Want to keep workers safe and healthy? Start with your supervisors.

Empire State Building workersAccording to a study by Deloitte, American businesses spend $70 billion a year and corporate training is growing by 15% a year.  The question is not whether your company needs to train employees; it is where your investment in training will have the biggest payoff.

The evidence is growing that spending on training for your supervisors and front line managers may be the best investment of your training dollars if you want to increase productivity, improve safety culture and reduce the cost and severity of injuries.  Part of this is just commonsense.  Supervisors spend more time with employees and have more direct impact on shaping attitudes, engagement and culture than any other position within a company.  In companies where new workers learn on the job, supervisors may have the most important role in the company.

Now research from Liberty Mutual Insurance shows that training supervisors in the soft skills of how to communicate with and gain the trust of an injured worker is a significant factor in how long that worker stays off the job and the severity of certain injuries. The study looked at work-related musculoskeletal disorders (WMSDs), such as low back pain and upper extremity disorders.   They found that the supervisor’s interaction with a worker with WMSD had a lot to do with the level of treatment necessary and how long the worker was away from the job.  Now surprisingly, if the supervisor blames the worker for the injury and complains about delays in production or impacts on OSHA recordables, it has a negative impact on the injury.

But the most interesting result of the study was that a short training class for supervisors dramatically improved the outcome of future injuries for employees working under that supervisor.  Training supervisors on how to relate to employees and what to do immediately after an injury helps keep workers and the company bottom line healthier.

In another study, a food service consultant named Alchemy found that when they taught supervisors how to reinforce worker training with corrective observations, the companies involved in the study saw a 26% improvement in safety compliance.   Again, company programs and worker training may be wastes of time and money if supervisors aren’t on board with implementing them.

How are you training your supervisors?  Are you teaching them the skills that are proven to improve safety and production, like communication and responsibility?   Our supervisory and leadership class, Buddy-to-Boss, is designed to help line managers make the career transition to manage crews and represent the company.  Unlike most leadership classes, we can tailor classes to your specific needs and policies.  Contact us at info@lifelinestrategies.com to learn more.


New Study Tracks Causes and Costs of American Workplace Injuries.

Most frequent cause of injuries on the job: Material Handling –  32% of injuries are caused by workers lifting, lowering, filling, emptying or carrying objects.

Most expensive injuries: Amputations – Indemnity claims alone average $102,500 per incident.

Those are just a couple of the facts to emerge from a comprehensive study that Travelers Indemnity Co. did on more than 1.5 million injury workers comp claims over a four year period.   All in all, it is one of the most complete pictures of the causes and costs of injuries in the American workplace.

While material handling shows up as the top cause of injury for every industry and businesses of every size, there are some important distinctions for some segments.  For example, workers in small businesses suffer injuries from hand tools at about twice the rate of other sized businesses. Part of that may be improper training, but it could possibly be that small contractors on construction jobs are more likely to use hand tools.  Oil and gas was the only sector to have motor vehicle accidents in its top five causes.  Those unique aspects should guide companies in their safety programs.

days away graphicStrains and sprains were the most common type of injury, followed by cuts or punctures, contusions inflammation and fractures.  Possibly the most interesting part of the study is what injuries cost and how long they keep workers away from the job.   Travelers found that strains and sprains caused workers to miss an average of 57 days away from work, but that inflammations, which only made up five percent of the injuries, averaged more than 90 days away from work.injury costs

Finally, and most significantly, the study tackles the average costs for injury claims.  The most common injuries are not the most expensive ones.   Again, amputations are by far the most expensive claims coming in at $107,000.  That is just for the claim.  Any fines or other expenses would just add to that total.   Strains and sprains cost an average of $17,000.

What does all of this mean to a company?   Businesses should already be doing all they can to prevent injuries and help injured workers recover.   The study gives clear evidence that protecting workers is a sound financial decision in addition to being the right thing to do.  Now companies can look at hard costs of injuries and make rational decisions about where to spend their money.   For instance, following the NFPA 70E guidelines for training workers on electrical hazards can cost a few hundred dollars.  One electric shock injury costs an average of $55,200 in claims alone.  It is a  pretty easy business decision to make.

