Archive for August, 2009

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Can you hear me now? Work-related injuries for musicians

Tuesday, August 11th, 2009

Last week, 61-year old rock musician Steven Tyler fell off the stage and suffered a broken shoulder, along with stitches in his head and back. He has had to cancel upcoming shows, though it’s likely he’ll be on a self-imposed return-to-work plan in the near future. Many musicians are like athletes in their devotion to their profession and their determination to return to work as soon as feasible. (Not to mention the economic impact of canceling shows, which although there is event cancellation insurance for that type of thing, still must take a bite from a musician’s earnings.)
Falling off stages isn’t all that unusual a work-related occurrence for musicians and other performers. Celebrity spills are a favorite fare on the Internet, with video clips drawing millions of viewers and little sympathy. Fashion model falls seem to be a particular favorite for the YouTubers, and frequently available given that a job-related hazard for models is teetering around on ridiculous footwear. But despite the vicarious pleasure that many viewers take in seeing pop culture icons coming down to earth, slips and falls are nothing to take lightly – they are one of the most common injuries in many professions, resulting in disabling injuries. They are also a leading source of fatalities in the construction industry.
Injuries beyond the falls
We went looking for more information about musician injuries and came upon Looking at Musicians’ Health Through the Ages, an examination of performance-related musculoskeletal disorders (PRMDs) from the scholarly Medical Problems of Performing Artists. This is a publication that bills itself as “…the first clinical medical journal devoted to the etiology, diagnosis, and treatment of medical and psychological disorders related to the performing arts. Original peer-reviewed research papers cover topics including neurologic disorders, musculoskeletal conditions, voice and hearing disorders, anxieties, stress, substance abuse, disorders of aging, and other health issues related to actors, dancers, singers, musicians, and other performers. Alas, the interesting articles entitled “Bagpiper’s Hernia” and “The Psychological Profile of a Rock Band: Using Intellectual and Personality Measures with Musicians” are available only to subscribers.
For some other sites related to musician injuries, see Musician’s Health, an educational website devoted to common musician’s injuries and information on preventing those injuries. Instrumental injuries often include similar repetitive motion injuries to those that are commonly associated with computer use. Musicians’ Injuries describes various types of performance-related injuries and offers advice on how to avoid them.
Hearing-related injuries are common for musicians
Hearing loss is another risk for musicians and conductors – and not just for rock musicians, as might be commonly assumed. Doug Owens, a USM music education professor and trumpet player who has experienced hearing loss himself, has been studying the issue of hearing loss and musicians. For his doctoral dissertation, he had ten high school band directors wear noise monitors for two days on the job.

“Owens found they were exposed to mean average noise levels of 85 to 93 decibels, similar to a vacuum cleaner or a leaf blower. Noise exposures peaked at 101 to 115 decibels, similar to a jackhammer or a crowd at a basketball game.
Comparing eight-hour exposure rates, Owen found noise levels for all of the band directors were more than three times higher than recommended by the National Institute of Occupational Safety and Health.”

In learning more about this topic, we also discovered H.E.A.R., a site with an acronym that stands for Hearing Education and Awareness for Rockers. The site describes itself as “a non-profit grassroots hearing health organization of hearing professionals, audiologists, ear doctors, educators, music industry professionals, and musicians dedicated to the prevention of hearing loss and tinnitus for musicians, music students, recording engineers, music industry professionals and music fans, especially young people.” The site offers the latest in hearing-related research, news and advice, along with a quick and easy test to assess whether concerts are harming your hearing.

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The End of Civil Discourse?

Monday, August 10th, 2009

We live, alas, in interesting times. As the health care debate spirals downward, the fault lines in our culture become more and more evident. On one side, anti-reformers stack town meetings to prevent any meaningful dialogue from taking place. These folks are even trying to intimidate unions. What am I missing here? Who is supposed to intimidate whom? On both sides of this momentous debate, pockets are being stuffed with special interest money. This makes the ultimate outcome – whether status quo or some degree of reform – highly suspect. The notion of genuine debate and civil discourse have disappeared altogether.
Which leads us back for a moment to the lingering conflict between UPS and FedEx. Back in December, we blogged FedEx’s unusual charter:

FedEx began 35 years ago as an airline. As such, it fell under the Railway Labor Act of 1926, which made unionization of public and commercial transport companies extremely difficult. By contrast, UPS began as a trucking company and was subject to the National Labor Relations Act from day one. UPS is unionized: they pay workers more than FedEx, they provide better benefits.

