Physical Fitness Physical Fitness, as Defined by Wikipedia: "Physical fitness is a general state of health and well-being and, more specifically, the ability to perform aspects of sports, occupations and daily activities. Physical fitness is generally achieved through proper nutrition, moderate-vigorous physical exercise, and sufficient rest." What is interesting is that before the industrial revolution, fitness was defined as "the capacity to carry out the day's activities without undue fatigue." Although with the recent huge leaps in technology and automation, we have created changes in lifestyles. In present times, physical fitness is considered more of a measure of the body's ability to function efficiently and effectively in work and leisure activities rather than more industrial daily activities. Physical fitness means to be healthy, to resist diseases, and to be functional in emergency situations. When it comes to physical jobs of today, I believe the previous definition still rings true and workers should be able to carry out the day's activities without undue fatigue. As safety professionals, we work hard to ensure our employees health and safety and send them home in one piece at the end of the day. However, as muscle strains and sprains continue to be at the top of the list for injuries, it is evident that many employees experience undue fatigue. What's your definition of physical fitness? As much as we want employees to resist diseases, the external factors of fitness and health are often the easiest to improve. Assessments of posture and functional movement are helpful as external indicators of physical fitness. These assessments can be incorporated in Post-offer Employment Testing (POET) or Physical Capacity Evaluations (PCE). Movement assessments are most helpful to the employee when results are shared for their knowledge and benefit.

Overview There are a multitude of reasons why employers create safety and health-related documentation. These include compliance with mandatory paperwork requirements promulgated by the Occupational Safety & Health Administration (OSHA) and the Mine Safety & Health Administration (MSHA), which range from injury/illness records, to documentation of training provided to workers (both formal courses and less formal "toolbox talks"), as well as workplace examinations, equipment inspections, industrial hygiene monitoring, and exposure control plans to guard against health hazards associated with asbestos, lead, silica, and other toxic chemicals. There is another universe of documents, which are routinely created and maintained in the course of business voluntarily or as a matter of "best practice." These include: employee handbooks, safety and health audits, safety and health programs, incentive and disciplinary programs, safety and health committee minutes, job hazard analysis (JHA) or other standard operating procedures, job descriptions, safety and health management systems, environmental compliance handbooks, occupational health programs, medical surveillance programs, and internal training materials. Properly prepared and maintained, these documents can be your best line of defense (a shield) against unwarranted citations or other enforcement actions. But failure to invoke legal privilege where available, carelessly written documents, or materials that contain information constituting an admission against interest by the employer or its agents of management, can be used as a sword against you by OSHA and MSHA. Even documents viewed as proactive, or helpful, by an employer can be used to show "employer recognition" of hazardous conditions, which can support enforcement actions under OSHA's General Duty Clause, or to heighten the level of negligence assigned to a citation by showing a pattern or practice of recurring safety and health problems. Documents that can inadvertently be produced voluntarily and then used as the government's "Exhibit A" against the employer include safety and health audits, safety and health committee meeting minutes, near-miss reports, and job hazard analysis forms. Moreover, improper destruction of documents, particularly those where a litigation "hold" has been placed under notice by OSHA or MSHA, can even give rise to criminal prosecution for obstruction of justice or conspiracy!

Introduction Worldwide, workplace cancer prevention has a much lower profile than workplace injury prevention, despite a real and present need to elevate the profile of workplace cancer prevention around the globe. Numerous organizations around the globe attest to the high number of annual work-related cancers and cancer deaths, but then invariably go on to say workplace cancer statistics are underestimated, the problem is even worse than statistics bear out, and the profile of workplace cancer prevention needs to be elevated. This apparent consensus begs several questions. This paper will explore, with the help of reputable resources from around the globe, the following questions: What is occupational cancer, how prevalent is it, and what are its causes? Why does cancer prevention have a much lower profile than workplace injury prevention? Are current occupational exposure limits (OELs) for carcinogens adequate? What are the problems associated with cancer cluster investigations, how reliable are they, and what needs to be done to improve them? What must be done to advance the cause of workplace cancer prevention? What are some valuable resources available to those wishing to help advance the cause of workplace cancer prevention? What Is Cancer, and How Prevalent Is It? According to the U.S. Department of Health and Human Services 14th Report on Carcinogens, 2016, cancer affects almost everyone's life, either directly or indirectly; about 1 out of 2 men and 1 out of 3 women living in the United States will develop cancer at some point in his or her lifetime. According to the American Cancer Society (ACS), cancer is the second most common cause of death in the U.S. and accounts for nearly 1 of every 4 deaths.

