|OSHSPA Reports on State Plan Activities > 2001 OSHSPA Report > State Initiatives: Reducing Workplace Risks|
|State Initiatives: Reducing Workplace Risks|
State plan states have been a strong national force in recognizing emerging workplace hazards and originating new methods for addressing those hazards, including the adoption of new standards. State plans emphasize that whatever the emerging issue, employers are still required to provide a safe and healthful place of employment
In particular, California was the first state in the nation to adopt an ergonomic standard in 1997. State plans are continuing efforts to reduce the number and severity of musculoskeletal disorders caused by risk factors in the workplace.
In 1999, California was first in the nation to place stronger requirements on employers to protect healthcare workers by preventing needlestick injuries. In addition, several state programs are developing formal rules as well as voluntary guidelines to help prevent workplace violence.
California adopted the first workplace ergonomic standard in the nation, effective July 3, 1997. The standard is triggered only when at least two employees at the employer’s worksite who are performing identical tasks are diagnosed with repetitive motion injuries (RMI) by a licensed physician within 12 consecutive months.
California’s workplace repetitive motion injury standard deals with musculoskeletal injuries caused by a repetitive job, process or operation. The Cal/OSHA ergonomic standard contains three independent elements:
Washington adopted a new ergonomics rule on May 26, 2000, which differs from California’s workplace repetitive motion injury standard–its requirements are triggered by specific hazards in the workplace rather than occurrence of musculoskeletal disorder symptoms or injuries. Intended to reduce work-related musculoskeletal hazards (WMSDs) that cripple or injure more than 50,000 Washington workers each year, the Washington rule was adopted after a 20-month rulemaking process that included conferences across the state, extensive work with two large advisory committees, publishing a proposed rule with supporting documents, and 14 public hearings in seven cities statewide.
Key elements of Washington’s ergonomics rule are:
Some employers and labor organizations are eligible for direct financial incentives–safety and health grants or workers’ compensation premium discounts–to help them implement the ergonomics rule. The state has convened a panel of experts to help determine whether employer and employee technical assistance activities are successful and sufficient before compliance with the new rule begins. Copies of Washington’s ergonomics rule, supporting documents, and other workplace ergonomics information and links are available on the Washington Department of Labor and Industries’ website. (See directory.)
North Carolina provides consultation on ergonomics, and the North Carolina Ergonomics Resource Center (NCERC) is a partnership between the state’s Department of Labor and North Carolina State University. Funds were appropriated to the Department of Labor for establishment of the center, which is housed at the university. NCERC opened in November 1994. Its services cover ergonomics consulting and training workshops, on-site ergonomic training individually tailored to a company’s needs, a variety of publications, a series of ergonomics tips dealing with specific industries and environments, and two employee video training packages.
Emphasizing applied research and timely delivery of programs, NCERC identifies, analyzes and corrects ergonomic deficiencies in the workplace. Its primary goal is to act as a bridge for technology transfer and information exchange between the university, state agencies and industry.
Michigan’s Strategic Plan includes musculoskeletal disorders as one of the targeted injuries and illnesses to be reduced 15 percent over the next five years. Even without a standard, MIOSHA can enforce the General Duty requirement and issue citations and penalties in the most extreme cases. Citations are issued where the state finds repetitive motion injuries of which the employer was aware and knew how to prevent, but did not make any reasonable effort to prevent them.
MIOSHA works to “educate before we regulate.” For a number of years the MIOSHA Consultation Education and Training Division has been working with employers and employees to reduce MSD injuries. MIOSHA has an Ergonomics Advisory Committee that was established in 1991 as a proactive voluntary compliance initiative. The committee’s main goals are to promote training regarding ergonomics and to advise on workplace ergonomics issues. The committee also oversees an awards program that recognizes voluntary ergonomic innovations and activities. The MIOSHA ergonomics recognition awards are given to companies that either do innovative ergonomics activities or can show through performance a significant reduction in ergonomics-related injuries.
Connecticut is developing training programs to complement its ergonomics enforcement, and plans to make such training available on CDs. Oregon plans no regulatory action, and is conducting increased training and outreach. A stakeholder advisory group has been formed to work on volunteer programs, a conference, publications and a website.
