MOS 5101

Handling of Ethical Dilemmas

--3 steps for handling ethical dilemmas: ----Apply the Guidelines: S&H professional should apply as many of the tests as necessary to determine the ethically correct decision; at this point, the goal is only to identify the ethical choice ----Select the Approach: best-ratio, black and white, and full-potential approaches; factors that effect the decision of which approach to use include your personal makeup, the expectations of the company, and the degree of company support ----Proceed with the Decision: proceed in strict accordance with the approach selected; proceed consistently; fairness is a large part of ethics and consistency is a large part of fairness

Organization and Coordination

--A company's *emergency response plan* should identify the different personnel groups that respond to various types of emergencies --One person should be identified and accepted by all emergency responders as the *emergency coordinator*; this person should be knowledgeable of the responsibilities of each individual emergency responder and how each relates to those of all other responders; this knowledge must include the *order of response* for each type of emergency set forth in the plan --It is important that one person is in charge, everyone involved knows who is in charge, and everyone has a role in responding to an emergency is given ample opportunities to practice in simulated conditions that come as close as possible to real conditions --Example: Union Carbide's Texas city plant has a unique way of coordinating responses; the planning and coordination of all emergency response belongs to the *emergency response management team (ERMT)*; composed of shift emergency directors, and a full-time fire chief, this group unifies all emergency groups and equipment into a single, coordinated effort

How to Plan for Emergencies

--A company's emergency action plan should be a collection of small plans for each anticipated emergency --*Emergency-Action Plan (EAP)* should contain: ----Procedures: specific, step-by-step emergency response procedures should be developed for each potential emergency ----Coordination: all cooperating agencies and organizations and emergency responders should be listed along with their telephone number and primary contact person ----Assignments and Responsibilities: every person who will be involved in responding to a given emergency should know his or her assignment ----Accident Prevention Strategies ----Schedules: should contain the dates and times of regularly scheduled practice drills

Resuming Business After a Disaster

--A comprehensive hazard assessment should be completed before business is resumed --Before business is resumed, an organization should consider the following factors: structural integrity; utility checks; cleanup protection; health and sanitation; air quality; ventilation; walls, ceilings, and floors; safety equipment; lighting; hazardous waste removal; machines and equipment; and furniture --All systems, conditions, and potential hazards should be checked and corrected as appropriate before resuming business after a disaster

AIDS Education

--A well-planned AIDS education program can serve several purposes: ----It can give management the facts needed to develop policy and make informed decisions with regard to AIDS ----It can result in changes in behavior that will make employees less likely to contract or spread the disease ----It can prepare management and employees to respond appropriately when a worker falls victim to the disease ----It can decrease the likelihood of legal problems resulting from an inappropriate response to an AIDS-related issue --Planning an AIDS Education Program: first step is to decide its purpose; a statement of purpose for an AIDS education program should be a broad conceptual declaration that captures the company's reason for providing the education program; the next step involves developing goals that translate the statement of purpose into more specific terms; the goals should tell specifically what the AIDS education program will do; an AIDS education program may consist of any of the following; one-on-one counseling, referral, posters, a newsletter, classroom instruction, self-paced multimedia instruction, group discussion sessions, and printed materials

Symptoms of AIDS

--AIDS is caused when humans become infected with HIV; this virus attacks the immune system, rendering the body incapable of repelling disease-causing microorganisms --Symptoms: enlarged lymph nodes that persist; persistent fevers; involuntary weight loss; fatigue; diarrhea that does not respond to standard medications; purplish spots or blotches on the skin or in their mouth; white, cheesy coating on the tongue; night sweats; and forgetfulness --How AIDS is Transmitted: through sexual contact, blood contact, and mother-to-child during pregnancy or birth; any act in which bodily fluids are exchanged can result in infection if either partner is infected; people at highest risk are homosexual men who do not take precautions, IV drug users who share needles, people with a history or multiple blood transfusions or blood-product transfusions, and sexually promiscuous people who do not take precautions --How AIDS is Not Transmitted: not spread by casual social contact in schools, workplaces, public washrooms, or restaurants; not spread via hand-shakes, social kissing, coughs, sneezes, drinking fountains, swimming pools, toilet facilities, eating utensils, office equipment, or by being next to an infected person; not spread from an infected person handling food, by giving blood, by mosquitoes or other insects, or by sexual contact by uninfected individuals who maintain an exclusive relationship

