Onsite Treatment to Revolutionize Employee Health Management

Workplace injuries are a constant concern among a variety of industries in the nation. Rising costs and inflation associated with medical care can also negatively impact employers as they respond to injury claims. Businesses also lose money from days of leave taken by injured employees and many additional costs can quickly add up. 

The Occupational Health and Safety Administration (OSHA) has published data suggesting that there are 2.5 injuries for every 100 construction workers in the United States. Statistics for this past year of reported injuries totalled more than 21,000 nonfatal cases caused by falls, slips, and trips. OSHA also publishes extensive safety protocols and education materials each year targeting at limiting these kinds of workplace injuries. American businesses are required to implement many forms of safety education, facilitation, and treatment for their employees. While there are a variety of tools aimed at preventing workplace injuries, they are still likely to occur and additional measures are being developed to further reduce the response time to employee claims. 

Treating Injuries Onsite

Treating injuries onsite is a newer method of response for employee injuries. Onsite clinics are equipped with the facilities, tools, and staff to effectively treat injuries that occur in a work environment. Onsite clinics allow professionals to take the necessary steps to mitigate and identify risks that could lead to accidents that pose additional risks to the company. The thought is that by having these onsite clinics available to employees, there will be improvements in the environment of safety on the job and a reduced response time to effectively treat minor injuries before they become more serious. 

Onsite Clinic Duties

• Rapid Evaluation of Injury

• The main role of an onsite clinic will be to rapidly identify and evaluate an employee’s injury. The professional report will determine the extent of the injury, cause, any trends, and lead to a diagnosis of treatment. 

• Knowledgeable Assessment of First Aid

• Many workplace injuries can be remedied by simple first aid administered by medical professionals.

• The official background and experienced staff employed by the onsite clinic will be able to translate their experience to the condition of the affected employee. 

• Recommend Treatment

• After identifying and evaluating the employee’s injury the medical staff will be able to address a diagnosis attached to treatment plans. 

• Having medically trained professionals administer diagnosis and evaluation will prevent minor injuries from getting referred to more serious and expensive practitioners. The professionals will also be able to facilitate many in house treatments that will additionally cut costs for employers and insurance lenders. 

All the nuances of treating onsite injuries without the medical professionals associated with an official clinic can add many complications to effective diagnosis and treatment of an injured employee. These complications result in exponentially higher costs harbored by the company as injury claims and workman’s compensation can be a lingering process. Last year the average worker’s compensation claim cost more than $41,000 according to the National Safety Council. With claim costs averaging such high amounts, it is vital employers and businesses across the nations develop methods to save money and adequately support their employees.

Industry Specific Customizations

By establishing a personal onsite clinic at work sites, employers will be able to customize the kind of specific care and capabilities they provide. Construction sites will be able to attribute more resources devoted toward bodily mobility injuries most commonly faced in their industry. Another feature that could be added to clinics are the ability to effectively respond to specific chemical exposures at different locations, which offers a much higher level of care and efficiency to patients.By allowing specifications to personal onsite clinics, employers will be able to save on injury costs in the future by preventing them before they happen and promptly responding when they do. 

Other Customizations

• Mobility injuries

• Bone and soft tissue treatments

• Respirator fit testing

• Medical surveillance

• Hazardous material exposure protocols

• Drug and alcohol screening

Implementing Prevention Protocols

With the breadth of knowledge and experience that will be associated with establishing an onsite clinic, employees will be able to access vital resources to treat their mental and physical well beings. It is crucial for employers who want to cut costs to not only engage in treatment and evaluation of workplace injuries, but also to invest in prevention programs that can stop injuries from ever occurring. Onsite clinics can design these prevention programs by establishing the knowledge and necessary designs to implement wellness programs that maintain a healthy and productive employee environment. 

Prevention programs will not only work to improve employee education and awareness of potential workplace injuries, but will also provide vital tools they can use to instill responsibility with employees themselves. Providing vital safety tools to employees will help them recognize safety hazards, onsite injuries, and indicators for compromised mental and physical health. 