If you need help either protecting your workers from injuries or in mitigating the damage through early intervention once an incident happens, contact me at info@lifelinestrategies.com.

OSHA’s “Name and Shame” Regulations Hit The Street.

The Occupational Safety and Health Administration (OSHA) released its long-awaited changes in injury reporting requirements on May 11th, saying it was going to “nudge” employers to prevent workplace injuries and illnesses.   “Shove” is more like it.

Although the actual regulatory language is relatively short, there is a lot to digest there and it will take some time to fully see the impact.  However, the bottom line is that starting next year American businesses will be required to post their injuries online for the world to see.  It is a continuation of a long-held OSHA philosophy to publicly identify companies that do not provide what the agency considers to be safe workplaces.

Under the rule, all companies with 250 or more employees must post their OSHA 300 (Log of Work-Related Injuries and Illnesses), 300A (Summary of Work-Related Injuries and Illnesses), and 301 (Injury and Illness Incident Report) forms beginning in January 2017.  Companies with 20-249 employees in certain high risk industries must file the 300A summary every year, starting in 2017.    Companies with less than 10 employees are still exempt from reporting, but it gets a little bit hazy when you look at companies with 10-20 employees or industries (like oil and gas) which have been identified in the past as being special focus industries, but were not on the list.

A few other points from the rulemaking:

Post-incident drug and alcohol testing – One of the biggest questions is how the rule’s language on post injury testing will be interpreted.  OSHA plainly states: “Blanket post-injury drug testing policies deter proper reporting,”  and “drug testing policies should limit post-incident testing to situations in which employee drug use is likely to have contributed to the incident, and for which the drug test can accurately identify impairment caused by drug use.”   But what does that mean?   Does OSHA really think that post-incident drug-testing is performed to “punish” workers for getting hurt?  There is a very good overview of this aspect of the new rule by attorney Kathryn J. Russo and I would urge employers to read it.  The only thing that I would add is that the creation of a drug and alcohol-free workplace and routine testing may be the most important safety measure adopted by transportation industries.  Discouraging post-incident testing is a dangerous step backwards.

Anti-retaliation policy – The regulation includes a couple of other requirements that may have impacts that we can’t gauge for some time.  The first is an anti-retaliation policy.  Companies must inform their workers that they have a right to report work-related injuries and illnesses without retaliation. OSHA suggests employers post its “Job Safety and Health – It’s the Law” Workers’ Right Poster to help accomplish this.

Emphasis on injuries as a measure of workplace safety – Granted, it is important to capture and analyze injury data.  But frankly a lot of industries are too obsessed with boiling their safety programs down to a number that can be reported at the weekly management meeting or used by host companies to decide which contractor to use.     Accidents tell you what happened.  Hazards and near misses tell you what could happen. As company safety programs evolve, they move away from injuries and focus on hazards and near misses.

For a smaller company, one incident a year raises their magic number so high that it can disqualify them from certain jobs.  Sticking that number up for the world to see may have unintended consequences that we can hardly define at this point.

Finally, and most importantly, this new regulation underscores the importance of having strong accident prevention programs and equally strong post accident injury management programs.   Contact me if you need some help on either of those programs.

Safety Speech: Why The First Half Hour After An Injury Is So Important.

COREHEALTHlogo (2)If you are in Houston, please come to the next STEPS meeting on Tuesday, May 17th.  We will be featured speakers talking about what you should do in the first half hour after a worker is injured on the job.   Study after study show that the actions you take right after an incident play a large role in determining whether the worker will receive the right treatment, whether the worker winds up on workers comp and how long he or she may stay off the job.   CORE Health Networks will also answer your questions on how to interpret OSHA reporting requirements from a medical professional’s standpoint.

STEPS is a national partnership between OSHA and the oil and gas industry, dedicated to sharing information and best practices on safety and occupational health.  The next Houston STEPS meeting will be held from



Groves Industrial Supply

7301 Pinemont Dr., Houston, TX 77040

owever, because we are expecting a good-sized group this month, please let me know if you are interested in coming by emailing info@lifelinestrategies.com.

Also, if you are interested in having CORE Health Networks speak to any groups that you are involved in or if you just want to discuss strategies for addressing worker injuries, contact me with that request as well.

