. 

For further assistance with training, including a demonstration video, check out the resources in the MEMIC Safety Academy or contact your MEMIC Safety Management Consultant.


Pic 1The "right pull" technique.

 Pic2The "incorrect lift."