Musculoskeletal Pain the Primary Health Risk to American Workers

Several studies exploring workplace injuries, chronic conditions, and American health has identified musculoskeletal pain as the primary risk to employees. Musculoskeletal pain can be caused by a variety of different factors, but poses risks to almost every industry in blue collar America. Scientists, and employers are working diligently to identify the root causes of the chronic illness and help industries prevent further distress. 

Statistics suggest that every 1 in 2 American employees experience some form of chronic musculoskeletal complications, supported by surveys sampling more than 252 million citizens.The industries with the highest risk of complications include software businesses, utility management, retail, transportation, hospitality, construction, manufacturing, healthcare, education, and more. These industries require employees to be sitting or standing for long periods of time, and sometimes also require heavy lifting that can pose risk to their musculoskeletal stability. Leading experts relate the hard manual labor and sedentary position of the body over long periods of time as some of the main causes of this specific injury. 

What is the Musculoskeletal System

The musculoskeletal system includes the bones, muscles, ligaments, joints, connective tissues, cartilage, and tendons. This system gives our human bodies structure and supports movement of the limbs. The MSK system is vital to a person’s mobility and can change with them over time. The overall endocrine system is stimulated by exercise and interacted with via biochemical signaling passed through other organs in the body. 

5 Main Functions of the MSK System

• Movement: The skeletal system pulls on bones causing movement at the joints. Facial skeletal muscles pull on soft tissues resulting in facial expressions. All the movement is caused by the respiratory system introducing oxygen into the blood supporting the systems, enabling the muscles to breathe.

• Support: Muscles in the system support the internal organs, but are prone to weaknesses with age or injury. Prolonged weakness to the system's muscles can result in organ displacement.

• Protection: Skeletal muscles protect vital organs and cushion exterior physical impacts taken by the body. 

• Heat Generation: Heat is a waste product of body metabolism which is maintained by keeping an internal body temperature of 98.6 degrees Fahrenheit. Shivering is a major control of the MSK system to regulate the body temperature and generate heat when the internal body temperatures fall below optimal levels. 

• Blood Circulation: Cardiac muscles pump the heart and control the body’s blood circulation to vital organs and other areas of the body. 

“Ergonomic injuries” are those that affect the MKS system. These injuries are the result of overuse, improper use, or exterior inflictions to the muscles, tendons, ligaments, or hard structures. Symptoms of MKS injuries include but are not limited to the inability to effectively use limbs or muscles to complete tasks, soreness, bruising, muscle tears, and bone fractures. These symptoms often accompany the hazards associated with sitting and working at a desk, impacting the employee over long periods. The study also analyzed the resulting economic expenditure associated with MSK-related injuries and discovered its national costs have more than doubled over the last decade. 

Associated Costs of Musculoskeletal Injuries

The cost to treat MSK is one of the third largest industries in the United States healthcare system, totaling more than $600 billion annually.Associated costs to treat MSK injuries include medical appointments, expert referrals, and leave from work. The injuries also have to be treated with various medications, physical therapy, and work limitations after being diagnosed. These costs fall predominantly on the employee who ends up having to take the excess leave from employment and source the kind of treatments that best fit their situation. Employers also take the brunt of any MSK injury costs by involving their insurances and liability officials. 

The Hinge study also acknowledged that the driving factor behind increasing costs is the undeniable connection between MSK and mental health treatments, as affected employees often use double the average worker’s sick days.  The average worker misses more than 8 days of work, while employees experiencing symptoms of MSK complications often miss upwards of 13 average days annually to deal with their treatment and mental health. The sheer absence of millions of workers for extended durations of time throughout the annual work year alone costs businesses and the greater US economy millions of dollars.

Impacts of New MSK Understanding 

The impacts of MSK are affecting many aspects of employee health and welfare in the United States, as medical costs and health inequities continue to increase. Access to MSK-associated healthcare, medicines, and affordable treatments have continued to drive up prices, far surpassing the economic costs shared by employers to treat other ailments like heart disease ($309 billion), cancer ($243 billion), and diabetes ($188 billion). It is no surprise that medical costs, insurance, and access to treatments have all become a much larger burden on the lower and middle working class of America.

