Archive for the ‘History’ Category

Bagpiper’s Fungus, Cheesewasher’s Lung & other obsolete occupational maladies

Friday, March 22nd, 2013

wool-srters
Did you ever hear of rose gardener’s disease, nun’s chastity of fiddler’s neck?
All apparent names for occupational maladies of yesteryear. Watch this fascinating short video clip charting 10 strange occupational hazards.
Some of these conditions are associated with professions that are confined to the dustbins of history – becoming a loblolly boy isn’t a career path for young boys anymore. And some of these conditions may still exist, they are likely just rebranded. Others may have just adapted to modern tastes – cheesemaker’s lung may be largely a hazard of the past, but unfortunately, Popcorn Lung is not.

Lessons from Ernest Shackleton’s Medical Kit

Tuesday, October 2nd, 2012
“Men wanted for hazardous journey. Low wages, bitter cold, long hours of complete darkness. Safe return doubtful. Honour and recognition in event of success.”

That is the ad that was allegedly posted to attract crew to Sir Ernest Shackelton’s Arctic Expedition on the Nimrod in 1907-09. There’s been a lot written about this adventure to one of the then-most remote corners of the earth. It is still among the most remote wilderness locations today – contemporary workers who agree to stint at Antarctic bases have to prepare for a long haul since some locations only afford a two to three month window when bases are reachable.
A few years ago, when Gavin Francis accepted the position as a medical doctor ‘wintering’ at Halley Base, a profoundly isolated research station on the Caird Coast of Antarctica, he had to plan accordingly since the base is unreachable for ten months of the year. He’s written a pretty fascinating article in Granta magazine comparing the preparations he took in terms of supplying a medical kit with the list of supplies in Shackleton’s Medical Kit.

“In the well-stocked polar section of the little base library I unearthed the packing list for Shackleton’s medical kit – the drugs and dressings he took on the sledge trips of his Nimrod Expedition of 1907, the one that turned back only ninety-seven miles from the South Pole. It added up to a weight of about three kilos, less than a sixth of the modern kit, and to my technomedical mind read more like a witch’s grimoire than the best medical advice of just a century ago.”

It’s a pretty fascinating read, one that we think might tickle the fancy of occupational physicians. We enjoyed the author’s observations about how the practice of medicine has changed, particularly in regards to the challenges of caring for a workforce in a remote location.
Chances are, no matter how remote your workplace, planning for employee health and safety program doesn’t have quite the same extremes in parameters. But one thing remains true: advance planning can still mean the difference between life and death; knowing how to respond quickly can be the difference between a relatively minor event and a life-changing tragedy.
What’s the status of your workplace first aid kit?
In Fundamentals of a Workplace First-Aid Program (PDF), OSHA suggests:

“Employers should make an effort to obtain estimates of EMS response times for all permanent and temporary locations and for all times of the day and night at which they have workers on duty, and they should use that information when planning their first-aid program. When developing a workplace first-aid program, consultation
with the local fire and rescue service or emergency medical professionals may be helpful for response time information and other program issues.”

The booklet outlines OSHA Requirements, recommended First-Aid Supplies, including Automated External Defibrillators, guidance on First-Aid Courses and Elements of a First-Aid Training Program. In addition to evaluating their own organization’s risk factors, employers should be aware of any state laws governing workplace first aid.
ANSI/ISEA Z308.1-2009 is the current minimum performance requirements for first aid kits and their supplies that are intended for use in various work environments. You can purchase these through the American National Standards Institute (ANSI) or the International Safety Equipment Association (ISEA). If you want to save a few dollars, you may be able to find a free copy, such as the one we found minimum contents list from the Minnesota Department of Labor and Industry.
Automated external defibrillators (AEDs) programs are an increasingly common component in a workplace health and safety program to address sudden cardiac arrest. These programs require some medical guidance and training to put in place.
Arguably, one of the most parts of your emergency planning should be to prepare your employees and your supervisors about what to do in the case of a medical emergency. Put your policies and protocols writing and communicate them to your employees frequently. Don’t forget to include solitary and remote workers in your emergency planning.