Utah, Virgin Islands
Utah has not adopted an ergonomics regulation, yet has worked with nursing homes and similar types of businesses since 1993 on the benefits of applying ergonomic principles and practices to help reduce workplace injuries and illnesses. Virgin Islands has not adopted state-specific ergonomics regulations, and its General Duty Clause is used when an employer should have known existing abatement methods for an injury that occurred.
Although it does not have a state ergonomic standard, Minnesota was one of the first states to examine and cite ergonomic problems in the workplace. The ergonomics team, which produced Guidelines for Resident Handling in Long-term Care Facilities, conducts comprehensive inspections of selected facilities that include a thorough review of injury and illness records, a complete walkaround inspection, and abatement recommendations.
On March 20, 2001, the President signed a joint resolution of Congress rescinding federal OSHA’s ergonomics standard and, at the same time, pledging to find a solution to ergonomic-related problems affecting the nation’s workforce. Federal OSHA’s ergonomics program standard had been issued November 14, 2000, and took effect January 16, 2001. Congress acted under authority of the congressional Review Act of 1996. As a result, the standard is no longer in effect, and employers and workers are not bound by federal requirements. In testimony before the U.S. Senate, the Secretary of Labor has stressed an approach based on cooperation and prevention, rather than the adversarial approach of years past.
Attention nationwide is focused on incorporating into OSHA requirements the new technologies of engineered sharps devices and systems without needles. Needlestick injuries are the primary mode of transmission of bloodborne pathogens in the workplace. On July 1, 1999, Cal/OSHA adopted major revisions to its bloodborne pathogens standard to strengthen protection of healthcare workers from the transmission of bloodborne pathogens, particularly Hepatitis B, Hepatitis C and HIV. California was first in the nation to place stronger requirements on employers to use needles and other sharps devices engineered to reduce the chances of inadvertent needlestick injuries.
California’s revised standard covers all employers whose employees may be reasonably anticipated to have contact with blood or other potentially infectious material–including emergency and public safety services, correctional and custodial care facilities–and providers of services to these employers, such as plumbers and launderers, whose employees risk exposure to bloodborne pathogens.
Many factors came together to prompt the revised standard, including state legislation requiring amendments to the existing standard, an advisory committee convened by Cal/OSHA, demands by unions representing healthcare workers for protective action, intensive media coverage and industry input. The concerted action by all parties involved helped ensure that healthcare workers not continue to incur needlestick injuries despite the availability of new technology.
Unions representing healthcare workers view the adoption of the California requirements and issuance of the new federal compliance directive as an important milestone in their effort to obtain protection for healthcare workers from potentially life-threatening exposures to bloodborne pathogens.
The Cal/OSHA standard as adopted has two major components:
Alaska, Hawaii, Minnesota, Tennessee
Since California’s breakthrough in July 1999, Alaska, Hawaii, Minnesota and Tennessee subsequently passed legislation for changes to their bloodborne pathogen standards. Hawaii’s state legislators adopted Senate Resolution 112, S.D. 1 for all healthcare facilities to have a workplace safety protocol in place by January 1, 2000. Alaska adopted a statute that requires employers to use new needlestick controls and mandates training. The new legislation took effect January 1, 2001.
Tennessee legislators enacted a law requiring the commissioners of labor and health to jointly review sharps injury technology to include needles with engineered sharps injury protection and systems without needles–and to jointly determine the environments where standards require that sharps injury prevention technology be employed.
Employers are required to revise their exposure control plans to reflect improvements in sharps prevention technology. They also must do the following to comply with Tennessee law:
Minnesota’s new law, which aims at reducing occupational exposure to bloodborne diseases through sharps injuries, is enforced by Minnesota OSHA in conjunction with the bloodborne pathogens standard. The exposure control plan must document evaluation and implementation of the engineering controls designed to eliminate or minimize exposure to bloodborne pathogens. If an engineering control is evaluated but not put into use, an explanation of why the device was not used should be included in the update to the exposure control plan.
The new law specifies that employee involvement must be through the employer’s safety committee, and this committee is responsible for recommending use of effective engineering controls. Half of the safety committee members must be representatives of job classifications that could use or encounter any device in the category evaluated. Employers not required to establish such a committee must involve their employees in evaluating the engineering controls. Committee recommendations are not binding on the employer.