The nuances of MSK and its lack of study have also prevented many employer insurance companies from effectively covering their employee’s risk of MSK exposure and rehabilitation. The lack of understanding has only recently resulted in studies highlighting the close relation to employee mental health welfare. Chronic pain can often intensify mental challenges resulting in increased anxiety and depression, worsening the MSK symptoms. Many health insurances fail to fill the gap in social and behavioral support needed to recuperate from mental health symptoms associated with the effects of chronic MSK in the workplace. 

Solutions recommended by the Hinge report and other health professionals suggest filling the gaps in coverage by addressing issues with physical recovery, behavioral support, and medical services. Remote care and support are ultimately important in treating the patient’s physical self-care and mental health. With digital accessibility at an all-time high, connecting patients to health professionals is easier than ever, and acquiring the kind of frequent care needed to recover from MSK complications entirely. 

Testing Workers Safety Gear

Many industries across the United States require workers to abide by certain safety standards set by the Occupational Health and Safety Administration (OSHA), often including basic safety gear. There are multiple different sets of safety gear that are differentiated based on the line of work employees are undertaking. These standards were developed to prevent serious injury and reduce the risk of any incidents while on an active job site. 

The kind of gear and duration of use is constantly modified to better fit the needs of employees and their environment. OSHA and other committees set out to test the gear to understand how they respond to real world situations, and if they comply with the American National Standards Institute (ANSI).

Types of Protective Gear

There are many different types of protective safety gear utilized by the general workforce in the United States. The purpose of utilizing safety gear while at work is to minimize workplace injuries, protect employee health, and promote healthy work environments. The most common gear observed in the field include, but are not limited to:

• Gloves

• Respirator

• Helmet

• Hearing protection

• Hard hat

• Goggles

• Eye protection

• Face shield

• Ear plugs

These types of protective wear otherwise known as PPE (personal protective equipment) were continuously developed in response to dangerous work environments where employees are interacting with chemical, radiological, physical, electrical, mechanical, and other unique hazards. The different types of PPE is completely dependent on the type of work being conducted and the risk to the employee. 

All PPE used in a work environment should also be maintained and clean in a reliable fashion to ensure its performance will be effective. All workplaces should have a system in place to source safely designed and constructed equipment that fits the employees comfortably and to encourage their use in the workplace. If the PPE does not fit properly workers are less likely to consistently choose to utilize them, increasing the risk of engaging in dangerous or exposed activities. Like all workplace duties, the use of specific PPE must be trained and there are a multitude of different online and in person resources available. Specific criteria included in the worker training programs requires users to understand wearing PPE:

• When it is necessary to source PPE.

• The type of PPE necessary.

• How to properly wear, remove, and adjust equipment.

• The limitations and effectiveness of certain PPE.

• The proper care, maintenance, lifespan, and disposal procedures for the PPE.

Testing PPE Effectiveness

Many different committees surrounding PPE have developed their own unique tests applicable to types of equipment to assess their usefulness and construction when used in the workplace. All PPE advertised by OSHA pass the ANSI standards, however there are additional tests done to ensure their application is necessary and effective in real world simulations. 

Many of the tests completed by committees are to study the way PPE responds when in motion. These tests are vital because they simulate real world situations when workers are climbing, walking on a site, or in motion in the event of an accident. Plenty of tests are run during the construction process of PPE to ensure their stability and durability in the face of exposure or collision. 

The most important tests that PPE is run through include their effectiveness when under different kinds of stresses. Most employers have working conditions that deal with at least one of these conditions, if not all of them. Some employees undergo working conditions that replicate all five tests on the same job. 

5 General Tests:

1. Ascent

2. Descent

3. Load bearing

4. Load bearing under stress

5. Friction

When ascending PPE needs to protect the worker from overhead dangers like spills, falls, and miscellaneous contusions. On the descent tests, PPE is analyzed in scenarios that replicate falls and rapid downward altitude changes. The descent test is incredibly vital in types of constructive work that involves large amounts of climbing and transporting materials from different levels. The load bearing test seeks to establish the stability of different PPE when a worker or equipment is suspended in place. Labs simulate load bearing under stress by adding swinging or momentum into the PPE test trial. The final test for PPE before deciding its credibility among employers is a friction test, establishing the durability of the equipment when moved between levels at high speeds. The friction test replicates the event of a fall or dropped item on a work site and can be applied to many different forms of PPE. 