Finding The Dollars, Cents and Sense of Wellness Programs

bandaid-fingerThe subject of health assessments came up with a client who is struggling with the impacts of an aging workforce.  It is an issue for companies all over the country. The key is to identify health problems and ensure that workers are not performing duties that put them at risk.  It is causing this client to consider physical assessments as an ongoing fit-for-duty tool, rather than just part of a post-offer, pre-employment physical.  Why?  I can tell you personal experience that the knees of a 50-something can be a lot less forgiving than the knees of a 20-something.

Which all brings up the subject of wellness programs.   They have gained a lot of support in recent years, but many question whether they are worth the money companies spend on them.  One earlier study said companies lose 50 cents per employee per month on wellness programs.

However, a new study that looks at 10 years of data says the right program can save companies a lot of money.  The study, reported by the Harvard Business Review, was done by the Rand Corporation and looks at data from a Fortune 100 company’s wellness program. The key apparently is to separate lifestyle management, focusing on smoking, obesity, and other health risks, and disease management, focusing on the population of workers who already have chronic disease or physical problems.

The study looked at one company’s program, a combination of lifestyle and disease management.  It found that the program was successful overall, but the real savings came from the disease management aspects that actually kept workers out of the hospital.  While the lifestyle portion did help with worker absenteeism and other positives, the actual return on investment was generated by addressing the workers who were most at risk of serious medical problems.  The lifestyle management returned about 50 cents for every dollar invested, so in other words, it lost 50 cents per worker. But disease management returned $3.80 for every dollar invested.

Why?  Because the savings from preventing hospitalization, followup treatment at disability payments are so high and the program has a direct impact on outcomes.  And it is not restricted to a small portion of the workforce.  In the Rand study, 13% of the workers fell under the disease management program.

That is not to say that lifestyle management is not a good thing.  Reducing smoking in younger workers cuts cancer rates at some point in the future.  Today’s weightless may prevent tomorrow’s diabetes.  But let’s face it – most lifestyle management means persuading workers to change their ways and most of us don’t want to change, so the long-term impact depends on our willingness to change.

What goes into a disease management program?  Well, the first step is helping identify workers who are at risk. The next part is encouraging them to follow their agreed treatment program, such as reminding them to take their prescribed medications or communicating gaps in care, such as missed lab tests, to their physicians.

The occupational health connection – Care for workers who have been injured or suffered a medical crisis on the job works on much the same principal.  CORE Health Networks, for example, offers post-incident injury management that provides an early intervention to determine the best initial course of treatment.  Then trained RNs can follow up with the worker to make sure that the treatment was effective and that they are going to doctors appointments or getting lab tests done. It is a cost-effective way to make sure that the types of incidents that can cost companies the most and can cost workers income are handled effectively.  We also administer return-to-work and fit-for-duty policies to identify and address occupational health issues.  For more information contact us at kwells@corehealthnet.com.



Drunk Worker is Injured – Is It Recordable?

OSHA tries hard to help industry interpret its regulations, but sometimes the clarifications only confuse things.  That may be the case with a new interpretive letter from OSHA that looks at workers who are injured while they are intoxicated.

The regulations say “You are not required to record injuries and illnesses if the injury or illness is solely the result of personal grooming, self-medication for a non-work-related condition, or is intentionally self-inflicted.”   A lot of companies take the view that workers who are injured while drunk or under the influence of drugs were self medicating and would do not want to put that down as a recordable.

However, OSHA has stated that companies may not automatically assume that a worker who is injured while intoxicated should not be counted as a recordable.  The agency interpretation comes in response to a letter from a construction company asking it a worker who was an alcoholic and “self-medicating” his addiction at the time of an injury should be recorded on the 300 log.   OSHA says no, drinking is a symptom of alcoholism, not a treatment.

So employers need to be cautious about not reporting an injury to a worker who was drunk.  That is obvious.   But the interpretation may raise more questions than it answers.   Could a depressed worker be “self-medicating” with alcohol.  Obviously drinking is not an effective medication, but that doesn’t stop a lot of people from trying.   What about a worker who starts taking Oxycontin for a back injury and slides into abuse?   More than 2.6 million people use medical marijuana.  How many of them are actually treating a condition?   In Colorado, it may be a treatment, but in Texas, where I live, it is a crime.

