A restaurant manager taking out the trash in Virginia, a tree trimmer in Ohio and an Alabama school coach sitting inside at a desk are all workers who inadvertently joined a unique club this year: lightning strike survivors. In any given year, the odds of being struck by lightning are about one in a million, but the lifetime odds (over 80 years) are 1 in 10,000. About 90% of all lightning strike victims survive. About 25% of the survivors suffer major medical after effects.
This week is Lightning Strike Awareness Week – and the National Weather Service wants to remind you to be safe. Public awareness campaigns appear to be working because lightning-related fatalities have been trending down in recent years. While there are 55 fatal lightning strikes in an average year, in 2010 there were 29 fatalities, which occurred in 19 states in 2010; in 2009, there were 34 fatalities; in 2008, there were 28 fatalities.
There have been 5 lightning-related fatalities in 2011, one each in LA, MO, MT, NC, PA. Three deaths occurred during agricultural work, one was related to tornado search-and-rescue, and one occurred during golf. While lightning strikes can occur in any month, they spike in the summer months.
When it comes to geographical risks, not all locations are equal – some states are riskier than others. Florida has often been called the “lightning capital of the world,” and although NASA scientists have clarified that Rwanda actually holds this dubious title, Florida still holds the North American title. Rounding out to the top five states for lightning-related fatalities, we have Colorado, Texas, Georgia, and North Carolina.
Are lightning strikes compensable under workers comp?
The answer to that question is a clear and resounding “maybe.” As with so many issues in workers comp, the devil is in the details: state law, where and when the injury occurred, and the nature of the work involved all are factors that come into play. Injuries related to lightning and other weather-related events fall under the murky area of “acts of God” or “neutral risks,” which are generally not considered to be the responsibility or liability of the employer. However, if a worker is exposed to heightened risk due to the nature of their work responsibilities, an injury related to a lightning strike could be compensable.
Often, the burden is on the employee to establish a causal link between their injury and their work or to prove that their job exposed them to increased or heightened risk. Recently, however, the North Carolina Court of Appeals upheld benefits for a framer who suffered injuries related to a lightning strike that occurred while he was at work. The court established that he did not have to provide expert testimony to establish increased risk. “The court concluded that the description of the physical characteristics of the jobsite supported a finding that the framer was at an increased risk of a lightning strike.”
Employers certainly can’t insulate their workers from “acts of God” but there are steps that employers can take to mitigate risk. It’s a good idea to review weather-related hazards with your employees seasonally to raise their awareness about safety best practices both on the job and off. And it is important to take particular care with workers who have outdoor responsibilities or work that might put them at heightened risk. Here are some tools & resources:
Posts Tagged ‘outdoor workers’
The one in a million club you don’t want to join
Tuesday, June 21st, 2011When lightning strikes
Tuesday, July 28th, 2009Summer brings extremes in weather that pose dangers to workers and challenges to employers who must plan for worker safety. This week, four construction workers were hit by lightning in Michigan. A quick Google search demonstrates this is not an anomaly – refinery workers, airport workers, firefighters, farmers and other working people all have too-close encounters with lightning, and a surprising number live to tell the tales of their harrowing lightning encounters.
In a recent MSNBC story, survivors share their experiences and stress the importance of safety. The article highlights 9 myths of lightning safety – including the common misconception that it’s unsafe to touch a lightning victim, a myth that often delays critical assistance, and the faulty idea that you are safe from lightning if you are indoors. As for your odds:
“Nearly 25 million cloud-to-ground strikes occur in the United States each year, according to the National Lightning Detection Network, with Florida topping the list with more than 1.4 million flashes a year and about 25.3 flashes per square mile. By contrast, Washington state is at the bottom of the list, with less than 20,000 flashes per year and about .3 flashes per square mile.”
While experts put your odds of being struck by lightning in any given year at 1 in 700,000, your lifetime odds narrow to 1 in 5,000, and your odds of knowing or being affected by someone who is struck by lightning are 1 in 500. And while it is not totally understood why, some people are struck more than once, such as this unfortunate Oklahoma plant worker who has been hit by lightning 4 times.
The National Weather Service (NWS) keeps track of annual lightning fatalities by state. This year, there have been 25 fatalities, with 4 of those occurring in Florida.