It would be to UPS’s advantage to remove their fierce competitor from the Railway Labor Act and force them to operate under the NLRA. That requires an act of congress, so it’s no surprise that UPS has been aggressively lobbying congress for this change. They say they want to level the playing field.
Level playing fields are fine. The devil is in the details: how do you accomplish your goal? Apparently, by playing unfairly. UPS has been accused of forcing union members to write to their congressmen, urging passage of legislation to eliminate the FedEx exemption. The letters bombarding congress appear to express the views of individual UPS drivers. In fact, many are based upon prescribed forms. We read in the Washington Post:

Officials with UPS and the International Brotherhood of Teamsters, which represents 240,000 UPS drivers, acknowledge that the company has paid for workers’ time to pen many of the letters and has supplied the envelopes, paper and stamps needed to mail thousands of them to Congress. UPS spokesman Malcolm Berkley said the effort was “totally voluntary, and any allegations to the contrary are ridiculous.”

But Internet sites dedicated to UPS-related discussions feature dozens of accounts from anonymous employees who in recent weeks have said they were forced to write the letters or felt they would be punished for not doing so. Such tactics could run afoul of both labor laws and lobbying disclosure requirements, according to legal experts.

So it appears that UPS may be violating labor laws in order to force FedEx to operate under labor laws. Were you expecting anything different?
Images
In one of Norman Rockwell’s many iconic images, a humbly dressed man stands up in a town meeting to express his opinion. The painting is entitled “Freedom of Speech.” We could certainly argue the degree to which such freedoms ever existed. But it’s all too clear that Rockwell’s image bears no relation to what is occurring today. If he were to depict our present situation, we would see an enraged citizen shouting down his local congressman. This individual would waive an inflammatory poster complete with Nazi symbols. In his pocket, we might glimpse the bus ticket that brought him into town. In the corner we might see an innocent mother, huddling to protect her child from the pending violence.
We are currently facing many complex issues, ranging from FedEx’s status as an employer to the health care options for every American. There are pros and cons to every path. No one really knows how to get from point A to point B. Indeed, we may not even agree on what point B is. But when civil discourse deteriorates into the ravings of the mob, we all lose. If winning is defined by who shouts the loudest, who cheats the most effectively, who succeeds in intimidating the oppostion, there will be no victory for anyone.

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Posted in Best Practices, Business, health care | 6 Comments »

Health Wonk Review’s Recess Edition and news from the blogosphere

Thursday, August 6th, 2009

Congress may be on vacation but the dedicated health policy bloggers are certainly on the case so you should face no shortage of wonkery. Jaan Sidorov has posted the August Recess Edition of Health Wonk Review at Disease Management Care Blog – well worth your perusal.
And as long as we’re on the topic of health care, kudos to the folks at Kaiser Family Foundation who have put together an interactive tool that allows for side-by-side comparisons of two or more healthcare reform proposals across a number of key characteristics and plan components. It will be regularly updated to reflect changes in the proposals and to incorporate major new proposals as they are announced.
Other news from the blogosphere and beyond
OSHA – President Obama has nominated David Michaels as Assistant Secretary for the Occupational Safety and Health Administration, Department of Labor. David Michaels, PhD, MPH, is an epidemiologist and is currently Research Professor at the Department of Environmental and Occupational Health at the George Washington University School of Public Health and Health Services. In addition to his biography in the release, read more about him in his biography at George Washington University. The folks at OSHA Underground have more and this nominee is also welcome news to The Pump Handle gang as evidenced by the comments in the announcement post.
In more OSHA news, Heidi at The Facility Blog posts about OSHA’s new national emphasis program (NEP) on recordkeeping. The NEP was prompted after congressional hearings last year which raised the issue of under-reporting. The program will institute a policy that prompts recordkeeping inspections at employers’ establishments with low incidence rates in historically high rate industries and will also incorporate inspections of a sample of construction firms. See Heidi’s post for more details on the program.
Pharma – Freshly back from his vacation in the Tanzanian bush, Joe Paduda offers his take on the workers comp implications of the Administration’s drug deal.
Lean claims handling – Roberto Ceniceros has made lots of good posts over at Comp Time this week. Read about how the manufacturing trend to streamlined processing is surfacing in insurance as “lean” claims handling.
Firefighters – August 17 to 21 is National Firefighter Health Week. Despite the dangers that they face on the job every day, the real threat to their health is heart disease – nearly half of all firefighter deaths are caused by heart attacks. The National Volunteer Fire Council sponsors a site with resources and programs designed to encourage first responders to learn their risk factors, commit to making healthy lifestyle changes, and keep the momentum going all year.
NY construction training scam – a new law in New York City requires 10 hours of training for all workers hired at high-rise buildings begun after July 1. The New York Daily news reports that fake 30-hour construction training cards are surfacing. Apparently, three companies in New York and one in Nevada have been busted for issuing these bogus cards and a few dozen other companies are under investigation.
Lighter side – Consumer Insurance Blog posts an amusing video of clever ads from Bangkok Insurance which do a good job illustrating the concept of probability.