And then there is the biggest can of worms – Painkillers generally mask symptoms; they don’t treat them.    One could argue that an alcoholic drinks to mask the symptoms of a medical condition.   Does that apply to a heroin user?  What about an Excedrin PM user?

So what should an employer do?

  1. Make sure your policies make it clear that workers in safety sensitive positions are prohibited from using illegal drugs or working while intoxicated.
  2. Consult HR law experts on whether workers in safety sensitive positions must report any prescription drugs that may impair their judgement or ability to work safely.
  3. Train workers on your policies and the dangers of working while under the influence.
  4. Implement an effective medical surveillance and intervention program, including a strong fit-for-duty program to intervene before an impaired worker is injured.

Do you need help setting up a medical surveillance or testing program? What about a post-incident injury management program?   contact us at  kwells@corehealthnet.com to find out how you can make sure your employees get the help they need and you have the right approach to minimizing recordables and workers comp.  



The Workplace Safety Rules Changed and Most Companies Don’t Even Know It.

OSHA ReflectionIn late March, a Houston company selling Christmas trees was hit with fines of $117,000 for OSHA violations.  The case stemmed from a worker injury in December, triggering an inspection that found more than a dozen serious violations.  The most significant thing about the case is that, prior to last year, OSHA would probably never have even inspected the location.  


At the beginning of 2015, the Occupational Safety and Health Administration (OSHA) launched one of the biggest changes in American safety in years and most companies don’t even know about it.  The change came in the form of a new definition for “severe injuries” under OSHA’s regulations and new reporting requirements.  Before, companies were required to report any time a worker was killed or at least three workers were hospitalized within eight hours of the accident.  However, as of January 1, 2015, employers are now required to report fatalities and any injury resulting in a hospitalization, amputation or loss of an eye.

One of the first businesses in the country to learn what a change that meant was a Houston-area construction company.  Less than one month after the change was instituted, a worker fell through a hole in the roof and was seriously injured on one of the company’s projects.  The details of the case caused OSHA to hit the company with a massive fine of $362,500, including $70,000 because it waited three days to report the accident.

Since then, more than 600 other companies have been fined for failing to properly report incidents, according to Bloomberg BNA.  But it is not the fines for failing to report that have made the biggest impact; it is the way the reports give OSHA an up-close, real-time view of how people get hurt on the job in America.

Now a year later, OSHA has released a report that shows just how much they have learned about on-the-job injuries.  For starters, the agency received more than 10,000 reports last year, about 30 a day.  Making matters worse, OSHA estimates that industry is under-reporting by 50 percent.

The reports that are made give OSHA two things: a big-data window into the relative safety of different industries, and a brand-new approach to inspecting and investigating individual businesses.

Big Data

The injuries included 7,636 hospitalizations and 2,644 amputations.  As one OSHA publication puts it, “statistics are people with the tears washed off.”  It is the amputation statistics that jumped out.  OSHA has been preaching to the manufacturing sector about amputation hazards for a long time.  However, amputations in grocery stores and other companies that use food slicers appear to have been an eye-opener for agency officials and they have singled that sector out with a program to raise awareness and also for stepped-up enforcement.

Grocers are one example of the way the new rule has allowed OSHA to target its limited resources.  Before, a store had relatively little chance of ever getting a visit from an OSHA inspector.   Now they are getting attention from regulators.   In March, a national grocery store chain was fined $45,500 after a worker sliced off a fingertip.   And that may be the least of that company’s worries.  As attorney Howard Mavity of Fisher & Phillips has pointed out, a second violation at any of a company’s stores in the next five years could potentially make it a repeat offender under the regulations and open the door to a $70,000 fine for each offense.