NWS also offers this breakdown of casualties by location or activity:
45% – Open Areas (including sports fields)
23% – Going Under Trees To Keep Dry
14% – Water Related Activities (swimming, boating, and fishing)
6% – Golfing (while in the open)
5% – Farm And Construction Vehicles (with open exposed cockpits)
4% – Corded Telephone (#1 indoor source of lightning casualties)
25 – Golfing (while mistakenly seeking “shelter” under trees)
1% – Using Radios And Radio Equipment
Experts estimate that about a third of all injuries occur during work. Survivors often face daunting medical after effects, which can include personality changes, seizures, memory lapses,fatigue, and depression. Victims are also often are left with permanent scars and markings that are sometimes referred to as lightning flowers or lightning trees, or arborescent erythema.
Resources
For help in learning about or coping with lightning strike after effects, survivors and their families can turn to the non-profit support group Lightning Strike & Electric Shock Survivors International, Inc. (LS&ESSI, Inc.).
The National Lightning Institute issues a fact sheet on Lightning Safety for Outdoor Workers. For more information, see NWS’ page of Factsheets, Publications, Statistics, Policy Statements, Lightning Strikes, More Links. Also, see our past posts on the topic: Lightning safety precautions for work and home and Lightning strike prevention and survivor resources
Compensable Sunshine, Revisted
Tuesday, May 26th, 2009Our blog last week linking skin cancer to workers comp has already generated a few comments. “Workers comp attorney” raises some interesting questions:
(1) How much weight do you give to the person’s leisure activities and/or length of employment? It seems these would certainly be factors in assessing whether the employment is the predominate cause.
When assessing the work-relatedness of skin cancer, claims adjusters will look carefully at non work exposures: hobbies such as hiking, fishing, boating, outdoor sports, surfing, swimming or simply tanning. Balanced against these exposures will be the work setting: outdoors all the time (eg, roofing, migrant farm work, paving) or just incidentally (framing carpentry).
While the case law is still rather limited, there are examples of compensable skin cancers involving a limousine chauffeur (!) in New York and an architect in Texas. [NOTE: a sun screen manufacturer, unsurprisingly, is keeping close track of case law developments!] It is safe to assume that the burden of proof remains on the employee to show that the cancer is work related, but this burden is now supported by substantial medical evidence. Indeed, the existence of government funded education on the risk – here is a CDC link – would tend to support claims of compensability.
As far as length of employment goes, it usually does not matter. As in the case of repetitive motion injuries, the most recent employer is usually on the hook for coverage, even if the employee has only been working for a few weeks.
(2) What steps could employers take to prevent work-related skin cancer other than the mentioned provision of sun screen and policies to enforce dress code?
Employers should just stick with the basics: provide – and enforce the use of – sun screens; require head gear. In the vast majority of exposed workers, this is not happening. There is research showing an increase in skin cancers among Latinos. I wonder if this is related to the negative cultural images associated with protective gear. [NOTE: my teenage daughters hate my wide-brimmed sun hat. It’s just not cool!] [I wear it anyway.]
(3) What about research indicating that some, if not all, sunscreen products are carcinogenic?
While there is some evidence that tanning booths may be associated with cancer, I am not aware of any medical evidence to support a connection between sunscreens and cancer. In any event, the risk of not using a sunscreen far exceeds the risk of using one.
4) What balance should be sought between skin cancer and heat-related illnesses (if any “balance”) as far as prevention is concerned?
Skin and heat protection are not mutually exclusive. People have been covering up in desert cultures for centuries by wearing light colored, loose clothing and head gear. (I hardly need add that American workers would vehemently reject any protective measures that made them resemble middle-eastern sheiks!)
Proactive, Reactive, Inactive?
Another reader wonders how many companies have actually implemented the recommended preventive measures. That’s a great question. Judging by limited observation of workers in the sun, smaller employers have done little if anything to prevent risk. Any time I see a worker in the hot sun, shirtless and hatless, I assume that the cancer issue is simply being ignored.
What, if anything, will mobilize employers to take action to limit sun exposures? It usually comes down to money. Employers who operate in states that view skin cancer as potentially work related will eventually find it cheaper to provide (inexpensive) sunscreens and hats to their workers in the great outdoors. If state courts reject these claims, the workers will bear the burden.
Let’s hope that employers take action before the courts force the issue. We have a known risk and we have proven remedies. Reason says that employers, at a minimum, will immediately share this information with exposed workers. But then again, how often is the voice of reason heard in the American workplace?
Working Outdoors: Skin Cancer and Workers Comp
Thursday, May 21st, 2009With the full heat of summer bearing down on us, the Insider has deputized its readership to become informal safety inspectors: the next time you leave the office, observe any people who are working outdoors. Your checklist should include the fundamental safety drill: fall protection for height exposures; personal protective equipment such as hard hats, work boots and goggles; secure scaffolds and ladders; proper use of machinery (lawnmowers, clippers, circular saws, etc.); proper lifting and efficient material handling.