Applications for PPE Tests

Many of the tests can be applied to the various PPE used by the industry, and having more than one test is an effective way at determining its durability in a real world environment. These tests not only put workers at ease knowing the equipment they use is in fact safe and effective, but also the employers. Industry leaders want the assurance that the kind of PPE they invest in for their companies is safe, effective, and actually prevents workplace injuries. The other caveat that comes from these tests is changes in the standardizations published by overhead administrations like OSHA and ANSI. If a certain PPE is found to be more or less effective than previously assumed, the standards advertised to employers may have to be entirely modified. These tests also provide clarity into the specific uses individual PPE should be used for, creating more uniform standards and expectations of certain industries. 

What is New With OSHA in 2023?

Each year occupational safety administrators seek to make changes that effectively keep employees safe while working. The Occupational Safety and Health Administration is a government agency working to ensure safety by setting and enforcing standards applicable to the United States Department of Labor.

Last year there were more than 2.5 million workplace injuries reported to administrators across the United States. These injuries more-or-less fit into categories involving overexertion, falls, object impacts, and bodily reactions to awkward postures. OSHA constantly makes reforms to their rules as needed in various industries. Their mission includes evolving with current events and addressing potential areas where any safety risks could occur. The changes with the new rules OSHA is proposing for 2023 will seek to better prevent these injuries and many others in the workforce. 

Who is OSHA?

OSHA began regulating workplace safety after the Occupational Safety and Health Act was passed in 1970. The origins of the administration arose after massive public outcries against rising injuries and death rates at work. Congress created the Occupational Safety and Health Administration to ensure safe and healthful workplace conditions existed for workers in all industries. The administration works to create and enforce specific safety standards by providing training, outreach, education, and assistance. 

Each year the administration receives a budget to effectively provide the resources needed to regulate workplace safety around the country. Originally this budget was utilized to develop the enforcement strategies best fit for businesses, but has gradually evolved into targeting more of those high-hazard industries that have continued ongoing workplace injuries. The current enforcement strategy aids in identifying the specific sites where high injury rates occur, and offers critical resources directly to the highest problem areas within labor departments. One of the most important proponents of OSHA’s enforcement plans is their education and outreach protocols that play vital roles dealing with health and safety. 

OSHA has invested heavily into its websites, educational materials, and resource distribution across the United States. More than 23 million users are present on the OSHA website each year, with more than 300,000 annual downloads of its advisor software systems. The administration has continued to branch out creating various web pages for individual employees, businesses, industry partners, and foraging counterparts in Europe and beyond. 

New Rules for 2023

This year OSHA has made some big changes in reforming many previously existing regulations to better fit the evolving industries in the United States. Here are 5 important changes that you should know about including record keeping, Lockout-Tagout changes, silica exposure, updated HazCom classifications, and shipping requirements. 

1. Recordkeeping Proposed Rule

OSHA published a new rule which would revise electronic injury and illness reporting requirements in US workplaces. Key impacts will include:

• Expanding reporting requirements to ensure companies with more than 100 employees are able to electronically submit all of their OSHA information, whereas previously they were only required to submit a single form’s data. 

• OSHA plans to publish the data collected from the electronic submissions on a public database after removing individual identifiers. Immediately this portion of the proposed ruling has garnered concerns about the likelihood and effectiveness of completely removing personal information from the data prior to being released to the public. 

• The new ruling will also provide exclusions for establishments with 250 or more employees from having to electronically submit their Form 300A information annually to OSHA. 

2. Lockout-Tagout (LOCO) Updates

LOCO is OSHA’s control of hazardous energy standards, initially established in 1989. This regulation has largely remained unchanged since its establishment although OSHA is finally modernizing it to match industry standards utilizing computer based safety softwares. 

• Most hazard controls in national industries recognize and incorporate many different computer based safety softwares. 

• A request for information (RFI) assessed the strengths and limitations of such software when controlling hazardous energy. 

• The RFI determined the current regulations in LOTO, which specifies control current devices are unsuitable for energy isolating devices, must be changed in response to recent technological advancements. Modern technologies may have improved the safety and control of such circuit type devices, and OSHA has responded by preparing to update the LOTO standard and compliance implications for employers. 