What happens when the data identifies a high number of injuries within a certain industry or area?  On March 16, after reviewing reports that indicated that meat processors in Nebraska had an injury rate well above the national average, OSHA launched a local emphasis program. The very next day, OSHA added a regional emphasis program for Kansas, Nebraska, Missouri poultry processors.  OSHA emphasis programs are part carrot, part stick approach – The carrot is a communications outreach to companies and workers. The stick is dramatically increased, targeting inspections.  In the words of the order, “Meat processing facilities will be evaluated to determine whether the employers are in compliance with all relevant OSHA requirements, to help employers come into compliance, and to ensure that employees are protected from the hazards related to animal slaughtering and processing. “

Once an industry is on the list, companies in that industry will see increased inspections, which bring the potential for new violations, the threat of becoming a repeat offender and, over time, more pressure on the agency itself to take any measures within its power to improve safety in that industry.  Suddenly companies that have flown under OSHA’s radar will get to know their regulators very well.

Company Inspections

The rules also triggered a complete change in the way OSHA handles investigations of incidents.   Most companies are still not prepared for this.  To understand the change, you must first understand that OSHA already does a lot with a very limited budget.   Once accident reports started flooding in, local offices did not have the resources to visit every accident site.

So they started a triage system.   About a third of the time, investigators went to the accident scene and performed an inspection.  About five percent of the time, they decided no investigation was required.  What about the remaining 62 percent?  For those cases, OSHA invented a new type of investigation, the Rapid Response Investigation (RRI).  Employers are asked to perform their own investigation, including a root cause analysis.  The company is told to:

  1. Analyze the incident;
  2. Identify the causes;
  3. Present its finding to OSHA, potentially including pictures and blueprints; and
  4. Propose steps it will take to keep the accident from happening again, such as training or changes to procedures.

For companies with staff who understand incident analysis and safety programs, this has not been much of a problem.   Anecdotally, company safety professionals have said OSHA was easy to work with and focused on prevention more than punishment, which should be everyone’s goal.

But smaller companies may lack that expertise and this process can be difficult and potentially expensive.  A lot of companies, especially those in low-risk industries, may go years without an incident, even though they don’t have formal programs or training in recognizing hazards.  However, if someone is hurt, they may find themselves in a kind of double jeopardy.  First they had the accident, and then they run the risk of bringing additional scrutiny by performing a haphazard investigation.  Sure enough, OSHA investigators say privately that they spend a lot of time explaining to small companies what they need to do to perform the investigation.

Finally, there is always the temptation to cheat.  As OSHA says, if there were 10,000 reports last year, there may have been 10,000 more injuries that went unreported.  Of course, lying to OSHA has always been a reckless approach that can result in criminal penalties.

Overall, OSHA is one year into an ambitious program that could dramatically improve workplace safety in America, but there are still some bumps along the way.  Companies need to understand the new paradigm, step up their safety programs and recognize that the way they investigate an accident and the steps they put in place to prevent it in the future are critical in determining how OSHA treats them in the future.

Ken Wells is the founder and president of Lifeline Strategies, consulting firm located in Houston.  Lifeline Strategies’ units work with companies to manage their safety and regulatory programs, maintain healthy workplace through occupational medicine management and establish integrated brands for their customers and the public.

How Long is Too Long to Wait to File Workers Comp?

Thanks to the excellent website www.safetynewsalert.com for calling attention to a case where an injured employee waited two months after an alleged incident to apply for workers comp.   His argument was that he didn’t think the injury was serious, but it got progressively worse for two months, when he had to see a specialist. He said he informed the company as soon as he realized the seriousness of the injury.  The company argued that “it always stressed to its employees the importance of immediately reporting injuries because of the presence of bacteria and chemicals in the workplace that could cause even minor cuts to become infected.”

It happened in Kentucky where the workers comp laws say workers need to tell the company about an injury “as soon as practicable.”

The courts found against the worker because so much time had passed, but it creates a question, how long is “as soon as practicable?”    Apparently it is not two months, but is it one month?  Is it a week?   Back injuries may take a while to heal or present themselves as a longer-term problem.  How long is too long to report?

For employers that creates a high degree of uncertainty and potential exposure for incidents they didn’t even know occurred.  It is a pretty common problem in the oilpatch where crews may head home after a hitch, only to see their local doctor and start the workers comp process.

That is one reason why companies should look at companies that provide immediate post-incident injury management.  Typically an injured worker will talk to a trained professional by phone and describe the symptoms. In most cases on-site first aid is warranted and the employee is urged to contact them again if the symptoms worsen.  If the injury requires treatment, the service may recommend a clinic or, if it is an emergency, the worker can be taken to an E.R.

