Opioid Litigation and Workers' Compensation

The newly initiated litigation by public entities against Big Pharma may prove to be a huge boost to the workers' compensation system. The lawsuits have the potential curtailing a massive drain of benefit dollars and may provide for subrogation as a result of the nations' opioid epidemic.

At a recent NJ State Bar Association meeting in May 2017 Atlantic City, Mark B. Zurulnik, an attorney who specializes in workers' compensation law, referred to the potential of a such a lawsuit.

NPR reported today that, "A wave of litigation by state attorneys general against the biggest opioid manufacturers and distributors feels reminiscent of lawsuits brought by states in the 1990s against the tobacco industry." Click here to read the entire NPR report.

Third party litigation can impact workers' compensation programs in multiple ways. Historically, both the tobacco and asbestos litigation curtailed the use of the hazardous products going forward. Subrogation is yet another situation though. It requires the ability of the parties to establish specific liens. While this was easily done in asbestos occupational exposure litigation, it was much more difficult to seek individual reimbursement or set-off in claims caused by or complicated by tobacco use in the workplace.

Notwithstanding the public entity, opioid litigation is yet another social cause that may, in fact, improve the lives of injured workers and in the long run provide tremendous benefits to both employers and their insurance companies.

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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). 

For over 4 decades theLaw Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Safeguarding Injured Workers From Cybersecurity Breaches

Under new Federal proposals, injured workers will be protected from cybersecurity breaches. The impact will be greater responsibilities and costs for law firms and, employers and their insurance companies.

Workers' Compensation stakeholders will be required to maintain better cyber hygiene, have better application update procedures and establish an adequate plan to respond to  breaches. Client and governmental agencies will require more secure networks and procedures for handling data transmission, access, and storage.

Hacking is an increasing concern for workers' compensation stakeholders. Some of the attacks by nation states are difficult to contain. Other attacks, by criminal ventures and amateurs, are less invasive. All the attacks can be hazardous, disruptive and costly. In the future, they will probably advance from the invasion of Personal Protective Information (PPI) to industrial ("Internet of Everything"), and national attacks, ie. WannaCry, and WannaCry (2nd wave).  See also, Envisioning the Hack That Could Take Down New York City  NYMag June 10, 2016  and "A Cyberattack "the World Isn't Ready For," NY Times, June 25, 2017.

The scope of potential exposure to injured workers is enormous. It extends from the hypothetical breach of a cardiovascular  (ie. medical device security) implant portrayed on the television series, Homeland, to real-world breaches of Personal Protected Information (PPI). An example of which is the breach of 32,599 patient records resulting in a $4.124 million class action settlement. Columbia Cas. Co. v. Cottage Health System, 2015 WL 4497730 July 15, 2015 Not Reported in F.Supp.3d. "The Court, therefore, DISMISSES the Complaint WITHOUT PREJUDICE, so that the parties may pursue alternative dispute resolution under the terms of the policy." The cybersecurity policy contained an exclusion for "failure to follow minimum required practices." See also the press releases from the NY State Attorney General.

Insurance carriers are not immune from liability as a result of cybersecurity data breaches. A $115 Million proposed class action settlement as a result of a cybersecurity attack on health insurer Anthem, Inc. has been announced. It is the largest data breach settlement in history,

More specifically, a recent American Bar Association opinion mandates that attorneys must take reasonable cybersecurity measures to protect client data. ABA Formal Opinion 477 (May 11, 2017). 

National regulation initiatives have been given a mandate through Presidential Executive Orders. Presidential Executive Order on Improving Critical Infrastructure Cybersecurity 13636 February 13, 2013 and Presidential Executive Order on Strengthening the Cybersecurity of Federal Networks and Critical Infrastructure  May 11, 2017. An Introduction to Data Security  (NIST) June, 2017. Digital Idenity Guidlines 800-63 Rev 3, (NIST) June, 2017.

The National Institute of Standards and Technology (NIST) has initiated a "Framework for Improving Critical Infrastructure Cybersecurity." This voluntary model is rapidly gaining acceptance throughout industry and government.

A Federal statutory cause of action has evolved under the Defense of Trade Secrets Act. 18 USC §1836, et. seq., as well as the Cybersecurity Act of 2015. See also, Cybersecurity Enhancement Act of 2014  P.L.113-274 .