Historical Perspective on Medical Marijuana The Chinese Emperor Shen Nung, in 2737 B.C., described the therapeutic use of marijuana for joint pain, constipation, malaria, and childbirth. Therapeutic and religious use achieved great popularity in India around 1000 B.C. Medicinal use of marijuana continued, and spread to Africa, the Middle East, and the Arabian Peninsula into the 18th century. Marijuana was introduced into western medicine by a physician, W.B. O'shaughnessy who, in 1839, described its use for pain control, muscle relaxation, appetite stimulation, and as a treatment for nausea, and for seizures. The psychiatrist Moreau, in 1845, published an article describing the use of marijuana in his patients. In 1850, marijuana was added to the U.S. Pharmacopoeia. Information regarding medical uses of marijuana disseminated throughout North America and Europe. By 1900, more than 100 scientific articles had been published on medical marijuana. Marijuana extracts were being marketed by prominent pharmaceutical companies. Use of marijuana declined in the U.S. from 1900 through the 1930s due to difficulty in standardizing preparations, development of alternative "mainstream" pharmaceuticals, and taxation by the Federal Marijuana Tax Act of 1937. By the 1930s, there were at least 2000 medicines, with over 280 manufacturers. Marijuana was removed from the U.S. Pharmacopoeia in 1942. In 1970, The Controlled Substances Act classified marijuana as a "Schedule 1" drug, in the same category as heroin.1 Mechanism of Action of Marijuana Marijuana is a synonym (slang) for cannabis, which is derived from the marijuana plant, Cannabis sativa. The primary active constituents in the marijuana plant are Delta9- tetrahydrocannabinol (THC) and Cannabidiol (CBD).2 The human body has a receptor-signaling system for marijuana known as the Endogenous Cannabinoid System (ECS). The ECS has two types of receptors that activate very different bodily functions: CB1 receptors are very abundant in the brain, and solely mediate the behavioral, analgesic, and euphoric effects of marijuana (THC) (e.g., memory, cognition, perception, and pain). CB2 receptors are not very abundant in the brain, but are highly expressed in the gut and immune cells where they regulate inflammation and immune function. Cannabidiol (CBD) activates these receptors (e.g., anti-inflammatory, antiseizure, anti-nausea, and anti-anxiety).

Introduction In the control of occupational diseases caused by breathing air contaminated with harmful dusts, fogs, fumes, mists, gases, smokes, sprays, or vapors, the primary objective shall be to prevent atmospheric contamination. This shall be accomplished as far as feasible by accepted engineering control measures (for example, enclosure or confinement of the operation, general and local ventilation, and substitution of less toxic materials). When effective engineering controls are not feasible, or while they are being instituted, appropriate respirators shall be used pursuant to this section. Respiratory Protection Respirators are designed to protect individuals from harmful airborne contaminants or low oxygen levels. Respiratory Protection Programs Respiratory protection programs establish acceptable practices for respirator use, responsibilities, and provides guidance on medical surveillance, proper selection, fit testing, use and care of respirators in accordance with the OSHA regulatory requirements. Permissible Practice OSHA has established hierarchy of controls requiring the use of feasible engineering controls as the primary means to control air contaminants. Respirators are required when " effective engineering controls are not feasible, or while they are being instituted." Paragraph (a)(2) requires employers to provide employees with respirators that are " applicable and suitable" for the purpose intended " when such equipment is necessary to protect the health of the employee."