3. Silica Exposure Considerations

Silica dust particles are incredibly small and can become trapped in the lung tissue of a person who is exposed, leading to inflammation and scarring that can affect their respiratory tracts. The minute particles can reduce the lung’s capacity to take in oxygen causing a condition classified as silicosis. Silicosis can result in permanent lung damage as it is a progressive, debilitating, and sometimes fatal disease. 

OSHA developed two standards for respiratory silica, one for general industries like construction and one for maritime. Those 2016 standards established exposure action levels reducing the acceptable amount of total daily exposure, installing exposure control measures, and implementing medical surveillance programs to monitor employee health. The established regulations also required businesses and recordkeepers to maintain written documentation of the ongoing exposure control plans and maintain the OSHA standards. 

Other chemical exposure regulations like those that deal with lead, cadmium, and formaldehyde also yield an additional medical removal provision that the former silica regulations lacked. The medical provision required employers to monitor certain airborne exposure indicators or those found in blood concentrations, removing the employee from the contact area once exposure levels are reached. The United States Court of Appeals concluded that OSHA failed to explain its decision to remove the medical provisions from the 2016 silica regulations and remanded the rule for additional consideration of the implications. 

• OSHA is planning to revisit the silica rules and to implement a medical provision installing surveillance programs and removal procedures. 

• Employers that are subjected to the silica rules must ensure they have effective workplace inspection and hygiene standards, efficient incident management strategies, and the ability to promptly record medical removal cases. 

4. Regulatory Activities in Regards to Heat Exposure

The United States Department of Labor reported that hazardous heat exposure resulted in an average of 35 fatalities and 2,700 annual cases in industries across the nation. These injuries also resulted in multiple days away from work during the length of injury. 

• Heat exposure injuries may be incorrectly diagnosed or underreported due to failures when documenting at what point the heat exposure caused or contributed to the official cause of death and injury. This is especially true when the victim ultimately succumbs to some other life threatening condition such as a heart attack or stroke, which may have direct correlations with the onset of heat exposure injuries. 

• OSHA will initiate work on a heat exposure index standard. 

• New emphasis on indoor and outdoor heat related hazards.

5. HazCom Proposed Rule

Proposed updates to existing HazCom standards to align with the United Nations Globally Harmonized System of Classification and Chemical Labeling. 

• Classifications for flammable gasses, aerosols, and desensitized explosives.

• Additional requirements for various sized shipping containers. 

• Specific requirements for bulk shipments. 

• Required classifications of hazards under normal use including those that result in chemical reactions and other physical changes. 

More Plans For OSHA

As OSHA continues to evolve to better fit modern industries there are likely to be many more reforms down the road. The administration will continue to focus on reducing injuries, illnesses, and fatalities in all traditional industries while also looking ahead toward future challenges. Future safety violations may surround new chemicals or other workplace hazards in the growing service sector industries. OSHA regulations must also adapt to many more hybrid workplaces utilizing virtual assistance and AI technologies to either replace or assist the bulk of their employees. 

OSHA’s Beat the Heat Contest to Further Temperature Hazard Prevention

Every year companies face challenges during the summer related directly to temperature and heat based injuries, with dozens of employees facing death and severe heat related illnesses every year in the United States. Just last year there were almost 2,000 reported injuries and illnesses related to environmental heat. States in the southwestern United States often face average summer temperatures well over 100 degrees Fahrenheit, subjecting construction and other outdoor industries to dangerous conditions. 

Employers all over the country have already started preparing for the start of summer, and the Occupational Safety and Health Administration (OSHA) has developed several educational resources, regulations, and aids to enhance employee safety. Some techniques OSHA has used to help prevent employee related heat injuries while at work include crafting temperature-illness prevention plans, teaching materials, and ensuring workers have access to things like shade and water. This year OSHA has also launched a ‘Beat the Heat’ contest to incentivize and reward industries taking the necessary steps to prevent employee injuries. 

The ‘Beat the Heat’ Contest

The ‘Beat the Heat’ Contest was started by OSHA this year to uncover more resources and further raise awareness of the risks employees and employers will face this summer. For the contest employers will submit any tools and resources they are implementing to contribute to employee education and work safety regarding heat hazards. The purpose of the contents is industry and public awareness related to the dangers of excessive heat exposure, and to motivate all entities to prevent heat illnesses from occurring. 