The recent initiatives in electronic security were highlighted at the recent NJ ICLE 2nd Annual Cyber Security Conference. The Presidential initiatives operationalized by National Institutes of Standards and Technology. The Cybersecurity Framework: Implementation Guidance for Federal Agencies - Draft NISTIR 8170 (NIST) May 12, 2017 Comment period through June 30, 2017 . Cybersecurity Framework Workshop 2017 , Addressing Gaps in Cybersecurity: OCR Releases Crosswalk Between HIPAA Security Rule and NIST Cybersecurity Framework  February 23, 2016.

The NIST Framework is being integrated into the infrastructure by the Executive Branch. Adoption and integration is anticipated by Health and Human Services  (HHS) (HIPAA-Office of Civil Rights), and Securities and Exchange Commission (SEC), Food and Drug Administration (FDA).

"An overriding question remains whether lawyers will be able to effectively protect their client’s confidentiality interests at any cost. Clients are becoming more sophisticated and they now demand that law firms adhere to security standards that will prevent a breach and if a breach occurs that the law firm will take adequate action to provide notice and, mitigate the potential damage."
"The ethical responsibility of lawyers, in most jurisdictions, is to take reasonable care to protect the personal information of clients in accordance with well-defined constitutional, statutory and administrative regulations, ethics opinions and the common law phraseology of the Restatement of Torts." See, Cybersecurity is an imminent and costly threat to lawyers and their clients.

Cybersecurity in workers' compensation remains in its infancy.  Cybersecurity is again placing the Federal government yet again in the lead on privacy and confidentiality as workers' compensation moves along the Path to Federalization. Going forward, increased regulation and stricter controls will safeguard injured workers.

This article is based on my presentation on Cybersecurity  at the NJ ICLE seminar on Hot Topics in Workers' Compensation Law 2016. The 2017 supplement to the treatise Workers' Compensation Law provides extensive and expanded coverage on this topic.

Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (2017 West-Thomson-Reuters). 

For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Updated: 06/29/17 06:30 am

Mesothelioma Law Know the Risk Factors

Mesothelioma Law Know the Risk Factors

Albeit a few materials can precipitate this malady, mesothelioma is principally ascribed to presentation to asbestos as detailed by the Agency for Toxic Substances and Disease Registry of the CDC. Moreover, Asbestos has been arranged by the US Environmental Protection Agency (EPA) as a human cancer-causing agent. 

As indicated by the CDC (Center for Disease Control and Prevention), introduction to asbestos expands the danger of creating dangerous Mesothelioma. The inertness time frame for the malady is accounted for to associate with 20 to 40 years. So introduction to asbestos can go unnoticed for a considerable length of time. Consequently, mesothelioma cases are analyzed years after the main introduction to asbestos happens. In a review led by the CDC's National Institute for Occupational Safety and Health (NOSH), yearly various reason for death records were dissected for the period from 1999 to 2005.

Who ought to be concerned? 

Asbestos is foreign made into the United States and was even mined in the nation amid the twentieth century. In the US, the utilization of asbestos topped in 1973 when it added up to 803,000 metric tons before declining to 1,700 metric tons in 2007. Mechanical laborers utilized in settings, for example, assembling, development and shipbuilding preceding 1980 are the ones who are at most hazard, as government security control was not set up at the that time. Presentation keeps on happening today in view of the pulverization of structures in which asbestos was utilized amid development. 

Ventures to Take in Case Of Asbestos-Exposure Related Mesothelioma 

In the wake of thinking about a few research discoveries, introduction to asbestos has been singled out as the primary driver of Mesothelioma much of the time. This presentation influences people in an unexpected way. A few elements are included, including fixation, recurrence and term of introduction and additionally the shape, size and compound cosmetics of the strands that decide your odds of contracting Mesothelioma. 

It is normal to feel worried about Mesothelioma on the off chance that you have encountered ceaseless presentation to asbestos. Specialists suggest that such individuals ought to get general CT outputs or trunk x-beams. They should likewise get lung work tests as these tests can identify issues brought about by asbestos strands. In the event that any issues are distinguished, you ought to get an expert Mesothelioma conclusion. In the shocking occasion of being determined to have Mesothelioma, you have the justification for documenting a claim.

An Increase Predicted of Reported Mesothelioma Cases

Asbestos is a naturally occurring fibrous mineral which was widely used in the manufacture of a variety of products beginning in the late nineteenth century. Although the majority of exposure to asbestos occurred between 1940 and 1980, in occupations such as construction, shipyards, railroads, insulation, sheet metal, automobile repair, and other related fields, exposure continues to this day.