Here is a safety issue that you are likely to observe in the breach: protection from skin cancer. Exposure to the direct rays of the sun, especially at midday, is a significant safety hazard. Alas, when most people labor in the full sun, they usually take action against the heat, at the expense of protecting themselves from the sun’s rays.
Cancer prevention dictates the wearing of long-sleeved shirts, a hat with neck flaps, sunscreen for exposed skin and sunblock for the nose and lips. When was the last time you saw a landscaper, carpenter or roofer dressed appropriately? When the heat rises, the shirts tend to come off. Bandanas and “do-rags” – considered cool in working circles – keep sweat out of the eyes, but they do little to protect the skin from the sun’s rays. Hats with flaps? Dude, you must be kidding. Goggles and hardhats? They are the first to go when the heat rises.
As for the advice to “avoid exposure between the hours of 10 am and 2 pm,” that is simply not going to happen. There is work to be done and those are prime hours for doing it. Siestas might be culturally acceptable in the tropics, but in our productivity-driven culture, siestas are not an option.
The Compensability Conundrum
As we have pointed out in prior blogs, the connection between work and occupational disease is often difficult to prove. With the exception of public safety employees, most workers face formidable odds in collecting comp for occupational diseases. There often are factors that mitigate against the acceptance of a claim: family history, smoking, fair skin, etc. Workers must be able to prove that workplace exposures are the “predominant cause” of the cancer. Sure, a laborer is under the sun at work; but he or she might also have significant exposure during leisure time, going to the beach, fishing, or just working in the garden.
It’s always interesting to see how state legislatures translate emerging hazards into proposed legislation: lawmakers tend to react in a limited, ad hoc manner. See for example this proposed bill in the New York legislature:
This bill would provide,with respect to active lifeguards employed, for more than 3
consecutive months in a calendar year, by certain local agencies and the Department of Parks and Recreation, that the term “injury” includes skin cancer that develops or manifests itself during the period of the lifeguard’s employment. This bill would further create a
rebuttable presumption that the above injury arises out of and in the course of the lifeguard’s employment if it develops or manifests during the period of the employment.
Note that the symptoms must develop during employment: this in itself may prove problemmatic, as many cancers occur some time after the direct exposure. Beyond that, the bill establishes a compensability presumption for one very limited class of workers, lifeguards. It does not address the myriad workers who face similar hazards on a daily basis (even if their work uniforms involve more than just a bathing suit).
Despite the fact that many workers will develop skin cancers which are likely to be work related, the number of compensable incidents will remain modest. The comp deck remains stacked against workers in the general area of illness.
Compensability and safety are two separate issues. We may not be able to do much about expanding coverage for work-related cancers, but we can take aggressive action to prevent them. It all comes down – as it does so often – to management: do you tolerate your workers’s ad hoc efforts to combat the heat, or do you enforce “best practices” in cancer prevention. Do you make sunscreens and head protection readily available on the jobsite, or do you allow your workers the “individual freedom” to do as they please?
We all know how most managers respond. They take the path of least resistance. The risk of an accident is one thing, the seemingly remote risk of illness is quite another. It will take many more tragic cases of work-related cancers before a true prevention mobilization takes place. For workers struggling under today’s galring sun, we can only hope that a word to the wise is sufficient.
Heat stress: rules, reports, and resources
Wednesday, July 9th, 2008Here in the Boston area, we approach another 90+ degree day and the air is thick and muggy, prompting air quality alerts. But that’s nothing compared to the heat in California where outdoor workers struggle in 104 degree temperatures, with things are even worse for the firefighters who battle to control rampaging fires. Triple digit temperatures have triggered the state’s heat emergency plan. California is one of two states – Oregon being the other – that has issued mandatory heat stress rules to protect outdoor workers. According to California’s Division of Occupational Safety and Health, employers were fined $828,440 last year for failing to comply with these rules.
CDC report: heat fatalities in crop workers
The CDC recently released an important report on Heat-Related Deaths Among U.S. Crop Workers, 1992–2006. During this 15-year period, 423 workers in agricultural and nonagricultural industries were reported to have died from exposure to environmental heat. The heat-related average annual death rate for these crop workers was 20 times higher than for other workers, or 0.39 per 100,000 workers, compared with 0.02 for all U.S. civilian workers. The majority of these deaths were in adults aged 20 to 54 years, a population not typically considered to be at high risk for heat illnesses. And in the dubious distinction department, North Carolina leads the nation in heat-related crop worker deaths.