A panel of OSHA and federal agency workers will form a judgment panel to decide on a winner of the contest. All members of the panel will have some expertise in relevant heat related subject matter and judge based on the how well the submissions:

• Identify heat risk to workers

• Provide informative messages

• Utilize creative communication methods

• Create engagement with employers, employees, and relevant stakeholders to work together forming effective communications concerning the hazardous risks of heat exposure in the workplace. 

• Apply effective communication and message strategies to be accessible and easily understood by all workers, employers, and relevant stakeholders. 

• Consider the geographic significance of the employment industry sector

Award Categories will include:

• Most Innovative

• Most Creative

• Boldest Message

• Best Non-English Submission

• Highlighting Indoor Heat Hazards

• Highlighting Young Workers

The employee industries will have until June 9, 2023 to submit their entries into the contest, and winners will be determined shortly thereafter. 

Heat-Illness Resources and Education

Heat stress is one of the most commonly reported injuries by workers exposed to extreme heat conditions on the job. Heat stress can result in a variety of complications including heat stroke, heat exhaustion, heat cramps, and heat rashes. High temperatures can also increase the risk of workplace accidents by causing sweaty palms, foggy protective eyewear, and disorientation. Another commonly reported injury is a variety of surface burns from the sun, and from contact with metal surfaces left in direct sunlight. 

Many workers and industries have exposed areas of risk when discussing heat related illnesses and injury. Workers at risk of heat stress include industries that contact the outdoors including hot environments including firefighters, bakeries, farmers, construction workers, miners, boiler room technicians, factory employees, and many others. 

These workers are at a much higher risk when they are overweight, over the age of 65, have heart disease, have high blood pressure, or take medications that may be affected by extreme heat exposure. 

Types of Heat Related Illnesses 

• Heat Stroke

• The most serious heat-related illness that occurs when the body can no longer control its temperature. The body’s temperature will continue to rise until the sweating mechanism fails and the body is unable to cool down, causing permanent disability or death if the person is left untreated. 

• Heat Exhaustion

• The body’s response to excessive loss of water and salt, most likely through excessive sweating. This will most commonly affect the elderly and people with underlying health conditions that are working in hot environments. 

• Rhabdomyolysis

• A medical condition associated with heat stress and prolonged physical exertion in high temperatures. Rhabdo causes the rapid breakdown of and death of muscle releasing large quantities of electrolytes and protein into the bloodstream. This condition can result in irregular heart rhythms, seizures, and kidney damage.

• Heat Syncope

• A fainting episode or unusual dizziness often associated with standing too long or sudden elevation changes of the head above the body. Factors that can exacerbate this condition are dehydration and lack of acclimatization. 

• Heat Cramps

• Usually affect individuals who often sweat profusely during physical exertion or strenuous activity. Sweating depletes the body’s salt and moisture levels creating painful muscle cramps, also an indication of the early stages of heat exhaustion.

• Heat Rash

• A skin irritation caused by excessive sweating during high temperatures and humid conditions. 

All of these conditions should be completely addressed by employer heat prevention plans, and all employees should be fully educated about the risks and early symptom signs related to each heat related illness. 

Heat-Illness Prevention Methods

Planning and supervision are two factors that can significantly reduce heat related illness and injury to employees while at work. Employers should develop a written plan to prevent heat-illnesses from happening so employees have the highest level of safety and awareness.

Prevention Plans should include:

• Who will provide daily oversight?

• How will new workers develop heat tolerance?

• Temporary workers may be more susceptible to heat and require closer supervision.

• Workers returning from leave  (more than two weeks) may be at increased risk.

• How will the employer ensure first aid is adequate and the protocol for summoning medical assistance in situations beyond first-aid is effective?

• How will heat stress be measured?

• How to respond to the National Weather Service’ heat advisories?

• How to determine if the total heat stress is hazardous?

• What training will be provided to workers and supervisors?

Heat conditions can change rapidly and must require day-to-day supervision to ensure all the policies and prevention plans effectively do their job to benefit employees. Supervisory individuals at a work site should be responsible for constantly monitoring and implementing employer heat plans as conditions change throughout the day, and ideally the individual should also be on site where the workers are.