Asbestos fibers are inhaled by workers and remain in the lungs where they can cause disease. Fibers are also inhaled by family members or any other person coming into contact with asbestos wherever it may be.

A recent study predicts that there will be an increase in the number of reported mesothelioma cases in the United States in the future. Therefore the continuing epidemic of workers' compensation claims for mesothelioma will not abate as previously predicted as many exposed workers' and their families seek benefits including medical monitoring.

"Mesothelioma, a rare tumor, is highly correlated with asbestos exposure. Mesothelioma, similar to all asbestos-related diseases, is dose/intensity dependent to some degree, and studies showed the risk of mesothelioma rises with cumulative exposures. Multiple processes occur in an individual before mesothelioma occurs. The impact of mesothelioma in the United States has been continuous over the last half century, claiming between 2,000 and 3,000 lives each year.

"Mesothelioma is a preventable tumor that is more frequently reported as associated with asbestos exposure among men than women. However, the rate of asbestos-associated mesothelioma is on the rise among women due to a better investigation into their histories of asbestos exposure. It is of interest that investigators detected asbestos-associated cases of mesothelioma in women from nonoccupational sources—that is, bystander, incidental, or take-home exposures.

"It is postulated that asbestos-associated mesotheliomas, in both men and women, are likely underreported. However, with the implementation of the most recent ICD-10 coding system, the correlation of mesothelioma with asbestos exposure is expected to rise to approximately 80% in the United States. This study examined the demographic and etiological nature of asbestos-related mesothelioma. Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States, Richard A. Lemen Journal Of Toxicology And Environmental Health, Part B Vol. 19 , Iss. 5-6,2016

"Workers' compensation benefits have been awarded to claimants who have been exposed to asbestos and who have suffered asbestos-related disabilities. Bolger v. Chris Anderson Roofing Co., 112 N.J.Super. 383, 271 A.2d 451 (Co.1970), aff'd 117 N.J.Super. 497, 285 A.2d 228 (App.Div.1971). The courts have recognized an asbestos exposure as causing multiple disabilities, and awards have been made for occupational exposure which has resulted in a “second disease”. Shepley v. Johns-Manville Products Corporation, 141 N.J.Super. 387, 358 A.2d 485 (App.Div.1976). Jon Gelman, Workers Compensation Law, 39 NJ Practice Series 9.20.

The United States has yet to completely ban the use of asbestos and recent regulations to do so have been put on hold by the Trump Administration. In light of the concerns raised by this study, reconsideration of a complete ban of asbestos products in the US should be reconsidered without further delay.

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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). 

For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

National Asbestos Awareness Week April 1-7, 2017

S. RES. 98 Designating the first week of April 2017 as “National Asbestos Awareness Week”.

IN THE SENATE OF THE UNITED STATES
March 27, 2017
03/29/2017 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent.  (All Actions)

Senator Jon Tester

Mr. Tester (for himself, Mr. Markey, Mr. Isakson, Mr. Daines, Mr. Durbin, Mrs. Feinstein, Ms. Warren, Mr. Merkley, and Mr. Leahy) submitted the following resolution;

RESOLUTION

Designating the first week of April 2017 as “National Asbestos Awareness Week”.

• Whereas dangerous asbestos fibers are invisible and cannot be smelled or tasted;

• Whereas the inhalation of airborne asbestos fibers can cause significant damage;

• Whereas asbestos fibers can cause cancer (such as mesothelioma), asbestosis, and other health problems;

• Whereas symptoms of asbestos-related diseases can take between 10 and 50 years to present themselves;

• Whereas the projected life expectancy for an individual diagnosed with mesothelioma is between 6 and 24 months;

• Whereas generally, little is known about late-stage treatment of asbestos-related diseases, and there is no cure for asbestos-related diseases;

• Whereas early detection of asbestos-related diseases may give some patients increased treatment options and might improve the prognoses of those patients;

• Whereas the United States has substantially reduced the consumption of asbestos in the United States, yet the United States continues to consume tons of the fibrous mineral each year for use in certain products throughout the United States;

• Whereas asbestos-related diseases have killed thousands of people in the United States;

• Whereas while exposure to asbestos continues, safety and prevention of asbestos exposure has significantly reduced the incidence of asbestos-related diseases and can further reduce the incidence of asbestos-related diseases;

• Whereas thousands of workers in the United States face significant asbestos exposure, which has been a cause of occupational cancer;

• Whereas thousands of people in the United States die from asbestos-related diseases every year;

• Whereas a significant percentage of all asbestos-related disease victims were exposed to asbestos on naval ships and in shipyards;