Introduction In the past year, there have been significant changes to regulatory and legal aspects of gender equal protection in the United States (U.S.). These changes have been enacted at both the U.S. Supreme Court and state level. After the 2016 Supreme Court Decision in Peggy Young v. UPS , occupational safety and health (OSH) professionals may notice an increased interest in, and concerns about, gender equal protection from management, occupational medicine providers, and human resource partners. Additionally, several states have passed, or are in the process of deliberating on, workplace laws about pregnancy accommodations and protection. These national conversations have re-energized the discussion about gender equal protection in the workplace. State-based laws have generally been termed a Pregnant Workers Fairness Act (PWFA) or similarly named acts. As of June 2016, there are 18 states, the District of Columbia, and 4 municipalities that have enacted PWFA legislation, including: Alaska, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Minnesota, Nebraska, New Jersey, New York, North Dakota, Rhode Island, Texas, Utah, and West Virginia (National Partnership for Women and Families, 2016). There is also a proposed Pregnant Workers Fairness Act (S.1512) at the federal level, but progress in passing the act is slow. Congress has "attempted multiple times to pass" the federal PWFA, but the law has been opposed by multiple sessions of Congress (Pisko, 2016). Also relevant are the upcoming regulatory changes associated with the revisions to the U.S. Environmental Protection Agency (EPA) Toxic Substances Control Act. As part of the Frank R. Lautenberg Chemical Safety for the 21st Century Act, a definition for "potentially exposed or susceptible subpopulation" has been established, to include a group of individuals with greater risk than the general population for adverse health effects relating to chemical exposure. This greater risk is further explained to be either from greater susceptibility or greater exposure, and includes infants, children, pregnant women, workers, and the elderly (Frank R. Lautenberg Chemical Safety for the 21st Century Act, 2016).

Introduction Eliminating or reducing risk of injury or illness in the workplace is critical to maintaining a safe and healthful environment. It is already known that the most beneficial risk-reduction solutions are implemented according to Prevention through Design (PtD) hierarchy of controls (ANSI/ASSE Z590.3-2011). This project examined existing hazards and determined, through visual observations and sampling results at hand-welding stations, that most welding fumes are not captured using the current strategies. While various alternative solutions were identified and evaluated, a new engineering control was implemented, representing a higher level on the PtD hierarchy of control of any current risk-reduction strategies. These engineering controls reduced the risk of Hexavalent Chromium (Cr VI) exposure to welders in an exhaust tailpipe and muffler assembly facility. The ergonomic risks were also addressed. The project ended by determining the business case associated with that solution or, more succinctly, "what was the value to the company for implementing this solution." Introduction to the PtD Business Case Model What Is the SH&E Business Case? A business case in occupational safety and health can be defined as a structured method used to justify a project (intervention or solution) for decision-makers. It captures the effects of implementing programs or activities on employee health (injury or illness), hazards present, risk level, risk management, and the business process. The effects include customary financial business metrics, such as net present value (NPV), internal rate of return (IRR), return on investment (ROI), and payback period (PbP), which are meaningful to business management. The effects also include non-financial measures, those that cannot be directly or easily monetized, such as changes in customer satisfaction, corporate social responsibility, product defects, presenteeism, turnover rate, process cycle efficiency (PCE), and corporate reputation. Finally, the business case presents the health and business risk analysis by explaining opportunities, threats, strengths, and weaknesses associated with identified hazards. In reality, the business case answers the question: What's in it for the company?