Computers and Emergency Response

--Advances in chemical technology have made responding to certain types of emergencies particularly complicated --Expert computer system especially programmed for use in emergency can help meet the challenge of responding to a mixed-chemical emergency or any other type of emergency involving multiple hazards --An *expert system* is a computer programmed to solve problems; such systems rely on a database of knowledgeable about a very particular area, an understanding of the problems addressed in that area, and expertise in solving problems in that area; the expert in this case s a computer program that pulls information from a database and uses it to make decisions based on *heuristics* (suppositional rules stated in an if-then format); human thought processes work in a similar manner --Advantages of expert systems are that they do not panic or get confused, they consider every possible solution in milliseconds, they are not biased, they do not become fatigued, and they are detailed --The similarity to human thought processes is why the science on which expert systems are based is known as artificial intelligence --A modern expert system used for responding to chemical emergencies provides information such as the following: ----Personal protective equipment needed for controlling and cleaning up ----Methods to be used in cleaning up the spill or toxic release ----Decontamination procedures ----Estimation of the likelihood that employees or the community will be exposed to hazard ----Reactions that may result from interaction of chemicals ----Combustibility of chemicals and other materials on hand ----Evacuation information ----Impact of different weather conditions on the situation ----Recommended first-aid procedures

Emergency Response

--An *emergency response team (ERT)* is a special team that responds to emergencies to ensure proper personnel evacuation and safety, shut down building services and utilities, work with responding civil authorities, protect and salvage property, and evaluate areas for safety prior to reentry --An emergency response team is a special team to handle general and localized emergencies, facilitate evacuation and shutdown, protect and salvage company property, and work with civil authorities --Typically composed of representatives from several different departments --Communities also have ERTs for responding to emergencies that occur outside of a company environment --Most dangerous spills occur on the road, and the greatest number of hazardous materials (hazmat) incidents occur on the manufacturer's loading dock; more than 80% of chemical releases are caused by errors in loading and unloading procedures --Another approach to ERTs is the *emergency response network (ERN)* which is a network of ERTs that covers a designated geographical area and is typically responsible for a specific type of emergency

Preventing and Responding to Needlestick Injuries

--An excellent source of help for health and safety professionals concerning needlestick injuries is NIOSH --NIOSH maintains a web site dedicated specifically to the prevention of needlestick injuries --This web site recommends a 5 step model for developing, establishing, and maintaining a needlestick-prevention program: ----Form a sharps injury prevention team ----Identify priorities ----Identify and screen safer medical devices ----Evaluate safer medical devices ----Institute and monitor the use of the safer medical devices selected --Responding to Needlestick Incidents: follow these steps: encourage bleeding where the skin is penetrated; was the penetration area thoroughly with copious amounts of warm, soapy water; if the eyes are somehow involved, wash them immediately with water; if the mouth is somehow involved, rinse it immediately with water, but do not swallow; get the injured employee to the hospital as soon as possible; contact a clinical virologist; make sure that management personnel for the company in question are fully informed of the situation

Evacuation Planning

--Contained is 29 CFR 1910.38; the standard requires a written plan for evacuating the facility in the event of an emergency; critical elements are: ----Marking of Exit Routes: clearly identified and marked routes of egress are critical during a time of crisis; ensuring that all signs, pictograms, and other markings to facility evacuation are visible during power outages is critical; battery backup systems are common; however, in facilities that cannot use battery backup systems, they can use photoluminescent signs which absorb normal light energy and release this energy in the form of light during periods of darkness ----Communication and Alarm Procedures: the communication component of an evacuation plan should include procedures for early detection of a problem, procedures for reporting an emergency, procedures for initiating an evacuation, and procedures for providing the necessary info to employees who are being evacuated; just pulling an alarm is not sufficient enough; verbal instructions must follow the alarm stating the situation is real, what people should do, and when it is over; all employees should know how to notify outside authorities of the emergency ----Outside Assembly: the company's evacuation plan should include an assembly area to which employees go once evacuated; there should also be a backup area; part of the evacuation plan relating to the assembly areas must be devoted to transient personnel (nonemployees such as vendors, visitors, contractors, etc.) ----Training: everything contained in the plan that requires action or knowledge on the part of employees should be part of the required evacuation training; training should be provided when employees are first hired, and retraining should be provided periodically as various elements of the plans are updated; drills should be a major part of the training provided for employees