• Whereas asbestos was used in the construction of a significant number of office buildings and public facilities built before 1975;

• Whereas people in the small community of Libby, Montana, suffer from asbestos-related diseases, including mesothelioma, at a significantly higher rate than people in the United States as a whole; and

• Whereas the designation of a “National Asbestos Awareness Week” will raise public awareness about the prevalence of asbestos-related diseases and the dangers of asbestos exposure: Now, therefore, be it


Resolved, That the Senate—

(1) designates the first week of April 2017 as “National Asbestos Awareness Week”;

(2) urges the Surgeon General of the United States to warn and educate people about the public health issue of asbestos exposure, which may be hazardous to their health; and

(3) respectfully requests that the Secretary of the Senate transmit a copy of this resolution to the Office of the Surgeon General.

Trump Administration May Bring a Surge in Occupational Disease Claims

Mesothelioma death rates remain high in the US even on the eve of an anticipated national ban of the asbestos fiber. Things may radically change for the worse as the Trump Administration goes forward with its announced intention to dismantle environmental regulation now in place and placed on-track for enactment during the former Obama Administration. With anticipated less EPA and OSHA regulation under the Trump administration, there is the potential for a serious surge of future occupational disease claims in the United States.

President Trump has remarked, “I believe that the movement against asbestos was led by the mob, because it was often mob-related companies that would do the asbestos removal. Great pressure was put on politicians, and as usual, the politicians relented.” Trump, The Art of the Comeback, 1997.

The Centers for Disease Control and Prevention (CDC) today published a report indicating that mesothelioma, a neoplasm, continues to be prevalent at high rates.

"Malignant mesothelioma is a neoplasm associated with inhalation exposure to asbestos fibers and other elongate mineral particles (EMPs). The median survival after malignant mesothelioma diagnosis is approximately 1 year. The latency period between the first exposure to asbestos fibers or other EMPs and mesothelioma development ranges from 20 to 71 years. Occupational exposure has occurred in industrial operations including mining and milling, manufacturing, shipbuilding and repair, and construction. Current occupational exposure occurs predominantly during maintenance and remediation of asbestos-containing buildings. The projected number of malignant mesothelioma deaths was expected to increase to 3,060 annually by 2001–2005, and after 2005, mortality was projected to decrease."

"During 1999–2015, a total of 45,221 malignant mesothelioma deaths were reported, increasing from 2,479 (1999) to 2,597 (2015). Mesothelioma deaths increased for persons aged ≥85 years, for both sexes, persons of white, black and Asian or Pacific Islander race, and all ethnic groups. Continuing occurrence of malignant mesothelioma deaths in persons aged <55 years suggests ongoing inhalation exposure to asbestos fibers and possibly other causative EMPs."

"Despite regulatory actions and decline in asbestos use, the annual number of malignant mesothelioma deaths remains substantial. Contrary to past projections, the number of malignant mesothelioma deaths has been increasing. The continuing occurrence of mesothelioma deaths, particularly among younger populations, underscores the need for maintaining efforts to prevent exposure and for ongoing surveillance to monitor temporal trends."

Asbestos is a naturally occurring fibrous mineral which was widely used in the manufacture of a variety of products beginning in the late nineteenth century. Although the majority of exposure to asbestos occurred between 1940 and 1980, in occupations such as construction, shipyards, railroads, insulation, sheet metal, automobile repair, and other related fields, exposure continues to this day. Asbestos fibers are inhaled by workers and remain in the lungs where they can cause disease. Fibers are also inhaled by family members or any other person coming into contact with asbestos wherever it may be. We believe that the evidence shows that the companies which manufactured these products knew that their products would injure people and that they actively conspired to hide this information in order to keep selling their products, and as a result, they are now being held liable for the resulting injuries.

"Workers' compensation benefits have been awarded to claimants who have been exposed to asbestos and who have suffered asbestos-related disabilities. Bolger v. Chris Anderson Roofing Co., 112 N.J.Super. 383, 271 A.2d 451 (Co.1970), aff'd 117 N.J.Super. 497, 285 A.2d 228 (App.Div.1971). The courts have recognized an asbestos exposure as causing multiple disabilities, and awards have been made for occupational exposure which have resulted in a “second disease”. Shepley v. Johns-Manville Products Corporation, 141 N.J.Super. 387, 358 A.2d 485 (App.Div.1976). Even where the exposure to asbestos can be identified as occurring 50 years earlier in the course of the employment, the resultant disease has been recognized as compensable. Bush v. Johns-Manville Products Corporation, 154 N.J.Super. 188, 381 A.2d 65 (App.Div.1977), certif. denied 75 N.J. 605, 384 A.2d 835 (1978)." Gelman, Workers' Compensation Law 3rd ed. §9,20 (Thomson-Reuters).