Labor Day Roundup: Here’s to the Workers

Tuesday, September 4th, 2012

As a belated tribute to Labor Day, we offer a smorgasbord of items about work, worker safety, and some of our favorite tributes to workers.
Celebrating the American Worker
America at Work – Alan Taylor compiles superlative photo essays for The Atlantic’s In Focus series. This collection of images from the recent Recession and its years of uncertainty — of men and women both at work and out of work in the United States.
Earl Dotter, Photojournalist – A remarkable portfolio of work documenting American workers. In the author’s words:
“For more than thirty five years the camera had enabled me to do meaningful work. Starting with Appalachian coal miners, and continuing through the years over a broad array of occupations in all regions of the country, I have observed and documented the working lives of Americans. Standing behind the lens, I have celebrated their accomplishments. I seek out those who are taking steps to improve their lives and their effectiveness at work, and use the camera to engage them by giving testimony to their achievements. The images that result tell of the satisfactions their work brings as well as its everyday challenges.”
Lost Labor – For more than 20 years, visual artist Raymon Elozua has been assembling a vast collection of company histories, pamphlets, and technical brochures that document America’s industrial history. This site features 155 photos from that collection – images of factories, machinery, and laborers hard at work. Many of the jobs depicted have faded into history. The artist grew up in the South Side of Chicago in the shadow of the giant steel mills and factories. His dad worked at U.S. Steel and his first job was at U.S. Steel, triggering a life long interest in everything about these industrial behemoths, from the architecture to the people who worked the jobs within. His interest in documenting this bygone era of American working life was sparked by the demise of the South Works industries.
Worker Safety
Hard Labor – The Center for Public Integrity says: “Each year, some 4,500 American workers die on the job and 50,000 perish from occupational diseases. Millions more are hurt and sickened at workplaces, and many others are cheated of wages and abused. In the coming months the Center for Public Integrity will publish, under the banner Hard Labor, stories exploring threats to workers — and the corporate and regulatory factors that endanger them.”
In particular, we point you to two recent stories:
Fishing deaths mount, but government slow to cast safety net for deadliest industry
Kentucky death case: Another black eye for state workplace safety enforcement
The Best Reporting on Worker Safety – ProPublica compiled “12 pieces of great reporting on workplace safety: from slaughterhouse diseases to lax regulatory oversight and deadly vats of chocolate.”
Workers in Popular Culture

From our archives

When it Comes to Safety, This is Just Ducky…

Monday, May 14th, 2012

We begin the week on a somewhat bizarre note, as Donald Duck does safety in this vintage 1959 cartoon clip entitled “How to Have an Accident at Work.” When it comes to safety, Donald is everyone’s nightmare worker. For those of us in the workers comp field, this may seem more horror film than cartoon, but Donald, unlike ordinary workers, is literally indestructible.

This clip was a sequel to “How to Have an Accident in the Home”

Safety Nets, Hard-Boiled Hard Hats & The Halfway to Hell Club: Safety Innovations in the Golden Gate Bridge Construction

Friday, April 20th, 2012

In an era when one death per million dollars spent on bridge construction was axiomatic, chief engineer of the Golden Gate Bridge Joseph Strauss decided his project would be different. He refused to accept the conventional wisdom that worker deaths were just a normal cost of doing business and introduced a series of safety innovations – you can see an overview in this brief video clip:

More on his commitment to safety during construction is presented in the PBS American Experience documentary “Golden Gate Bridge.” Perhaps the innovation that was most touted was the introduction of a safety net, “… similar to a circus net — suspended under the bridge. The safety net extended ten feet wider than the bridge’s width and fifteen feet further than the roadway’s length.” While there was one deadly accident when a scaffold platform fell and broke through the net resulting in 10 fatalities, there is no doubt the net saved many other lives. Nineteen survivors whose falls were stopped by the net became de facto members of “The Halfway to Hell Club.”
Strauss employed many other fascinating safety innovations, ranging from sauerkraut juice “cures” for men suffering from hangovers to special hand and face cream to protect against winds. But next to safety nets, the other noteworthy safety practice that emerged during the bridge’s construction was the reliance on hard hats. The hard hats of the era were called “hard-boiled hats,” and were made of leather and canvas. You can read more about the history of the hard hat at the Bullard site. Edward W. Bullard first introduced the hats in 1919, based on a doughboy hat he had worn in WWI. His hats were originally created to protect miners. The Bullard history says:

America’s first designated “Hard Hat Area” was set up at the San Francisco Golden Gate Bridge construction site. “The project’s chief engineer, Joseph B. Strauss, shared a vision with my grandfather that the workplace could be a safer environment for the worker. One problem the bridge project faced was falling rivets, which could cause serious injury,” said Bullard. “My grandfather transformed the mining helmet into a durable industrial hard hat.”

We would be remiss if we did not note that the status of being “the first official hard-hat area” is under some dispute – some contest that the Hoover Dam construction was the first work site to mandate hard hats:

The Bullard Company asserts that the first official “Hard Hat Area” was the Golden Gate Bridge project in San Francisco. The project’s chief engineer, Joseph B. Strauss, beginning on January 5, 1933, directed all the workers to wear hard hats to protect themselves from falling rivets and other materials. However, the Six Companies constructing Hoover Dam first required all its workers to wear hard hats by November 1931.Bullard-Hard-Boiled-Hats

Here’s a picture of the vintage “Bollard hard boiled hats” of the era, courtesy of Hal’s Lamp Post, a site with an excellent and very interesting collection of mining artifacts.

Original image source

100 Years of Workers Comp

Tuesday, April 3rd, 2012

vintage photo of ambulance and injured worker
We’re happy to bring you this 12-minute, must-watch video commemorating the 100th Anniversary of Workers Comp. The video highlights progress in worker safety, treatment of injured workers and risk management in the past 100 years. In addition to telling the history of comp, it also features three visionary women who were instrumental in furthering health and safety of workers…one of whom witnessed the Triangle Shirtwaist fire. Until this clip, I did not realize the strong role that women played in this history.
Kudos go to Sedgwick as well as to our colleague and friend Peter Rousmaniere. who wrote the script.
Here’s some additional information about the women highlighted in the video clip:
Crystal Eastman
Frances Perkins
Alice Hamilton MD

From imagination to reality in less than a century: Telemedicine and Electronic Health Records

Tuesday, March 20th, 2012

1925-feb-science-and-invention-sm-cover

Today, we slip back in time to 1925 and put on our Flash Gordon glasses to speculate about the future, a time when a doctor not only “sees what is going on in the patient’s room by means of a television screen” but also employs a robotic-like instrument called the Teledactyl (Tele, far; Dactyl, finger — from the Greek) to “feel at a distance.”

This image and the story comes from a delightful Smithsonian blog called Paleofuture in a post entitled Telemedicine Predicted in 1925. The post discusses an article by Hugo Gernsback that appeared in the February, 1925 issue of Science and Invention. You can read more about the intriguing robotoic Teledactyl device and Gernsback’s predictions for medicine of the future.
Fast forward to 2010, and we see how remarkably prescient Mr. Gernsback’s predictions were. Courtesy of a blog comment by Christoph Hadnagy, we find this link to a New York Times story on Denmark Leads the Way in Digital Care, in which 77-year old patient Jens Danstrup talks about what it’s like to be a telemedicine patient:

“You see how easy it is for me?” Mr. Danstrup said, sitting at his desk while video chatting with his nurse at Frederiksberg University Hospital, a mile away. “Instead of wasting the day at the hospital?”

He clipped an electronic pulse reader to his finger. It logged his reading and sent it to his doctor. Mr. Danstrup can also look up his personal health record online. His prescriptions are paperless — his doctors enters them electronically, and any pharmacy in the country can pull them up. Any time he wants to get in touch with his primary care doctor, he sends an e-mail message.

All of this is possible because Mr. Danstrup lives in Denmark, a country that began embracing electronic health records and other health care information technology a decade ago.