Company's Role in Ethics

--Creating an internal environment that promotes, expects, and rewards ethical behavior: a company creates an ethical environment by establishing policies and practices that ensure all employees are treated ethically and then enforcing these policies; one effective way to create an ethical environment is to develop an ethics philosophy and specific, written guidelines for implementing that philosophy are shared with all employees; ethics credo shows employees that they have obligations extending well beyond their work units --Setting an ethical example of ethical behavior in all external dealings: companies that take the do as I say, not as I do approach to ethics will no succeed; company's must support S&H professionals who make ethically correct decisions

Random Stuff Chapter 24

--Difference between bloodborne and airborne is risk --Training and education is most important --We have a right to know what we are at risk for catching --Employers are responsible for educating the employees --Unions: ILO--AFL-CIO--CLC; these are not unions; affiliated means we belong to one of these groups and we have to pay; just because its a union does not mean it is not a management hierarchy; unions should listen from bottom (employees) up --Lawsuits happening today are against individual managers --Unless we have a certification, we have no authority; a medical doctor does; transfer the risk to the authoritative figure --Epstein bar virus is a precursor to lymph node cancer --An employer has to know if an employee has a communicable disease, but cannot tell other employees about it --We don't test people for non related job functions (i.e. person can't walk but they don't need to for the job); person can be qualified with and without a disability --Employee Assistance Program can include counseling; what is in the EAP is determined by the organization --The labels and signs on trucks tell you the risks associated such as flammable --Rehabilitation Act is vocational not just physical --UNT is covered by the Rehab Act and ADA because we are a public institution --It is not the responsibility or agent of the employer to as if they need accommodation; employee or applicants responsibility to as for accommodation --Core function or HR functions is job analysis (job title, specifications, work environment, etc) --Employer defenses: employer does not have to make an accommodation that causes undue hardship or has no business necessity (ex- fast food employees do not have to be given a break because it is a business necessity that their position be covered); bonafide merit and seniority systems; BFOQ; employer decides what is a reasonable accommodation; reasonable deals with money --Validation means job related (defensible); if it is not job related it is a problem --Employers covered by ERISA cannot discriminate on employees with AIDS --Reasonable anticipation theory? --OSHA does not attempt to list everything in these standards --10% of people in the U.S. are functionally illiterate; literacy is a big problem --First case dealing with bloodborne pathogens was tuberculosis (TB) --First concerned with HBV, not HIV; Hep. C is irreversable liver damage -Type 1 and 2 deals with how frequently we are exposed to risk --Rules are under hazard communication and OSHA standards --Employees do not have to pay for standards requirements (PPE, etc.); employer responsibility

Planning for Workers with Disabilities

--Do not develop a separate EAP specifically for workers with disabilities, they should be included as a normal part of the organization's plan; Preparing the Workplace for Everyone is an excellent set of guidelines for this --Involving Key Personnel --Implementing Shelter-In-Place (SIP) Plans: rather than evacuating, immediate shelter is sought; SIP comes into play when attempting to evacuate might increase the risk of harm or injury --Evaluating Personnel Needs: before evaluating the needs of personnel with disabilities, consult your HR department to develop guidelines that are consistent with the Rehabilitation Act --Distributing and Communicating the Plan --Balancing Employer Responsibilities and Employee Right to Self-Determination --Working with First Responders: these personnel and those who carry out the EAP should coordinate closely on all matters pertaining to implementation of the plan --Implementing an Elevator Policy: the use of elevators during an emergency can become a critical issue when the needs of personnel with disabilities are considered --Developing Emergency Notification Strategies: once an EAP is developed, all stakeholders must be notified of its contents and what they mean --Practicing and Maintaining the EAP: the EAP should be viewed as a living document that is updated and maintained continually as well as practiced periodically