Introduction "Space, the final frontier. These are the voyages of the Starship Enterprise. Its 5-year mission: to explore strange new worlds, to seek out new life and new civilizations, to boldly go where no one has gone before. " This is probably one of the most recognized quotes, and one that conjures up a sense of exploration, pride, and a can-do attitude. Just like the members of the Starship Enterprise, it is that sense of exploration that motivates the authors of "Exoskeleton Technology – Making Workers Safer and More Productive," to explore unchartered territory of using exoskeleton technology in the workplace. The mission of the authors was to test if upper body exoskeleton technology, in fact, makes a worker safer, and in given applications, more productive through the reduction of muscle activation and fatigue associated with an employee's job. This paper will provide some insight into the depths the authors went on their mission to provide evidence for or to disprove this hypothesis. Unlike subjective and limited ergonomic assessment tools, such as the Rapid Entire Body Assessment (REBA) and Rapid Upper Limb Assessment (RULA), the authors worked with Jason C. Gillette, Ph.D., Associate Professor, and Mitchell L. Stephenson MS, CSCS, in the Department of Kinesiology at Iowa State University, to gather quantifiable data to test the physical benefits of upper body exoskeleton technology on reducing fatigue. This paper presents those findings, along with the need "to boldly go where no one has gone before," with expanding current ergonomic assessment tool effectiveness by quantifying the physical benefits of applied exoskeleton technology, in addition to subjective risk assessment scores derived from these standard ergonomic risk assessment tools. The authors will discuss the results of measuring muscle activity, using EMG sensors on the shop floor while employees performed their jobs, with and without the aid of an upper body exoskeleton. Findings from measuring productivity with and without an exoskeleton on users performing dynamic work will also be presented.

Introduction Wearable technology is currently defined as: Electronics that can be worn on the body, either as an accessory or as part of material used in clothing, and are connected to a data collection device that monitors personal metrics or environmental conditions. While the lure of these evolving technologies is undeniable, the costs of purchasing and implementing wearables can be substantial. Without careful planning, wearables might not deliver either the anticipated results or a meaningful return on investment (ROI). Wearables are hardly a panacea for solving the spectrum of workplace safety and productivity issues. Thus, their acquisition and deployment should include an assessment of potential issues and a framework for addressing them. Potential pitfalls with wearables include: information overload, integrating wearables into employee-focused safety systems, corporate exposures with personal data collection and protection, potential liabilities with health-related monitoring, and specific logistical issues in providing meaningful feedback. Definitions For the purpose of this paper, the following definitions will be used: Ergonomics is a body of knowledge around human ability, human limitation, and human characteristics relevant to design. Ergonomic design is the application of that knowledge to the design of tools, systems, and environments for safe and efficient use. A safety device is a device which seeks to prevent death, injury or illness or is designed to reduce the potential severity of injury (i.e., a seatbelt). A safety tool may be a safety device, but will require human decision-making to be effected (i.e., pulling a cord to activate a parachute). Wearable technology is defined here as: Electronics that can be worn on the body, either as an accessory or as part of material used in clothing, and are connected to a data collection device that monitors personal metrics or environmental conditions.

Introduction The results of an analysis of the cognitive information-processing workload of patient monitoring technicians working in central monitoring units (CMU) of five hospitals in Oklahoma are presented. The analyses were conducted in June 2016 during a visit to the four of the hospitals. The analysis included conversations with the management team, nurses and monitoring technicians at all five hospitals. The objective of the study was to determine whether the information processing (IP) load exceeds the processing capacity of monitoring technicians, and whether any overload is great enough to necessitate consideration for IP load-reducing strategies and interventions. This determination was accomplished by identifying whether an IP load gap exists between the current load and an industry-accepted IP load limit. The healthcare literature appears to be sparse in this area, making difficult any determination that changes in error rates are a function of changes in IP load. However, it is assumed for this study that an increased IP load or length of exposure to the current load will result in an increase in error rates among technicians. Errors are defined (albeit forensically) in this study as events, such as missed alarms, late response to alarms, misinterpretation of alarms and/or EKG strips, missed alarm notifications of nursing staff, etc. The alarm processing load for a technician is partially derived from a measured number of alarms collected at one of the hospitals between 12/23/2015–1/19/2016. During that time, there were 748,150 alarms noted. The load may be smaller at the other hospitals; however, fewer technicians on duty make the processing load similar across all five hospitals. There is a probability of 31% that an alarm will activate in any one operational second (0.31 alarms/second). A measure of the rest of the IP load was derived from the amount of additional data analyzed and/or managed by the technicians, such as EKG interpretations, hospital admissions and discharges, phone calls made to nursing staff, etc. The visual IP load per technician was calculated and determined to be approximately seven to eight bits/second (a "bit" is the amount of information necessary to decide between multiple alternatives (Freivalds, 2014)). This is compared to a recommended IP load limit of three to four bits/second for visual information processing (Miller, 1955). While the information load for each technician is high, it appears that the screen information density is reasonable, and that this may be able to be safely and effectively managed, but only in the short term (∼two to four hours). Two-to-four hour rotations should be considered (Chewning and Harrell, 1990; Goldstein and Gigerenzer, 2002; Marois and Ivanoff, 2005; and Nadav-Greenberg and Joslyn, 2009).