Adoption of Electronic Health Records in the US
The Centers for Disease Control issues an annual survey on the use of electronic health records in physician’s offices. Last year, partly bolstered by meaningful use incentives in the Affordable Care Act, use grew by 6%. Dr. Elliot King blogs on the EHR increase, noting that:

“In 2011, 57 percent of office-based doctors used electronic medical records/electronic health records (EMR/EHR), according to the CDC. That number compares to the 50.7 percent of physicians’ offices using EMR/EHR’s in 2010 and 48.3 percent in 2009.”

Some physicians are also taking to telemedicine via Skype, FaceTime and other video conferencing services. In Doctors who Skype: Renegades or Heroes?, Jean Riggle looks at the pros and cons of video chat as used by physicians. She notes that there currently aren’t any guidelines for electronic communication between physicians and patients and there there are several important questions yet to be solved:

  • How can these chats be integrated into the patient’s medical record?
  • Can the actual video be captured and inserted into the record or should a summary of the call suffice?
  • How should physicians be reimbursed for the time they spend using social media?

To follow developments in telemedicine, we offer a few sources:
HealthIT.hhs.gov
Federal Health IT programs
American Telemedicine Association
iHelathBeat
Healthcare IT News

Remembering Two Prominant Risk Takers

Thursday, June 30th, 2011

We are about to observe the 235th anniversary of the Declaration of Independence. As is so often the case with holidays, the ways we celebrate will not have much to do with the original events. As we indulge in a weekend of family reunions, sporting events, cookouts, libations and fireworks – along with hours sitting in traffic – we are unlikely to give much thought to the conditions that led to the promulgation of that remarkable document. So as we prepare to hit the roads, let’s take a moment to acknowledge two of the remarkable risk takers who helped make this all possible.
Let’s begin with John Adams. He trained at Harvard to become a minister, but chafed at being told what to believe and what to think, so he became a lawyer instead. On March 5, 1770, six years before the formal break from England, an unruly mob gathered in front of Boston’s Customs House. After pelting British troops with snowballs and rocks, the crowd surged forward; the troops fired into the mob, killing five people. From the colonial viewpoint, this was the “Boston Massacre.” As far as the British were concerned, it was a riot. Both views are credible.
Unpopular Cause
Captain Thomas Preston and 12 soldiers were charged with murder. No Boston lawyer would take their case, so the plea was made to John Adams, who at the time was practicing law (not all that successfully) in Quincy, about 15 miles from Boston. Adams took on the case, at considerable personal risk. His words at the time should be taken to heart by any politician seeking a vote:

“Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.”

Under Adams’ skillful defense, six of the soldiers were acquitted. Two who had fired directly into the crowd were charged with murder, but were convicted only of manslaughter. Adams was paid eighteen guineas by the British soldiers, or about the cost of a pair of shoes. Beyond the fee, Adams wanted to prove to the world that American justice was balanced and fair.
Self-Evident Truths
Just six years later Thomas Jefferson wrote – and Adams helped edit – the Declaration of Independence. After ratification of the final language (which, to Jefferson’s chagrin, excluded a ban on the importation of slaves), a prayer was said and in silence the delegates to the convention applied their signatures to the document.
In the entire history of risk taking, there are few events of greater magnitude. The document would be considered treason by the most powerful government in the world; should the revolution fail – and that itself must have seemed highly likely – each signer would pay with his life, .
The Perspective of Time
One month before his death, Adams wrote of the upcoming July 4, 1826, festivities:

My best wishes, in the joys, and festivities, and the solemn services of that day on which will be completed the fiftieth year from its birth, of the independence of the United States: a memorable epoch in the annals of the human race, destined in future history to form the brightest or the blackest page, according to the use or the abuse of those political institutions by which they shall, in time to come, be shaped by the human mind.

Somber thoughts from one who was there at the beginning – and who would likely be appalled by some of the subsequent uses and abuses of his work.
As most Insider readers probably know, Adams and Jefferson both died on July 4, 1826, fifty years to the day after the Declaration was issued. Adams desperately wanted to outlive Jefferson; just before he died, he said – perhaps bitterly – “Thomas Jefferson survives.” Ironically, word had already gone out from Monticello that Jefferson had died earlier the same day. It is perhaps reassuring that such great souls could also be small minded and petty. There is still hope for us all.