Emergency Planning and Community Right-to-Know Act

--Emergency Planning and Community Right-to-Know Act (EPCRA): aka Title III of the Superfund Amendments and Reauthorization Act of 1986 (SARA); designed to make info about hazardous chemicals available to a community where they are being used so that residents can protect themselves in the case of an emergency; applies to all companies that use, make, transport, or store chemicals; the following are components of this act --Emergency Planning: requires that communities form *local emergency planning committees (LEPCs)* and that states form *state emergency response commissions (SERCS)* ----LEPCs: required to develop emergency response plans for the local communities, host public forums, select a planning coordinator for the community, and work with the coordinator in developing local plans; plans for individuals companies in a given community should be part of that community's larger plan; local emergency response professionals should use their community's plan as the basis for simulating emergencies and practicing their responses ----SERCs: required to oversee LEPCs and review their emergency response plans --Emergency Notification: requires that chemical spills or releases of toxic substances that exceed established allowable limits be reported to appropriate LEPCs and SERCs; immediate notification may be verbal as long as a written notification is filed promptly; such reports must contain the following: the names of the substances released, where the release occurred, when the release occurred, the estimated amount of the release, known hazards to people and property, recommended precautions, and the name of a contact person in the company --Information Requirements: local companies must keep their LEPCs and SERCs and the public informed about the hazardous substances that the companies store, handle, transport, or use --Toxic Chemical Release Reporting: requires that local companies report the total amount of toxic substances released into the environment as either emissions or hazardous wasted; reports go to the Environmental Protection Agency (EPA) and the state-level environmental agency

Customizing Plans to Meet Local Needs

--Emergency plans must be *location-specific*; the following rules of thumb can be used to ensure that EAPs are location-specific: ----A map of the plant: should include the locations of exits, access points, evacuation routes, alarms, emergency equipment, a central control or command center, first-aid kits, emergency shutdown buttons, and any other important elements of the EAP ----Chain of command: an organization chart illustrating the *chain of command* (who is responsible for what and who reports to whom) also helps localize and EAP ----Coordination of information: all telephone numbers and contact names of people in agencies with which the company coordinates emergency activities should be listed ----Local training: all training should be geared toward the types of emergencies that may occur in the plant; practice drills should take place on-site and in the specific locations where emergencies are most likely to happen

Rationale for Emergency Preparation

--Emergency: potentially life-threatening situation, usually occurring suddenly and unexpectedly --Preparation involves a combination of planning, practicing, evaluating, and adjusting to specific circumstances

Hepatitis B Virus (HBV) and Hepatitis C Virus (HVC) in the Workplace

--Employees at greatest risk from viral hepatitis are those who are elderly and those who have diabetes mellitus, cancer, or any other illness severe enough to require surgery and transfusions --Hepatitis B Virus (HBV): HIV gets more attention, but the greater risk is from the spread of HBV; extremely strong compared to HIV; can live on surfaces for up to a week if it is exposed to air; much more concentrated than HIV; caused by a double-shelled virus; can be transmitted in the workplace in the following ways (contact with blood or contact with body fluids, including tears, saliva, and semen); HBV virus can live in body fluids for years; persons infected with HBV may contract chronic hepatitis, cirrhosis of the liver, and primary heptocellular carcinoma; symptoms include jaundice, joint pain, rash, internal bleeding ----HBV Vaccination: OSHA standards require employers to offer the three-injection HBV vaccination series free to all employees who are exposed to blood or other potentially infectious materials as part of their job duties; includes health care workers, emergency responders, morticians, first-aid personnel, law enforcement officers, correctional facilities staff, and launderers, as well as others; more than 90% of those vaccinated develop immunity to the HBV --Hepatitis C Virus (HCV): the most common chronic blood-borne infection in the U.S.; many may be unaware of their infection; those infected are at risk for chronic liver disease which is the 10th leading cause of death among adults in the U.S.; transmitted primarily through large or repeated direct percutaneous exposures to blood; in the U.S., the 2 most common exposures associate with the transmission of HCV are blood transfusion and injecting-drug use; preventing and controlling HCV requires a strategy comprised of at least the following: ----Primary prevention activities: screening and testing blood, plasma, organ, tissue, and semen donors; virus inactivation of plasma-derived products; risk-reduction counseling and services; implementation and maintenance of infection control practices ----Secondary prevention activities: identification, counseling, and testing of persons at risk; medical management of infected persons ----Education and training ----Monitoring the effectiveness of prevention activities to develop improved prevention methods