With the anticipated dismantling of EPA and OSHA regulations by the Trump Administration, in conjunction with a return to manufacturing jobs in the US, there remains to be seen whether there will be a resurgence of occupational disease claims and fatalities in the US,  as a result of the continued work-related exposures to such toxic substances such as asbestos.

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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). 

For over 4 decades theLaw Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Occupational Exposure to Lead Continues to be a Serious Health Issue

The California Department of Health has reported that the workers' occupational exposure to lead continues to be a serious public health issue.

"According to a report released in January by the California Department of Public Health, more than 6,000 California workers have elevated levels of lead in their blood. Health problems from lead exposure include heart disease, reproductive problems, cognitive difficulties and kidney failure. 

"From 2012 to 2014, 38,440 workers had their blood tested for lead, and 6,051 workers were identified with an elevated level of 5 or more micrograms of lead per deciliter (about 3.3 ounces) of blood. Workers with the highest blood lead levels — 40 micrograms or more per deciliter — mostly worked at shooting ranges or in ammunition manufacturing, gun repair, and firearm instruction, although some worked in other metal industries, painting and construction.

One of the most common health problems for American children today is lead poisoning. The Center for Disease Control and Prevention has indicated that lead poisoning is entirely preventable. Our office has joined with other law firms to dedicate our efforts to the victims of childhood lead poisoning. In this effort we work with leading national researchers, including geochemists, psychiatrists, toxicologist, pediatric neurologists and neuropsychiatrists to assist our clients who suffer from lead poisoning.

Lead is absorbed into the bodies of small children more easily than adults. Human beings are exposed to lead through the ingestion of lead chips, dust, soil and various other means. When lead is ingested by children six years old or younger, the effects are most serious and they effect detrimentally the brains of children that are in developmental stages. Studies have shown that lead, even at low levels, is a neurotoxin and can cause permanent brain damage.

Lead exposure can pose serious dangers to pregnant women and industrial workers. Exposure to battery plants and lead smelters that use lead in their processing may also expose workers and children to dangerous levels of lead. Painters and workers with occupations involving welding, soldering, the chemical industry, foundries, gasoline refineries and the copper industry may bring dust home from the workplace resulting in secondhand exposure and poisoning to children.

Lead exposure occurs in both industrial and occupational exposures also. There is exposure to lead in battery plants and lead smelters they utilize lead in their processing. Adult workers may be exposed and children may be exposed to dangerous levels through the household contact of their parents. Painters and workers involved in occupational industries such as welding, soldering, the chemical industry, boundaries, gasoline refineries and that copper industry may transport landed home and expose their household contacts.

Click here to read the complete report. "Blood Lead Levels in California Workers." 

Click here to read more about "Lead Litigation."

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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). 

For over 4 decades theLaw Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Hearing Loss Remains a Significant Problem at Work

Today's post is shared from the cdc.gov:

"Noise-induced hearing loss is a significant, often unrecognized health problem among U.S. adults. Discussions between patients and personal health care providers about hearing loss symptoms, tests, and ways to protect hearing might help with early diagnosis of hearing loss and provide opportunities to prevent harmful noise exposures. Avoiding prolonged exposure to loud environments and using personal hearing protection devices can prevent noise-induced hearing loss."

Noise-induced hearing loss is a significant health problem among U.S. adults, is more prevalent among males, and increases with age. Persons with auditory damage caused by noise frequently do not recognize it; one in four U.S. adults who reported excellent or good hearing had an audiometric notch. Among persons who reported work exposure to loud noise, one third had a bilateral or unilateral notch.

Noise exposure is the second most common cause of acquired hearing loss (after aging). An estimated 24% of hearing loss in the United States has been attributed to workplace exposures. Noise exposure is associated with numerous adverse health effects, and reducing noise exposure is likely to improve health. A recent study suggested that reducing environmental noise exposure might save lives by decreasing the prevalence of cardiovascular heart disease (10). Avoiding exposure to loud environments and effective use of personal hearing protection devices (earplugs or earmuffs) have been shown to prevent hearing loss. Evidence also exists that stronger occupational regulation leads to decreased noise levels . Persons who already have impaired hearing from noise exposure can benefit from clinical rehabilitation, such as amplification through hearing aids, learning to read lips, and other compensation strategies. Use of technology, such as smart phone apps to measure sound level, provides new ways of informing decisions and actions.