Introduction Most successful businesses are beginning to understand that the reactive approach to employee health–providing group health insurance to cover employees when they get sick-is far less effective than one that combines preventive efforts with transparent/reactive medical services. Adding a traditional "wellness" program to group health benefits used to be the first step for employers who want to "proactively" reign in their increasing group healthcare costs. This approach is slow, sometimes ineffective, and difficult to measure success. More importantly, this philosophy is becoming obsolete. By adding a new generation of non-traditional "wellness" programs to their healthy workforce strategy, employers can take their program to a whole new level. Employers will look to a new generation of "comprehensive healthy workforce programs" to address not only nutrition, cessation education, exercise, and disease management, but also disease prevention, functional employment testing, job analysis, ergonomic assessment, and injury prevention. By looking at the total health of our workforce, employers can impact all healthcare costs including: Group health insurance premiums Workers' compensation insurance premiums and claims Absenteeism Presenteeism (workers who come to work but underperform due to illness or stress) Morale Worker satisfaction Recruitment and retention Cost of rehiring and retraining workers to replace hires that cannot perform the essential functions of a job and therefore, become injured and make workers' comp claims Many of these programs will be introduced within the context of the workers' compensation and safety, rather than the traditional benefits market. Instead of being an outsider to the process, workers' compensation philosophies will be the foundation of implementation, and the key mechanism to measure the success of the program and an employer's return on investment.

Introduction In the past year alone, a number of significant events have occurred that have had implications and impact on global and local business. When the bombing in Brussels occurred, the airport was shut down for a significant period of time. What if you had business travelers in Brussels, or needed to ship product through that airport? Zika virus seemed to emerge from nowhere, and suddenly the fear of mosquito-borne illness took on mammoth proportions. Do you have employees and business operations in Brazil or Puerto Rico? What if business travelers to affected areas contract Zika virus? What if that business traveler is pregnant? How will you deal with this? How will you prevent or minimize exposure? Do you have the communication systems and resources in place for your company to anticipate, respond, and recover from the threats of a constantly changing landscape? Business today must not only be able to respond to an emergency, but must also be aware of the situations that can cause business interruption and take steps to mitigate them. What does it mean to be "prepared" for all hazards and to be resilient as an enterprise? What process should be in place on an ongoing basis to decrease risk from external threats to the business? Who should be on the "team," and what is the role of the health and safety professional in the process? This paper will address the basic elements of an all-threats preparedness strategy, the steps to achieve sustainable internal systems to anticipate and respond, and the essential role of the health and safety professional. The difference between preparedness, emergency response, and business continuity will be clarified. Businesses must have plans and teams in place that can flexibly respond to whatever event occurs, and base their process on previously agreed-upon principles. Stakeholder communication, roles and responsibilities, and tools to protect employees and company assets, must be in place before an event is active.

Introduction While management may feel they successfully help injured employees through the healing process and ultimate return to work, an injured employee's experience can give useful insights on where your injury management program needs to be tweaked. Enhancing your efforts can improve the employee's experience and morale, reduce lost time, and reduce the company's costs associated with the injury. Pitfalls and Solutions Initial Report of Injury or Absence Injury management can go wrong from the very first step. Each workplace injury has its own unique onset and method of being reported. Acute and severe injuries have urgency and typically present a clear and immediate indication that the injury is work-related. When an injury is cumulative, or involves vague pain, its origins and relation to the workplace are less clear. To complicate matters, the employee may report their injury, pain, or doctor visit via phone. Additional difficulty arises if time has passed since the injury onset or the doctor visit. Management needs to know how to quickly get things back on track. When Joe called his supervisor, Sam, to say he wouldn't be coming to work because his back hurt, Sam asked no questions. You can't fault a supervisor when his mind immediately jumps to worrying about how he will fill the gap of the absent employee or how production may get behind. In this case, the lack of simple questions led to Joe being off multiple days. Sam thought he was giving Joe time off, but it turned out to be a Workers' Compensation claim, so those were counted as lost-time days. Since it became a lost-time claim, the entire cost of that claim went into the company's Experience Modifier. The delay in identifying the employee injury as work-related also delayed medical care, and prolonged the recovery period.