AIDS in the Workplace

--Employers are feeling the impact of AIDS in increased insurance premiums and health care costs, time-on-the job losses, decreased productivity AIDS-related lawsuits, increased stress, and related problems that result from misconceptions about AIDS --Need to develop and comprehensive AIDS policy which should at least contain the following areas at minimum: ----Employee Rights: treat HIV-positive employees compassionately, allowing them to work as long as they are able to perform their jobs; develop the AIDS policy and accompanying program before learning an employee is HIV positive (allows the company to act rather than react); make reasonable allowances to accommodate the HIV-positive employee (AIDS is recognized as a disabling condition); ensure the employees have access to private health insurance that covers the effects of AIDS; include provisions for evaluating the work skills of employees to determine whether there has been any degradation of ability caused by the disease ----Testing: according to the CDC, there is no single test that can reliably diagnose AIDS; there is a test that can detect antibodies produced in the blood to fight the virus that causes AIDS but the presence of these antibodies does not necessarily mean that a person has AIDS; whether a company can, or even should, require AIDS tests of employees or potential employees is widely debated; there is a growing body of support for mandatory testing ----Education: the general public is becoming more sophisticated about AIDS; people are beginning to learn how AIDS is transmitted; however, research into the causes, diagnosis, treatment, and prevention of this disease is ongoing; important to have an ongoing education program because the body of knowledge about AIDS changes continually; AIDS is having an effect on the workplace, yet only 5% of all employers have a written corporate policy on AIDS

Facts about Testing for AIDS and Other Diseases

--Ensuring the accuracy of an HIV antibody test requires 2 different tests, one for initial screening and one for confirmation ----The screening test currently used is the enzyme-linked immunosorbent assay (ELISA) test; relatively accurate, but it is susceptible to both false positive and false negative results ----The confirmation test is the immunofluorescent assay (IFA), or the Western Blot test --The American College Health Association makes the following recommendations concerning the HIV antibody test: not a test for AIDS, but for antibodies to HIV; talk to a trained, experienced, sensitive counselor before deciding whether to be tested; if you decide to be tested, do so only at a center that provides both pre- and posttest counseling; if possible, use and anonymous testing center; be sure that the testing center uses two ELISA tests and a Western Blot of IFA test to confirm a positive result; a positive test result is not a diagnosis and does not mean you have the HIV infection; a positive test result does mean that you can infect others and that you should avoid risky or unsafe sexual contact and IV needle sharing; it can take 6 months or, rarely, longer after infection to develop antibodies, so the test result may not indicate whether you have been infected during that period; a negative test result does not mean that you are immune to HIV or AIDS, or that you cannot be infected in the future

Ethical Behavior in Organizations

--Ethical behavior in organizations is influenced by both individual and social factors --Trevino identified 3 personality measures that can influence employee's ethical behavior: ----*Ego strength*: an employee's ability to undertake self-directed tasks and to cope with tense situations ----*Machiavellianism*: the extent to which an employee will attempt to deceive and confuse others ----*Locus of control*: the perspective of workers concerning who or what controls their behavior; those with an internal locus of control believe they have some control over their own behavior; those with an external locus of control feel that their behavior is controlled by external factors --Social factors that influence ethical behavior include gender, role differences, religion, age, work experience, nationality, and the influence of other people who are significant in an individual's life; people learn by observing the behavior of significant role models

First Aid in Emergencies

--First aid consists of lifesaving measures taken to assist an injured person until medical help arrives; OSHA requires that companies have at least one employee on site who has been trained in first aid --First-Aid Training Program: the continuing education departments of community colleges and universities typically offer first-aid training; the American Red Cross provides training programs in first aid specifically geared toward the workplace; the National Safety Council (NSC) also provides first-aid training materials; part of preparing for emergencies should include training employees to administer first aid --Beyond Training: have well-stocked first-aid kits available; have appropriate personal protective devices available; post emergency telephone numbers; keep all employees informed and up-to-date concerning first-aid info