Illinois Comp: The Nuclear Option?

Tuesday, May 17th, 2011

Illinois is struggling mightily with its bloated workers comp system. Currently ranked 3rd highest for overall cost in the Oregon study, the governor and legislature are under intense pressure from the business community to lower the cost of comp insurance. Aiming its powerful bulldozers at the state capital, the Caterpiller Company has threatened to move their business somewhere else if reforms are not implemented immediately. In exploring all options, the legislature has gone so far as to think the unthinkable: abolishing workers comp.
In looking for ways to save money, Illinois does what all states do: first, identify the cost drivers and then try to change the statute to bring down costs. Among the hot issues on the table are the medical fee schedule (too generous), employee choice of doctor (too flexible), duration of benefits (too long), causation (too vague). Ah, behind every cost driver is a vested interest (perhaps literally vested, with many of the lobbyists wearing three piece suits). The common denominator among all states struggling with high comp costs is the omni-present stakeholder, who is deeply committed to the status quo.
Governor Quinn would like to see a number of reforms, including the capping of carpal tunnel benefits, denying claims where employee intoxication is a significant factor, attacking fraud (see our blog on Illinois’s dubious arbitration services), capping wage differential benefits at age 67 or five years after an injury, and implementing utilization review for physical therapy, chiropractic and occupational therapy services.
Going Nuclear
The Illinois legislature is so frustrated with the slow progress and with stakeholder resistance to change, they are now threatening to blow up the entire system. Interesting to note, this pressure is coming from the Democrats. John Bradley (D-Marion) has filed House 1032, a bill to repeal the workers comp act and send all workplace-injury issues into the court system. Should this happen, Illinois will find itself in the world prior to 1912, when injured workers had to sue their employers and could collect benefits only if their injuries were caused by someone other than themselves. They would collect no benefits while awaiting adjudication of their claims. They would be out of work and out of luck.
In all likelihood, repeal of workers comp is not a serious option in Illinois; it’s a political strategy for getting the attention of inertia-bound legislators. But the prospect of abolition does raise an interesting issue. Workers comp came to America 100 years ago. By the end of the World War II, every state had implemented the program.
What if there were no workers comp programs today? What if each state were starting from the beginning and tackling the issue of protection for injured workers? I find it hard to imagine that state legislatures would be willing to implement a program, totally funded by employers, that provides indemnity for lost wages and 100 percent medical benefits for injured workers. Why so generous? Why so inclusive? It’s too expensive. It will create disincentives for working. The cost will drive employers out of business or out of state.
With today’s acrimonious, ideology-driven debates, workers comp would be a hard sell. That’s too bad, for despite its problems and inequities, despite the wide variations in benefits and costs from state to state, comp is a compelling example of effective social engineering. In Illinois, cooler heads will likely avoid the meltdown option. To be sure, Illinois comp is a mess, but the alternative – a workplace without workers comp – would be far worse.

Are events in Wisconsin part of a union busting initiative?