Scholars in the athletic field have studied heat-related illnesses and their impact on athletes of all ages and levels. Their findings can be applied to industrial settings to aid safety professionals in preventing heat-related illnesses in the workplace. Heat-related illnesses, injuries, and death are entirely preventable in the workforce. OSHA's national heat stress campaign centers around prevention, water, rest, and shade best practices, and has been very successful at raising awareness to the safety concern around heat stress. Yet heat-related deaths doubled from 2014 to 2015, and the number of non-fatal cases resulting from excessive heat exposure rose to 2830 (Bureau of Labor Statistics, 2015). With weather patterns becoming increasingly unpredictable, it is more important than ever for safety professionals to be informed on the latest research to prevent future heat-related illness and injuries. We will explore the science behind heat stress, how to recognize symptoms in the field, and how research from athletics can be used to prevent occupational heat illnesses, injuries, and most importantly, deaths. Performance and Physiology The Science Behind Heat Stress Heat-related illness (HRI) is an umbrella term used to describe a variety of health issues that result from prolonged exposure to environmental heat and humidity, including heat rash, cramps, heat syncope, heat exhaustion, and heat stroke. They are studied at length by professionals in various fields, including occupational health and athletics. To better understand how these illnesses and injuries occur, it is important to understand the underlying body processes that are taking place, and how they contribute to the onset of symptoms. Thermoregulation is the complex interaction of the body's central nervous system, the cardiovascular system, and the skin that helps maintain a core temperature of approximately 98.6° Fahrenheit. Thermoregulation operates like a home thermostat system in that the body (the hypothalamus) receives information from skin receptors and circulating blood and initiates heat transfer responses as needed.

Introduction Concerns about diacetyl and related flavorings have spread from the microwave popcorn industry to new areas, such as coffee processing. The CDC published a report on the health effects of chemicals produced during coffee processing, that stated, "Roasting coffee beans naturally produces diacetyl and 2,3-pentanedione. Volatile organic compounds, including alpha-diketones (e.g, diacetyl and 2,3-pentanedione), can be released during grinding of coffee.". The CDC also reported that exposures to these chemicals at certain levels may result in reduced lung function, severe fixed obstructive lung disease, and an irreversible, and sometimes fatal, lung disease, obliterative bronchiolitis. After five cases of former workers of a coffee processing facility that roasted, ground, and flavored coffee were identified in 2012, additional studies were undertaken based on worker concerns. In August 2015, the American Journal of Industrial Medicine reported several other cases in the coffee processing industry, leading to the need for evaluation of work places beyond the microwave popcorn and flavoring industries, where concerns about these chemicals first arose. Workers may be exposed to diacetyl and 2,3-pentanedione during several phases of coffee processing, including grinding, roasting, flavoring, and packing. One study measured the highest exposures in the flavoring and grinding of unflavored coffee. Other industries with fermentation and pyrolysis products can also generate diacetyl exposures, such as in the manufacture of beer, wine, and dairy products. As these relationships illustrate, this is clearly an area where medical and scientific knowledge is evolving. Source material includes numerous points made by government agencies or regulators (such as NIOSH, CDC, OSHA, etc.), and the science at this point is likely incomplete or subject to change. Employers facing issues related to flavoring-type exposures during coffee processing, such as diacetyl and 2,3-pentanedione, need to be aware of, and follow, all applicable regulations for their specific circumstances.