Noise reduction and avoidance can prevent hearing loss or slow its progression. This can be accomplished by avoiding high volumes on personal listening devices; reducing listening time to high volumes of music; taking breaks from exposure; requesting lower volumes in public settings (restaurants, movie theaters); using quieter products (e.g., household appliances, power tools, recreational vehicles); reducing equipment noise by replacing worn or unbalanced machine parts; moving as far as possible from the loudest sound-producing source, such as loudspeakers or cannons at college stadiums; and using hearing protection devices ). Hearing protectors need to fit well to reduce noise exposure effectively.

Noise exposure at younger ages needs particular attention. Damage to hearing accumulates over time so that hazardous exposure that begins earlier in life has the potential to be more damaging as persons age. The high prevalence of audiometric notches (one in five) among persons aged 20–29 years suggests that early life interventions need to be developed.

Hearing screenings can help reduce delays in diagnosis and improve access to hearing aids for those with hearing loss, thus improving health-related quality of life, yet a 2014 report found that only 46.0% of adults who had any trouble hearing had seen a health care professional about their hearing in the past 5 years (5). Hearing loss often progresses for years before being self-perceived or diagnosed. Talking to one’s personal health care provider about hearing loss symptoms, tests, and ways to protect hearing, might support early diagnosis and access to hearing rehabilitation if needed.

During routine exams, primary care providers can examine patients’ hearing; ask about patients’ hearing and noise exposures and inform them about the benefits of hearing protection; monitor patients with hearing loss symptoms, recommend or provide hearing tests when indicated; and counsel patients with hearing loss. Studies indicate, however, that 40%–77% of primary care providers have not asked about or screened for hearing loss. Patients reporting hearing-related symptoms or risk factors such as noise exposure need to be referred for objective hearing assessment., Although there is currently a lack of data to support the benefits of regular hearing screening in adults aged >50 years, the American Speech-Language-Hearing Association (ASHA) recommends that adults be screened at least every decade through age 50 years and every 3 years thereafter. Healthy People 2020 includes objectives to increase the proportion of adults who have had a hearing examination in the past 5 years and to increase the number referred by their health care provider for hearing evaluation and treatment.

Although there are no federal regulations regarding exposure to nonoccupational noise, a 1974 Environmental Protections Agency report identified 70 dB over 24 hours (75 dB over 8 hours) as the average exposure limit for intermittent environmental noise. World Health Organization (WHO) 1999 Guidelines for Community Noise recommend avoiding noise exposure levels that exceed 70 dB(A) over a 24-hour period or 85 dB(A) over a 1-hour period. CDC’s National Institute for Occupational Safety and Health (NIOSH) has established an 8-hour, time-weighted average 85 dB(A) recommended exposure limit to protect most workers from developing hearing loss from noise exposure over a 40-year career. However, at that sound pressure level [85 dB(A) time-weighted average], approximately 8% of workers could still develop hearing loss, and thus NIOSH recommends that hearing protection be worn whenever noise levels exceed 85 dB(A), regardless of the length of exposure.

The U.S. Department of Health and Human Services (DHHS) and WHO are raising awareness about noise-induced hearing loss. DHHS is collecting data on hearing status and risk factors, as well as developing guidelines on hearing aids. WHO is developing guidelines on noise exposure. Other public entities, such as states and counties, partner with community groups to reduce noisy environments and use evidence to inform policies that decrease noise exposures. Other ways to reduce environmental noise exposure include using sound-absorbent materials in office buildings and public venues, erecting highway barriers, and passing noise ordinances. Managers and owners of public venues can decrease the loudest sound levels at those locations to help decrease noise exposure.

Click here to read the complete article.

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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). 

For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

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OSHA Issues FInal Beryllium Exposure Rules

A new rule issued today by the U.S. Department of Labor's Occupational Safety and Health Administration dramatically lowers workplace exposure to beryllium, a strategically important material that can cause devastating lung diseases. The new beryllium standards for general industry, construction and shipyards will require employers to take additional, practical measures to protect an estimated 62,000 workers from these serious risks.

Beryllium is a strong, lightweight metal used in the aerospace, electronics, energy, telecommunication, medical and defense industries. However, it is highly toxic when beryllium-containing materials are processed in a way that releases airborne beryllium dust, fume, or mist into the workplace air that can be then inhaled by workers, potentially damaging their lungs.