Tuesday, March 8th, 2011

Later this month, we will mark the 100 year anniversary of New York’s horrific Triangle Shirtwaist Fire, an event that claimed the lives of 146 garment workers – young girls and women – who had been locked in the sweatshop to prevent theft. Most died in stairwells, jumping down the single elevator shaft, or by hurtling themselves from 9th story windows in desperate attempts to escape the fire. PBS recently ran a special on this disaster. (If you missed it, you can watch online: Triangle Fire). My colleague Jon Coppelman has also written about the fire in his post The Original “No Exit”.
This fire was a watershed event that galvanized the nation. It occurred in an era where there were no regulations or labor protections. Workers often worked 12 hour shifts, 7 days a week. There were no child labor laws or safety mandates. Ironically, the day before the Triangle Fire, New York courts had struck down the state’s first compulsory workers compensation law as unconstitutional.
This tragedy, along with some of the horrific mine disasters that resulted in wholesale loss of life, were catalysts which led to the enactment of various worker protections – including statutory workers’ compensation.
Meanwhile, today in Wisconsin …
We think this bit of history is an important backdrop to what’s going on in Wisconsin today.
Wisconsin has the distinction of being the first state in the union to have enacted a workers’ compensation law that survived legal challenge in May of 1911. In fact, the state of Wisconsin has a long, storied and sometimes bloody history of being on the front lines for worker rights. Workers and labor unions were in the forefront of the fight for the 8-hour day and the 40-hour work week. In 1932, Wisconsin was the first state to enact unemployment compensation.
To any who know this history, it comes as no surprise that, once again, Wisconsin is on the front lines in the battle for labor’s future.
It’s the budget, stupid – or is it?
The ostensible issue, according to Governor Walker, is that the state of Wisconsin is broke and a large part of the problem lies with overly generous benefit packages of public workers – teachers, prison guards and the like – which are said to be crippling the state. He called on unions to do their part and to make a sacrifice for the greater good.
All that might be well and good. The unions have indicated their willingness to take a financial haircut. But the part of Governor Walker’s Budget Repair Bill that is going over somewhat less well is a call for the elimination of collective bargaining — and therein lies the rub.
With a Republican majority in Wisconsin’s House and Senate, the bill was all but a given until the Democratic senate contingent fled the state to prevent a vote. Since that time, there have been massive protests over three weeks and the so-called Fab 14 remain holed up in un-named Illinois’ hotels. And there has been no shortage of drama in this story: an embarrassing and revelatory 20-minute prank call to Governor Walker from an impersonator of corporate financier David Koch; and a sheriff’s refusal to play the role of “palace guard”, among other things.
Part of national union busting agenda?
Critics of Walker’s Budget Repair Bill say that the issue is not about budget balancing or overly generous benefits, but an ideological push to eliminate or curtail public unions – in a phrase, union busting. Opponents say that this is a corporate-funded campaign to eliminate public unions in Wisconsin and other states, and to privatize many institutions that are currently staffed by public workers. No less a staunch Republican than former Congressman and now host of MSNBC’s “Morning Joe” program, Joe Scarborough, has publicly called Governor Walker’s actions, “Un-American.”
In Wisconsin, suspicions are high because Koch enterprises funded a large part of Walkers gubernatorial campaign. The fact that the budget bill contains a provision authorizing Walker to conduct no-bid sales of some state properties also heightens suspicion. Many are troubled by his plans for privatization of some public services. In his prior role as Milwaukee County Executive, Walker also used budget emergency as a justification for privatizing security guards, a move that proved less than successful.
Other states have also embarked on this path: Ohio may be making more headway in curtailing unions. In Indiana, Democratic legislators have followed Wisconsin’s lead and left the state to postpone a vote. In Rhode Island, nearly 2000 teachers have been dismissed. Other states may be contemplating similar measures, although some may be a bit shy of action given the shifting public sentiment, which favors retention of collective bargaining and has given Walker a black eye – to a point where voters say they would not elect him again if they had a do-over. (see Wisconsin Public Research, Rasmussen, USA Today/Gallup, Public Policy Polling and various other polls. )
It’s uncertain what will happen in the next chapters, but we will be watching. It is clear this is another watershed point in labor history, a public policy fork in the road, perhaps the beginning of the end of the movement that was propelled into mainstream America by that terrible fire 100 years ago. While polling indicates that sentiment is currently on the side of the teachers in this dispute, the future of public unions is under serious threat. Is the role of unions obsolete? Has the public dialogue achieved an equilibrium between the rights of workers and those of management?
At Lynch Ryan, we have great respect for unions, which have historically played a critical check-and-balance role in labor-management power dynamics. They have also been in the forefront of the fight for worker safety and other worker protections. We also admire and respect many employers we have been privileged to work for who are perceptive and wise enough to manage their companies so well that unions are not needed. We’d like to say that all employers are this enlightened and do not need union checks and balances to do the right thing, but unfortunately our experience tells us that this is not always the case.