Ethics Defined

--Managing ethical behavior is one of the most pervasive and complex problems facing business organizations today --As applied to business: the organization's culture sets standards for determining the difference between good and bad decision making and behavior --Terms associated with ethics are conscience, morality, and legality --Definition for the purpose of the textbook: the application of morality within a context established by cultural and professional values, social norms, and accepted standards of behavior; Morality refers to the values that are subscribed to and fostered by society and people within a society; ethics attempts to apply reason in determining rules of human conduct that translate morality into everyday behavior; *Ethical behavior* is that which falls within the limits prescribed by morality; ethics typically fall into a gray area --Guidelines for Determining Ethical Behavior: necessary to distinguish between illegal and unethical; something can be legal and unethical at the same time; *morning-after test* (how will you feel about this tomorrow morning?; *front-page test* (would it be embarrassing if printed on the front page of a newspaper?); *mirror test* (how will you feel when you look at yourself in the mirror); *role-reversal test* (requires you to trade places with the people affected by your decision); *commonsense test* (listen to your instincts; if it feels wrong, it probably is); 4 question test (is the decision truthful?, is the decision fair to all stakeholders?, will the decision generate goodwill for my organization?, is the decision beneficial to all stakeholders?) publicity test

Protecting Employees From AIDS

--OSHA's guidelines for preventing exposure to HIV infection identify 3 categories of work-related tasks: ----Category I: involve routine exposure to blood, body fluids, or tissues that may be HIV infected ----Category II: do not involve routine exposure to blood, body fluids, or tissues, but some aspects of the job may involve occasionally performing Category I tasks ----Category III: do not normally involve exposure to blood, body fluids, or tissues; most industrial occupations fall into this category (very little risk on contracting AIDS on the job) --The U.S. Public Health Service recommends the following precautions: ----Abstain from sex or have a mutually monogamous marriage, or relationship, with an infection-free partner ----Refrain from having sex with multiple partners or with a person who has multiple partners ----Avoid sex with a person who has AIDS or whom you think may be infected ----Do not use intravenous drugs or, if you do, do not share needles --CPR and AIDS: because the HIV virus has been found in saliva (though no legitimacy that it can be transmitted that way), there is concern about contracting AIDS while trying to resuscitate someone; because of this concern, disposable face masks and various other types of personal protective devices are now being manufactured --Safety Needles: employees who work with needles for taking blood, giving injections, or inserting intravenous systems should be considered at high risk for becoming infected with HIV; injury prevention devices on syringes, IVs, catheters, blood-drawing equipment, vaccination instruments, lancets, and scalpels must be one-handed to be considered safer

OSHA's Standard on Occupational Exposure to Bloodborne Pathogens

--OSHA's standard on occupational exposure to bloodborne pathogens is contained is 29 CFR Part 1910 --Scope of Application: this standard applies to all employees whose job duties may bring them in contact with blood or other potentially infectious material; the deciding factor in whether an occupation falls under this standard is the "reasonably anticipated theory" (if it can be reasonably anticipated that employees may come in contact with blood in the normal course of performing their job duties, the standard applies); does not apply in instances of Good Samaritan acts in which one employee attempts to assist another employee who is bleeding; the standard covers blood and these other infections materials: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, amniotic fluid, saliva, miscellaneous body fluids mixed with blood; other potentially infectious materials include: unfixed human tissue, or organs other than intact skin, cell or tissue cultures, organ cultures, or any medium contaminated by HIV or HBV --Exposure Control Plan: OSHA's standard requires employers to have an exposure control plan to protect employees from exposure to bloodborne pathogens; these plans should have the following components: ----Administration: all employees are responsible for the following: knowing which of their individual and specific job tasks may expose them to bloodborne pathogens, participating in training provided concerning bloodborne pathogens, carrying out all job duties in accordance with the organization's various control procedures, and practicing good personal hygiene; supervisors and managers are responsible for: coordinating with the exposure control officer to implement and monitor exposure control procedures in their areas of responsibility; exposure control officer: overall responsibility with for carrying out the organization's exposure control plan and employee training ----Methodology: describes the procedures established to protect employees from exposure; these procedures fall into one of the following 5 categories: general precautions (assuming that all body fluids are contaminated, etc), engineering controls (design and technological precautions), work practice controls (precautions individual employees take), personal protective equipment (gloves, goggles and face shields, respirators, aprons, coats, and jackets), and housekeeping controls (use, disposal, and changing of protective coverings; decontamination of equipment; and regular cleaning of potentially contaminated areas) ----Vaccinations: the vaccination procedure must meet the following criteria according to the U.S. Public Health Service: available at no cost to employees, administered at a reasonable time and place within 10 days of assignment to a job with exposure potential, and administered under the supervision of a licensed health care professional ----Postexposure Investigation and Follow-Up: postexposure investigation should determine at least the following: when did the incident occur?, where did it occur?, what types of contaminated substances or materials were involved?, what is the source of the contaminated materials?, what types of work tasks were being performed when the incident happened?, what was the cause of the incident?, were the prescribed precautions being observed when the incident occurred?, what immediate action was taken in response to the incident? ----Labels and Signs: describes the procedures established for labeling potential biohazards; important to label the following: biohazard areas, contaminated equipment, containers of potentially contaminated waste, containers of potentially contaminated material, and containers used to transport potentially contaminated material ----Information and Training: describes the procedures for keeping employees knowledgeable, fully informed, and up-to-date regarding the hazards of bloodborne pathogens; training should cover at least the following: OSHA standards, the exposure control plan, fundamentals of bloodborne pathogens, hazard identification, hazard prevention methods, proper selection and use of personal protection equipment, recognition of warning signs and labels, emergency response techniques, incident investigation and reporting, follow-up techniques, and medical consultation; important to document training and keep training records that must be kept for at least 3 years and include dates of all training, content of all training, trainers' names and qualifications, and names and job titles of all participants --Record Keeping: OSHA standards require that medical records be kept by employers on all employees who are exposed to bloodborne pathogens; should contain employee's name and SS number, hep. B vaccination status, results of medical exams and test, results of incident follow-up procedures, a copy of the written opinions of health care professionals, and a copy of all information provided to health care professionals following an exposure incident