Introduction Musculoskeletal disorders, more commonly known as MSDs, are of a complex etiology, for the origin is as different as every individual. This salient ingredient in safety and health of the employee and company continues to evade typical programs. There are other arenas of business – sports in particular - where there is a strong focus on preventing and maintaining the health of the employee - the athlete. Other industries are no different: oil production and exploration, assembly manufacturing, food processing, farming and construction. All industries and businesses have the same denominator as sports businesses: the employee is an athlete. Therefore using proven preventative sports medicine ideas and techniques is the next wave to subdue musculoskeletal injuries in the workplace. This talk delves into why individuals are vastly different, why this is now more important than ever to incorporate proven, approved methods to a company's existing safety program and to utilize ways for a team approach in a worker's physical safety. We will also discuss how this type of preventative program changes emotions in workers and look at the current studies on how emotions really affect and effect the worker in the work place. Musculoskeletal Disorders, MSDs MSDs continue to be a leading cause of pain, suffering, and disability in the American workplace In a recent publication from the Occupational Health and Safety Administration, OSHA, it is reported that approximately 40% of injured workers are not receiving any type of financial compensation from work related injuries; thus burdening the family, our social system, other subsidized programs and private insurances. As a clinician, I wonder how many "accidents", not classified as a MSD, are really the result of a MSD that is not reported due to the lack of early intervention programs in the workplace, or the notion of the worker and the company, that the soft tissue complaint is from an "old football injury in high school".

The PDF file is a slide presentation. Workplace Health Safety - usually associated with acute injuries, short-term, traumatic exposures Health - usually directed at chronic exposures, persistent, prolonged, repeated Definition Industrial Hygiene - "that science and art devoted to the anticipation, recognition, evaluation, and control of those environmental factors or stresses, arising in or from the workplace, which may cause sickness, impaired health and well-being, or significant discomfort, and inefficiency among workers or among the citizens of the community" Environmental Stresses Chemical - environmental concentrations Physical - noise, heat, ionizing, etc. Ergonomic - man-machine interface Biological - micro living organisms States of Matter Solids - definite shape and volume Liquids - definite volume but no definite shape Gases - neither definite volume nor shape Chemical Stresses Dusts - solid particles from handling, grinding, crushing, impact (1–25 microns) (cotton, grain, grinding wheels) Smoke - carbon or soot particles less than .1 microns in size and are the products of incomplete combustion (fire, gas engines) Fumes - solid particles generated by condensation from the gaseous state (welding, soldering, brazing) Aerosols - solid particles or liquid droplets of fine enough size to remain dispersed in air for a prolonged period of time (powder sprays, paint sprays) Mists - suspended liquid droplets generated by condensation of liquids, or by breaking up a liquid into a dispersed state (mixing vats, maintenance degreasers) Vapors - volatile form of a substance normally a liquid or solid at STP (paint thinners, nail polish remover)

Introduction Last year, OSHA promulgated a chemical-specific standard for Respirable Crystalline Silica (RCS) in the forms of quartz, cristobalite, and tridymite. Among other impacts of the standard, it lowered the Permissible Exposure Limit (PEL) significantly and established an Action Level (AL) at one-half the PEL that triggers various aspects of the standard. Medical surveillance is required if workers are exposed to greater than the AL for 30 days or more per year. This chemical-specific standard is different from the others in that it requires the use of objective data by employers to demonstrate compliance in industries or work environments known to carry the risk for exposure to RCS. This document focuses on the general industry standard, 29 CFR 1910.1053. The standard incorporates a phased compliance approach within five years of the effective date, June 23, 2016. Most aspects of the standard become enforceable within next year in 2018. Medical surveillance is required for workers found to be exposed to RCS levels at or exceeding the PEL on that date; however, employers are allowed to delay surveillance activities for workers exposed to less than the PEL but at or more than the AL until 2020. Operations involving hydraulic fracturing have one more year, in 2021, to implement feasible engineering controls. This is likely due to ongoing partnership activities occurring between that industry and OSHA. The previous PEL was based on epidemiological and toxicological research available prior to the publication of the 1968 ACGIH Threshold Limit Values (TLV's) that were incorporated into Subpart Z at the time of promulgation in the early 1970's. Much more has been learned about the effects of exposure to RCS in the 50 years since. The primary disease associated with exposure is silicosis, or a type of pneumoconiosis that results in chronic progressive obstructive pulmonary disease. Besides the obvious reduction in the quality of life among affected workers, the disease may result in lung cancer. Other diseases, such as those affecting the kidney or an increased susceptibility to tuberculosis are also known to be associated with exposure to RCS. OSHA estimates the exposure limit reduction along with medical surveillance will save 642 workers annually from these occupational diseases.