Recent scientific evidence shows that low-level exposures to beryllium can cause serious lung disease. The new rule revises previous beryllium permissible exposure limits, which were based on decades-old studies.

"Outdated exposure limits do not adequately protect workers from beryllium exposure," said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. "OSHA's new standard is based on a strong foundation of science and consensus on the need for action, including peer-reviewed scientific evidence, a model standard developed by industry and labor, current consensus standards and extensive public outreach. The new limits will reduce exposures and protect the lives and lungs of thousands of beryllium-exposed workers."

The final rule will reduce the eight-hour permissible exposure limit from the previous level of 2.0 micrograms per cubic meter to 0.2 micrograms per cubic meter. Above that level, employers must take steps to reduce the airborne concentration of beryllium. The rule requires additional protections, including personal protective equipment, medical exams, other medical surveillance and training, as well. It also establishes a short-term exposure limit of 2.0 micrograms per cubic meter over a 15-minute sampling period.

OSHA estimates that - once in full effect - the rule will annually save the lives of 94 workers from beryllium-related diseases and prevent 46 new cases of beryllium-related disease. Workers in foundry and smelting operations, fabricating, machining, grinding beryllium metal and alloys, beryllium oxide ceramics manufacturing and dental lab work represent the majority of those at risk.

Beryllium exposure is also a concern in other industries. Employees handling fly ash residue from the coal-burning process in coal-fired power plants risk beryllium exposure. In the construction and shipyard industries, abrasive blasters and their helpers may be exposed to beryllium from the use of slag blasting abrasives. Work done in these operations may cause high dust levels and significant beryllium exposures despite the low beryllium content.

To give employers sufficient time to meet the requirements and put proper protections in place, the rule provides staggered compliance dates. Once the rule is effective, employers have one year to implement most of the standard's provisions. Employers must provide the required change rooms and showers beginning two years after the effective date. Employers are also required to implement the engineering controls beginning three years after the effective date of the standards.

The final rule is available today at the Federal Register here.

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OSHA cites Jersey City Medical Center (St Barnabas) $174,393

OSHA investigation of Jersey City Medical Center worker's fatal fall finds facility exposed employees to dangerous electrical hazardsCitations issued: On Dec. 21, 2016, the U.S. Department of Labor's Occupational Safety and Health Administration issued citations to the medical center for one willful and four serious safety violations.

OSHA began its inspection on June 28, 2016, after the employer notified the Agency that a worker needed to be hospitalized after falling from a ladder as he changed an overhead ballast in a light fixture. The worker later died from his injuries on July 17, 2016.

The agency cited the willful violation because the facility required employees to change ballasts without the proper lockout/tagout training on practices and procedures necessary to disable machinery or equipment to prevent hazardous energy release, as well as other safety hazards and related unsafe practices.

The serious violations involved the medical center's failure to ensure de-energized circuits were locked out, maintain an electrical lockout/tagout program, ensure that only qualified persons worked on live circuits, provide personal protective equipment, and ensure workers did not work on live parts.

"This worker's tragic death was preventable. Jersey City Medical Center did not have basic lockout/tagout safeguards in place to prevent exposure to electrical hazards, and failed to train its maintenance workers on these safeguards. As a result, the worker sustained an electrical shock while changing the ballast, fell approximately 6 feet off a ladder and died from his injuries," said Kris Hoffman, director of OSHA's Parsippany Area Office.

Proposed penalties: $174,593

The citation can be viewed at: https://www.osha.gov/ooc/citations/JerseyCityMedicalCenter_1158589.pdf

The employer has 15 business days from receipt of its citations and proposed penalties to comply, request a conference with OSHA's area director or contest the findings before the independent Occupational Safety and Health Review Commission.

To ask questions; obtain compliance assistance; file a complaint; or report amputations, eye loss, workplace hospitalizations, fatalities or situations posing imminent danger to workers, the public should call OSHA's toll-free hotline at 800-321-OSHA (6742) or the agency's Parsippany Area Office at 973-263-1003.

Lung-sparing surgery for patients with advanced mesothelioma results in prolonged survival, new study shows

Patients with advanced malignant pleural mesothelioma (MPM) treated with a combination of surgery to remove the cancer but save their lung, plus photodynamic therapy and chemotherapy, had a median survival of nearly three years, with a subset of patients living longer than seven years, according to new research published in the Annals of Thoracic Surgery.