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Distractions Behind the Wheel, Revisited

Tuesday, August 4th, 2009

The other Nicholas Sparks is in a bit of trouble: not the well-known writer, but an obscure 25 year old tow truck driver from upstate New York. The lesser known Sparks has earned himself a place in the Business Hall of Shame when he raised multi-tasking to new heights (or better, depths). He was talking on one cell phone, texting on another(!), when, surprise of surprises, he lost control of his vehicle, smashed into another car, careened across a front lawn and plunged his flatbed tow truck into a swimming pool. The 68 year-old woman driving the other car suffered head injuries but is in good condition; her 8 year old niece suffered minor injuries.
Sparks has been charged with reckless driving, talking on a cell phone and following too closely. He was driving a truck for Adams Towing Company. While I was unable to find an area company listed under this name, I do hope they carry robust liability coverage. The company is clearly guilty of negligence and will pay dearly for their multi-multi-tasking employee.
Driven to Distraction
The New York Times has singled out the use of cell phones while driving as a major danger. They have a begun a series focusing on this new road hazard entitled “Driving to Distraction.” In their most recent article, they describe the ubiquitous talking on cells performed by taxi drivers. (My family caught a cab during a downpour in Brooklyn last week; I sat in the front seat and listened to one side of a conversation in an Arabic tongue that was underway when we entered the cab and continued after we had paid and exited.)
While New York City has one of the most stringent laws in the country prohibiting taxi drivers from using cell phones while driving, it is rarely enforced. Fewer than 800 summonses were issued to cab drivers in 2007. If the law were enforced, the annual summonses would run in the hundreds of thousands.
It all comes down to this: anyone who drives can no longer plead ignorance to the dangers of talking/texting and driving. A new and potentially huge liability has emerged for the employers of people who drive in the course of employment. The employers are going to be held accountable for the mistakes of their employees. Property will be damaged and people will be hurt, even killed. In order to avoid liability, management will have to demonstrate that effective cell phone policies have been both promulgated and enforced.
Which leads to one final question: with liability ultimately falling to the insurance companies, what steps have they taken to ensure that policy holders have mitigated this ever-increasing risk? How will their underwriters identify the companies most likely to produce the next Nicholas Sparks – the driver, that is, not the writer.

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Posted in Best Practices, Safety & Health | 2 Comments »

Compensable Fun

Monday, August 3rd, 2009

There is an ongoing debate concerning the compensability of injuries that occur during company sponsored recreation. As Dr. Suess might say, “These things are fun and fun is good,” except when your employer makes you do it. There is a fine line between employees participating because they want to, as opposed to feeling that they have to.
Clark Kauffman has a nice summary of the compensability issues in the Des Moines Register. He sites the case of Robert Powell, an employee of the Cedar Rapids Gazette, who injured his back bowling at a “Family Fun Fest” sponsored by his employer. His injury was compensable – to the tune of $100,000 – because the employer urged participation: “Don’t make us cancel this event from lack of interest/attendance.”
Iowa has some interesting case law regarding compensability:
Hunting: way back in 1933 Claire Fintzel was trying to close a deal while pheasant hunting with a business associate. He was shot in the leg. He received $15 a week for 100 weeks (a paltry sum, to be sure, but this was back in the depression).
Boating: In 1941 Roy Linderman, a salesman for Cowie Furs, won a company-sponsored contest for highest sales. His prize? A fishing trip, during which, alas, he drowned. His death was deemed compensable.
Basketball: In 1982 Professor Charles Campolo of Briar Cliff College was partcipating in a faculty-student basketball game. At age 40, Campolo had a known heart condition. He died in the game’s final seconds. Because the school derived a benefit from his participation, the death was compensable.
State by State
Kauffman takes a brief look of the compensability issue from state to state. It usually boils down to this: is the event truly voluntary? Does the employer derive a direct business benefit from the activity? To some degree the burden of proof is on the employer to demonstrate that there is no pressure on employees to participate – that participation is not the only true measure of “team spirit.”
The state of Tennessee recently revised their comp statute, to provide clarification on the compensability issue. The statute is brief but comprehensive:

Public Chapter 407 (SB1909/HB1500) excludes from workers’ compensation injuries that occur during recreational activities that are not required by the employer, and do not directly benefit the employer. Workers’ compensation injuries that are covered under workers’ compensation include those that occur where participation:
1) was expressly or impliedly (sic) required by the employer; or
2) produced a direct benefit to the employer beyond improvement in employee
health and morale; or
3) was during work hours and was part of the employee’s work duties; or
4) occurred due to unsafe conditions the employer had knowledge of and failed to
curtail or cure the unsafe condition.

This statutory language summarizes the issues without tying the hands of judges unnecessarily. It’s a good model for legislators contemplating changes. Beyond that, it’s good policy guidance for employers who want to encourage team building and fun, without creating inadvertant comp exposures.
NOTE: Our collegue Julie Ferguson has related blogs here and here.

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