Methicillin Resistant Staphylococcus Aureus (MRSA) in the Workplace

--Potentially life threatening infection caused by bacteria that mutate and become strongly and more resistant to antibiotics with each mutation --The problems associate with MRSA are now so widespread that it must be considered a workplace hazard --5 events have led to the emergence of MRSA: ----Bacteria are able to mutate ----Antibiotics have been overprescribed for decades (allowing bacteria to become resistant) ----People stop taking their antibiotics as soon as symptoms subside rather than finishing the prescription as instructed ----Antibacterial soaps have proliferated and been overused (killing good bacteria and allowing harmful bacteria to become resistant) ----New tendency of people to skip showers after strenuous exercise or physical activity (dirty, moist, and salty skin is the perfect breeding environment for MRSA) --Prevention Steps: ----Ensure that employees was their hand regularly and shower after strenuous physical activity ----Ensure that employees treat and cover wounds; breaks in the skin are the primary way that MRSA gains entry into the body ----Do not allow employees to share personal items ----Encourage employees to use a dryer rather than clothesline for drying towels and clothing ----Ensure that employees wipe down and properly clean tools, work gear, and equipment

Dealing with the Psychological Trauma of Emergencies

--Psychological trauma among employees involved in workplace disasters is as common as it is among combat veterans --*Trauma* is psychological stress; occurs as the result of an event, typically a disaster or some kind of emergency, so shocking that it impairs a person's sense of security or well-being; traumatic events are typically unexpected and shocking, and they involve the reality of threat of death --Dealing with Emergency-Related Trauma: control it, take care of the injured, clean up the mess, and get back to work; often, the psychological aspect is ignored; response to trauma is best accomplished by a *trauma response team (TRT)* --Trauma Response Team: the TRT should be included in the assignments and responsibilities section of the EAP; the job of the TRT is to intervene as early as possible, help employees acknowledge what they have experienced, and give them opportunities to express how they feel about it to people who are qualified to help (part of the training safety and health professionals receive involves recognizing the symptoms of employees who need professional care and referring them to qualified care providers); a group approach is best when dealing with employees who do not require outside care; group approach offers several advantages (it facilitates public acknowledgement of what the employees have experienced; it keeps employees informed, thereby cutting down on the number of unfounded rumors and horror stories that will inevitably make the rounds; it encourages employees to express their feelings about the incident; it allows employees to see that they are not alone in experiencing traumatic reactions and that these reactions are normal) --Convincing Companies to Respond: psychological trauma that is left untreated can manifest itself into PTSD (characterized by intrusive thoughts and flashbacks of the stressful event, the tendency to avoid stimulations, paranoia, concentration difficulties, and physiological symptoms such as rapid heartbeat and irritability); early intervention is important