What does this accomplish?

  1. It establishes a treatment regime that is aimed at the right treatment for the injury.  Sending an employee home with an injury that could get worse with time doesn’t help the employee or the employee. Proper and early intervention has been shown to dramatically reduce the need for workers comp and shorten the period before an employee is able to return to work.
  2. It answers worker questions quickly and opens a communications channel in case the injury needs further treatment.  This helps encourage workers to report an injury when it happens.
  3. It “freezes the facts” by giving a quickly documenting what happened, the severity of the injury in real time and the recommended course of treatment.
  4. It gives a clear process and documentation that makes it harder for a worker to not report an incident and come back later with a claim.

CORE Health Network‘s TimeZero injury case management gives companies and their employees the peace of mind to know that an RN is just a call away if there is an incident.  CORE’s nurses are experienced in injury management and OSHA regulations, and are certified on workers comp in all 50 states.  If a worker is injured, they will be on the phone immediately to perform triage, find the nearest clinic qualified to treat the specific injury and will follow-up to ensure that the worker is receiving the right care.   For more information contact kwells@corehealthnet.com. 



Sex and Drugs: OSHA’s New Walk on The Wildside

OSHA inspectors spend their days sorting through the details of missing machine guards and slippery walkways.  That is a long way from the world of Sex, drugs and, potentially, rock and roll.  But some recent cases have you wondering if OSHA hasn’t decided to take a walk on the wild side.


In California, Cal-OSHA, the state agency enforces safe workplace requirements, has been wrestling with how to regulate the porn industry, particularly how to reduce the risk of sexually transmitted diseases.  This month, Cal-OSHA fined a film company run by a porn star $78,000 for violations, including not requiring actors to use condoms, the porn industry’s versions of Personal Protective Equipment.   However, earlier this year the Cal-OSHA Standards Board considered and failed to get the required number of votes for a blanket rule requiring condom use for all porn films.  One argument against the requirement – it could force the industry back underground.   the other arguement was, if you require condoms, what else would you require:

“If you think about how porn is looking today, and how it’ll look…. we’re talking about gloves, full body cover, and goggles,” said Eric Leue, executive director of the Free Speech Coalition, a porn industry trade group. “It’s going to turn into surgical porn.”  

Surgical porn?   Kinky!


The whole decriminalization of marijuana has also created some strange issues for the government.  Even though states have allowed medical or recreational use, pot use is still against federal law.  And yet, OSHA needs to ensure that the new marijuana industry operates safely.   A tragic event at a New Mexico medical marijuana lab sent two workers to the hospital and resulted in an OSHA fine of $17,500.   You can read about it here.   Clearly this is an industry that still needs to grasp its responsibilities to provide a safe workplace.  


Rock and Roll

Oh and, as for Rock and Roll, that came last fall when a TV station did an investigation of the mind-numbingly loud music played in health club spin classes.   They found that noise levels were consistently higher than allowed by OSHA standards.  Watch that video here.  No word on whether OSHA is investigating music noise levels.





News Reports on Occupational Health: Experience Matters!

There are a lot of occupational health and medicine companies around.  A quick google search of the words “occupational” and “clinic” turns up more than 100,000,000 entries. The number of companies involved in Occ Med will continue to grow.  I even  saw an article recently by a chiropractor telling his colleagues how Occ Med Services were a good way for them to new income to their current practice.

However, this is one field where companies that need help testing new employees, handling return to work clearances or helping injured employed after an incident really need to look at the experience and expertise of the service providers.   This is especially true in the area of telemedicine – helping companies by handling their administrative needs, interpreting results or working to manage injuries by phone, email or video.  It presents great opportunity for companies to solve occupational medicine headaches and save money, but it all depends on the quality of the provider.

I recently took on a new client, CORE Health Networks, and they are generating some positive feedback from the media, especially for the experience of their staff and expertise at handling occupational health needs.

Here are a couple of articles that included CORE, one from the Society for Human Resource Management that looks at the ways  telemedicine can help HR departments and another from the employment website Monster.com that looks at the need for quality medical personnel who can work remotely.

Contact me at kenwells@corehealthnet.com if you would like to learn more.