Employers must establish internal procedures to document the route of exposure and detail the circumstances of any exposure incident. This information should include: engineering controls in use at the time; work practices followed; description and brand name of the device in use; protective equipment or clothing used at the time of the exposure incident; location where the incident occurred; employee training; and the injured employee’s opinion about whether any other engineering, administrative or workpractice control could have prevented the injury. The new law is on their website. (See directory.)
New Mexico has worked extensively with the Emergency Medical Services (EMS) Operations Bureau to develop statewide training and prevention programs for reducing needlestick injuries. The program also encourages local EMS providers to coordinate activities, training and equipment with local hospitals to ensure compatibility of equipment and use of safe needle devices.
Two states have passed legislation requiring the agency to prepare a study and make recommendations. Iowa’s labor commissioner and Department of Public Health are to “…study state and federal laws and regulations relating to protection of persons who may be at risk of needlestick injuries in the course of employment,” with a report to be submitted “…to the governor and the general assembly by December 15, 2001. The report shall include any recommendations for changes in state law or rules…”
The Consultation and Education Bureau is providing presentations and training to long-term healthcare facilities and hospitals on needlesticks, sharps containment and bloodborne pathogens. In 2001, Iowa engaged in a Local Emphasis Program with long-term care facilities with emphasis on needlestick issues.
The Maryland legislature set a committee of Department of Health and MOSH staff to review existing bloodborne pathogen standards and recommend ways to improve worker protection against needlesticks in the healthcare industry. State-specific regulations are pending a legislative hearing.
Puerto Rico approved a Local Emphasis Program on bloodborne pathogens exposure in clinic and reference laboratories covering 677 establishments identified by the Board of Medical Technicians. Emphasis was on the severity of violations to the regulations, and the concentrated enforcement was expected to eliminate these serious issues. In 1996 PROSHO successfully litigated a discrimination case on behalf of three employees required by their employer to either sign a waiver to the Hepatitis B vaccine or bring a certificate of vaccination as a condition for keeping their jobs. The court ordered back pay with accrued interest and reinstallation.
The Needlestick Safety and Prevention Act, which was passed unanimously by Congress, took effect November 6, 2000. The act specified revisions to federal OSHA’s bloodborne pathogens standard and directed the agency to make these changes within six months. The revisions clarify the need for employers to select safer needle devices as they become available, and to involve employees in identifying and choosing the devices. The changes went into effect April 18, 2001.
Specifically, the changes to the federal standard obligate employers to consider safer needle devices when they conduct their annual review of their exposure control plan. The agency conducted a 90-day outreach and education effort before enforcing the regulations.
Alaska, California, Connecticut, Indiana, Michigan, Minnesota, New Mexico, Utah, Virgin Islands, Virginia, Washington
Workplace violence is an occupational safety and health hazard that demands action. Whether the risk of violence comes from a coworker, client, patient or the public, employers must be provided with tools to develop comprehensive plans that reduce levels of risk. State programs are developing formal rules as well as voluntary guidelines to help prevent this type of workplace hazard. Alaska, California, Connecticut, Indiana, Michigan, Minnesota, New Mexico, Utah, Virgin Islands, Virginia and Washington have conducted special emphasis or training programs related to workplace security. Indiana and Minnesota have issued general duty clause citations on workplace violence.
Oregon takes a strong information and training approach to raise awareness and encourage action. By creating several publications and working directly with the Associated Oregon Industries and other groups, statewide education network training forums address this emerging area. Oregon offers on-line training for employers: Developing Your Violence Prevention Program.
California’s 1994 conference on workplace security, the first of its kind, was part of a drive to promote additional research and develop guidelines for preventing workplace violence. California issued Guidelines for Security and Safety of Health Care and Community Service Workers, Cal/OSHA Guidelines for Workplace Security and a Model Injury and Illness Prevention Program for Workplace Security.