Employer best practices
The following are best practices for employers with outdoor workers:
- Train employees and supervisors in heat illness prevention, as well as how to recognize the symptoms of heat-related illness and what to do if someone exhibits symptoms
- On days when temperatures require preventive measures, increase the volume of water available to employees. California suggests one quart per hour. It is not enough to simply provide it – workers must be encouraged to drink the water.
- Have shade available for outdoor workers and allow frequent breaks – at least 5 minutes of rest when an employee believes they need a preventative recovery period.
- Have the ability to appropriately respond to any employee with symptoms of illness
- Allow gradual acclimation for workers unaccustomed to working outside – it can take 4 to 14 days
- Know where the nearest hospital is and directions to your work site in case emergency medical attention is needed
Heat-related resources
- Heat Illness – materials in multiple languages
- CDC Extreme Heat
- National Weather Service warnings – or search by state
- Heat Stress Control and Heat Casualty Management (PDF) guidance from the Department of the Army and Air Force
- OSHA Technical Manual on Heat Stress
- CDC Frequently Asked Questions (FAQ) About Extreme Heat
- Heat Stress: Fluid and Electrolite Imbalance Can Be Fatal
- Heat-Related Illness Prevention – California Division of Occupational Safety and Health
- Outdoor Heat Exposure – Washington State Department of Labor and Industries
- NIOSH: Working in Hot Environments
Heat stress rules go into effect in Washington, California
Thursday, June 28th, 2007For the second year in a row, Washington is implementing an emergency heat-stress rule designed to protect outdoor workers. It took effect on June 5 and will run through October. The rule requires employers to provide outdoor workers with a quart of drinking water per hour, to educate employees about risk factors for heat-related illness, and to have some area to treat workers who exhibit heat-related symptoms, such as shade canopies or air conditioning.
The Department implemented the rule after the death of an agricultural worker from heat-related stress in 2005; in 2006, a construction worker died on the job while working in a trench, further solidifying the Department’s resolve about the need for such a measure.
Unsurprisingly, the measure is unpopular with several business groups, which view the rule as both needless and an intrusive layer of bureaucracy. An additional bone of contention is that business had no input into the measure. At the end of this season, the state’s Department of Labor & Industries plans to establish a permanent rule and to seek public input in the process.
California regulation was the pacesetter
Washington is not the only state with such a measure. In 2006, California became the first sate to adopt a heat stress regulation after a spike of 13 heat-related deaths in 2005. In a reminder to employers for the coming season, Cal/OSHA reviews the basic provisions:
Under the new heat illness regulation, employers are required to take four basic steps to prevent heat illness at all outdoor worksites: develop and implement written procedures on heat illness prevention; provide heat illness training to all employees; make readily available and encourage each employee to drink four 8-ounce cups of fresh water per hour; and provide immediate access to shade or any cool area out of the sun for recovery periods for at least five minutes at a time.
Coming to a state near you?
Could such regulations be the beginning of a trend that will move to other states? Last year, the Centers for Disease Control and Prevention issued a report which showed that heat-related deaths are increasing, although some think that the increase can be attributed to better tracking. The report is not specific to workplaces, but if the numbers of heat-related deaths continue on an upward trend, it is possible that we may see an increase in state efforts to protect at-risk populations, including workers
Wise employers who have outdoor workers will look to control risk and prevent heat-related illness, regardless of state mandates. Any time the temperature exceeds 90 degrees, workers should be protected. In addition to providing sufficient water and access to shade, employers should be on the alert for employees with high risk factors. Acclimation to the heat is very significant – a new worker or a worker returning from vacation is at greater risk than a worker who has been acclimated to the heat over a few weeks. Many cases of heat stress occur to workers on the first day of the job. Other risk factors may include pre-existing medical conditions – obesity, diabetes, and heart, lung and kidney disease. Workers who are on medications and workers who are nursing hangovers may be at risk because they are starting work already in a dehydrated mode. OSHA has a Quick Card on Heat Stress (also in Spanish), as well as a Fact Sheet about Working Outdoors in Warm Climates(PDF) that includes prevention tips for heat stress, along with other outdoor hazards.
Additional resources
California – Heat related illness prevention and information
Washington – Outdoor Heat-Related Illness (Heat Stress)
OSHA Technical Manual on Heat Stress
Heat Illness in the Workplace: How You Can Control the Risk
CDC Frequently Asked Questions About Extreme Heat
Heat stress: fluid and electrolyte balance can be fatal