Indoor Air Quality–A Modern Occupational Health Issue Modern building construction and operations have come a long way since the first energy crisis of the 1970's. Both occupant comfort and cost-effective management practices have improved compared to ages past. Yet while building construction has proven the ability keep warm or cool air sealed in and thereby reduce operating costs of Heating, Ventilation and Air Conditioning (HVAC) systems, the same energy-efficient design has had a paradoxical effect on select human health concerns. Additionally, people spend more and more time than ever indoors according to the American Lung Association. These two facts of modern life have brought on a growing phenomenon of ‘Sick Building Syndrome’ and ‘Building –Related Illness.’ (BRIs) One of the downsides of energy management in the nature of building construction is to keep contaminants that originate in building operations or are brought in by occupants sealed in along with the warm or cool air. Symptoms that make these contaminants suspect sources include anything from upper-respiratory infections and itchy, watery eyes to asthma. Known causes include mold mycotoxins, bacteria and other organic particulates. These biological etiologies are encouraged to grow, using the building materials and environments for food, moisture and required temperature. Other sources of certain BRIs can be found in the building materials themselves. These include asbestos, silica dust or chemicals and other materials used in the operations taking place in the building. The increase in BRIs is even more pronounced when natural or man-made disasters strike and create conditions for accelerated growth or airborne dispersal of contaminants. Mold follows flooding, wildfires beget distributions of any manner of particulates, and any event which causes structural damage can increase the concentrations of asbestos or particulates from other building materials in the air being breathed by building occupants. Even a simple electrical power outage can render HVAC systems all but useless for several days, creating perfect environments for growth of biological contaminants.

Introduction The declining health status of today's workforce has decreased the predictive value of risk assessment practices in Occupational Health and Safety (OHS), and has contributed to an emerging issue threatening workforce safety. Common risk assessment practices used across industries do not consider today's escalation in debilitating medical conditions among workers and the resulting increase in likelihood and severity of injury for the general workforce population. This paper will serve to expand the OHS professional's knowledge base regarding workforce health and raise awareness of this issue. Risk assessment is an essential component of any comprehensive safety and health program. This practice has been effective in reducing the likelihood of injury, illness or accident before such an adverse event is experienced. This fundamental practice has contributed to the standardization of safety practices through attempting to address the multitude of factors contributing to potential injury, illness or accident. Although necessary and utilized widely, the process of identification of potential harm to workers through risk assessment practices is losing effectiveness. This is a bold statement; however, we must acknowledge there is a glaring omission across the most commonly used risk assessment practices today: the underlying health status of the worker. A critical contributor, underlying health, is not considered in any of the commonly used risk assessment practices and therefore the physical and mental condition of the worker is assumed a constant in risk prediction. Yet this single unaccounted for factor is quite varied across individuals and one of the largest contributors to injury, illness and accident in the workplace. Underlying Health as a Deterrent to Workforce Safety and Productivity Health risk factors are physiological conditions or lifestyle habits, such as hypertension or smoking, which can negatively impact physical or cognitive functioning. Underlying health risk factors are associated with the increased incidence of declining health and the onset of diseases such as diabetes, heart disease or mental health issues. These health risk factors and diseases have an impact on basic human function such as potential decreased cognitive function or declining physical capacity. As a result underlying health and the presence of health risk factors are major determinants of both performance at work, and the likelihood and severity of workplace injury and illness.