Cal/OSHA has been investigating violent worksite events since 1993. Although workplace violence is part of a larger societal problem, the employer in California is still required to provide a safe and healthful place of employment. Employers at risk of robbery or other violent assaults must include workplace security in their injury and illness prevention program. And in response to the growing recognition of violence in the workplace, government agencies that oversee workplace safety are incorporating security issues into safety plans. Fatalities from assaults and violent acts accounted for 18.8 percent of the 1999 California workplace fatality total, down from 23.4 percent in 1998 and decreasing steadily: from 194 in 1995 to 111 in 1999.
Minnesota’s Workplace Violence Prevention Program helps employers and their employees reduce the incidence of violence in their workplaces by providing on-site consultation, telephone assistance, education and training seminars and a resource center. This program targets workplaces at high risk of violence: convenience stores, service stations, taxi and transit operations, restaurants and bars, motels, guard services, patient care facilities, schools, social services, residential care facilities and correctional institutions. The program is administered by the Workplace Safety Consultation (WSC) Division.
Outreach tools include a brochure, Workplace Violence: Are You at Risk? to increase awareness of workplace violence and outline steps to minimize its threat, and a guide, Minnesota Workplace Violence Prevention–A Comprehensive Guide for Employers and Employees, providing sample policies, checklists and tools to help assess and prevent violent incidents.
Washington developed safety and health standards for the late-night retail industry in 1990, and uses enforcement and consultation for hazard abatement and prevention. The Workplace Violence Awareness and Prevention workshop helps participants assess risk factors and develop preventive measures. A written guide covering these topics and a sample prevention program were developed by WISHA with over 30 representatives of labor, business and the academic community. WISHA’s video Is It Worth Your Life? with real-life scenarios demonstrates what workers and employers can do to prevent injuries. The video is distributed to employer networks and associations.
In 1997 the Washington State Department of Labor and Industries’ Safety and Health Assessment and Research for Prevention program completed a comprehensive study of workplace violence based on federal and state data for 1992-95. Homicide was the fourth leading cause of workplace deaths in Washington, and most incidents were consistent with well-known risk factors. Most were committed by persons unknown to the victims, and most of the victims worked in retail trade, security services or transit. The majority of non-fatal injuries also occurred in predictable settings, but in contrast to the fatal assaults, most of these injuries occurred in a setting where the victim and attacker were in a custodial or client-caregiver relationship such as healthcare or social services. While the trend for assaults against private-sector workers in the state was downward, that for state government workers was rising. This study counters the notion that violence on the job is a random event and impervious to remedy. Prevention strategies such as hazard assessment and de-escalation training address risk factors in the work setting.
Utah believes that substance abuse and workplace violence need to be addressed together because of their relationship to each other. Utah has provided seminars for employers and their employees on workplace violence prevention and drug-free workplace programs for the past five years. Since statistics show that over 70 percent of those using illegal drugs are employed, the effect of illegal drug use in the workplace is an issue that demands attention. Since 1997 Utah has been promoting its Take Safety Seriously campaign during prime time with award-winning 30-second spot television announcements, and is one of the first states to produce these infomercials on the effects of substance abuse in the workplace.
Virgin Islands’ Workplace Violence Prevention Program helps employers and their employees reduce the incidence of violence in their workplaces by providing on-site consultation, telephone assistance, education and training seminars and a resource center. In 1999 there were three workplace violence employee-to-employee incidents that required workers’ compensation claims filing. VIDOSH recognizes the need to address workplaces at high risk of violence: convenience stores, service stations, taxi and transit operations, restaurants and bars, motels, guard services, patient care facilities, schools, social services, residential care facilities and correctional institutions. Staff are being trained to provide workplace violence prevention assistance.
During the 2000 session of the General Assembly, the Virginia Department of Labor and Industry was requested to study workplace violence in the commonwealth and submit its written findings and recommendations to the governor and 2001 session of the General Assembly.
Michigan has recently completed work on a "Violence in the Workplace" program. The heightened awareness of the population to workplace exposures due to terrorism, domestic violence and potentially out-of- control workers, along with many requests from employers for assistance, has led to the development of outreach materials by the Consultation Education and Training (CET) Division. Seminars, workshops and training materials are available to assist employers in developing their own workplace violence prevention protocols. The CET Division has developed a program that can be adapted to any workplace, however special segments will focus on high-risk areas such as nursing facilities, late-night establishments and occupations where employees work alone.
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