The disease, which is most commonly caused by exposure to asbestos, is an incurable cancer that affects the lining of the chest cavity. Patients treated with chemotherapy alone, the standard of care, typically live only 12 to 18 months. In the United States, 2,000 to 3,000 patients are diagnosed with MPM each year.

"These are among the best results ever published for patients with an epithelial subtype of pleural mesothelioma, which accounts for about two thirds of all cases," says the lead author, Joseph S. Friedberg, MD, the Charles Reid Edwards Professor of Surgery and Head of the Division of Thoracic Surgery at the University of Maryland School of Medicine and Thoracic Surgeon-in-Chief of the University of Maryland Medical System.

"This is among the most virulent cancers known to man, and we have a long way to go, but it's encouraging to have achieved results we can report in years not months even for these patients with such advanced disease," Dr. Friedberg says. "Although, from a technical perspective, it is more challenging to save the lung than to sacrifice it, it does appear that this technique helps to not only extend life but to also preserve quality of life."

The study followed 73 patients with MPM who had surgery to remove the cancer, followed by a therapy using a photosensitizing agent and light to kill microscopic cancer cells. Ninety-two percent of the patients also received chemotherapy. Overall median survival for all the patients in the study was nearly three years (35 months), the researchers report, but that figure more than doubled, to 7.3 years, for 19 of these patients whose cancer had not spread to their lymph nodes. Median survival is the length of time at which 50 percent of patients are alive after treatment. In addition, researchers also found that overall survival was three times higher than disease-free survival, which is the length of time until the cancer recurs.

For the 73 patients in the study, median disease-free survival was 1.2 years, a third of the overall survival of three years. In the group of 19 patients with overall survival of 7.3 years, disease-free survival was 2.3 years. The majority of the patients had Stage III or Stage IV disease.

"It's unusual to find such a difference in between overall and disease-free survival rates. When this cancer recurs, which it almost always does, patients usually live only a few months," says Dr. Friedberg of the study results, which were published online in November.

While the researchers caution against drawing definitive conclusions based on this non-randomized study, they are intrigued by the findings. Dr. Friedberg and his colleagues are now looking for mechanisms behind the difference, in order to work on improving survival even more.

Dr. Friedberg performed the lung-sparing surgery on the patients in the study while he was at the University of Pennsylvania, where the research was conducted. He has pioneered lung-sparing surgery for mesothelioma and now serves as Director of the Mesothelioma and Thoracic Oncology Treatment and Research Center at the University of Maryland School of Medicine. The center is part of the University of Maryland Greenebaum Comprehensive Cancer Center.

The lung-sparing surgery is a 6- to 14-hour operation to remove detectable cancer from the lining of the chest and spares the lung and as many other normal structures as possible. Dr. Friedberg developed his lung-sparing technique as an alternative to removing the entire lung, diaphragm and sac around the heart.

Dr. Friedberg and his colleagues say that this study shows that the lung-sparing technique can be safely used to achieve a "macroscopic complete resection" -- the removal of all detectable cancer -- while preserving the lung. "The role for lung-sparing surgery for mesothelioma has not been completely defined, but this series demonstrates that it is an option, even in advanced stage cases," they conclude in the journal article.

"The results showing extended overall survival for some patients are very promising and warrant further study," says E. Albert Reece, MD, PhD, MBA, vice president for medical affairs at the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and dean of the University of Maryland School of Medicine. "Under Dr. Friedberg's leadership, our new Mesothelioma and Thoracic Oncology Treatment and Research Center is fast becoming an major center for important scientific discovery as well as highly specialized, multidisciplinary care for patients with mesothelioma and other thoracic cancers."

Story Source:

Materials provided by University of Maryland Medical Center/School of Medicine.

Journal Reference:

1. Joseph S. Friedberg, Charles B. Simone, Melissa J. Culligan, Andrew R. Barsky, Abigail Doucette, Sally McNulty, Stephen M. Hahn, Evan Alley, Daniel H. Sterman, Eli Glatstein, Keith A. Cengel. Extended Pleurectomy-Decortication–Based Treatment for Advanced Stage Epithelial Mesothelioma Yielding a Median Survival of Nearly Three Years. The Annals of Thoracic Surgery, 2016; DOI: 10.1016/j.athoracsur.2016.08.071

University of Maryland Medical Center/School of Medicine. "Lung-sparing surgery for patients with advanced mesothelioma results in prolonged survival, new study shows." ScienceDaily. ScienceDaily, 14 December 2016. <www.sciencedaily.com/releases/2016/12/161214145608.htm>.

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