Recovering from Disasters

--Recovering quickly is the key to staying in business --A comprehensive disaster recovery plan should have at leas the following components: ----Recovery Coordinator: must be able to take command of the situation, assess the recovery needs, delegate specific responsibilities, approve the necessary resources, interact with outside agencies, and activate the organization's overall response ----Recovery Team: consists of key personnel to whom the disaster coordinator can delegate specific responsibilities ----Recovery Analysis and Planning: involves assessing the impact of the disaster on the organization and establishing both short and long term recovery goals; one of the ways to do this is to consider various predictable scenarios and plan for them ----Damage Assessment and Salvage Operations: this component of the plan has two elements (preparedness and recovery); the *preparedness* element should include the following info: a comprehensive inventory of all property at the facility in question, a checklist of the items on the inventory that are essential for maintaining the facility, a list of all personnel who will aid in the recovery, a list of all vendors, contractors, and so on who assistance will be needed during the damage assessment and salvage phase of recovery, a worksheet that can be used to document all actions taken during recovery operations, and procedures for quickly establishing a remote operational site; the *recovery* element should include procedures for securing workspace for the recovery team and coordinator, identifying areas of the facility that must be accessible, maintaining security at the facility and reporting it to the recovery coordinator, assessing the extent of damage to goods, supplies, and equipment, photographing and videotaping damage to the facility, taking appropriate action to prevent additional damage to the facility, repairing, restoring, and resetting fire detection and suppression equipment, and investigating accidents ----Recovery Communications: communication is one of the most important considerations in disaster recovery; this component of the plan should deal with both who is to be notified and how that is to take place; people who might have to be contacted as part of the disaster recovery operation includes customers, vendors and suppliers, insurance representatives, employee's families, appropriate authorities, and media outlets ----Employee Support and Assistance: after a disaster, employees are likely to need various types of assistance, including financial, medical, and psychological

Terrorism in the Workplace

--Role of the Employer: Run a safe a caring operation; listen to employees; train employees; communicate; know your personnel; empower personnel; harden the site against external threats and restrict access; remove any barriers to clear visibility around the facility; have and enforce parking and delivery regulations; make sure that visitors can be screened from a distance; keep all unstaffed entrance doors locked and alarm; make air intakes and other utilities inaccessible to all but designated maintenance personnel; prevent access to roofs and upper stories; secure trash containers; ensure that employees, contractors, and visitors wear badges; have an emergency response plan and practice it periodically; be cautious of information place on your company's web site; keep up to date with the latest safety and security strategies; protect the integrity of your facility's key system --Securing Hazardous Material: one of the tactics of terrorists is to convert hazardous materials used in the workplace into weapons of mass destruction; the goal of the security plan should be to implement measures that deter, detect, delay, or defeat the threat; deterrence can be improved by using highly visible measures and randomness (cost efficient and complicates the threatening person or group's planning); this plan should have to components (personnel security and physical security); the fundamental elements of the personnel component are to determine who should be granted access to the materials, conduct comprehensive background checks on all individuals who require access, submit employees who require access to psychological screening to ensure stability, and require identification badges with photographs or fingerprints of those authorized access; the physical security component consists of measures taken to prevent or control access to the hazardous materials in question (includes using fences, lights, alarm systems, guards, reaction forces, and the two-person rule that requires two employees to be present in order to gain access to the hazardous materials)

Counseling Infected Employees // Easing Employees' Fears About AIDS

--Safety and health professionals that are faced with an infected employee should: ----Listen ----Maintain an nonjudgemental attitude ----Make the employee aware of the company's policy on AIDS ----Respond in accordance with company policy --Safety and health professionals should be prepared to make appropriate referrals to infected employees; transfer the risk (of litigation) to a qualified medical professional --Employee Assistance Programs (EAPs): should have an AIDS component so that employees can seek confidential advice and counseling about the disease; confidential counseling, referral, the provision of AIDS-related information, etc. should be provided ///////// --People tend to react to AIDS from an emotional perspective; fear, panic, and even hysteria are all common reactions to AIDS --Strategies for easing fears: ----Work with higher management to establish an AIDS education and awareness program that covers the following topics at minimum: how HIV is transmitted, precautions that workers can take, and concerns about AIDS testing ----Conduct group round-table discussions that allow employees to express their concerns ----Correct inaccuracies, rumors, and misinformation about AIDS as soon as they occur

Testing Issue

--The issue of testing is perhaps the most contentious legal concern growing out of the AIDS controversy --Issues regarding testing for AIDS and other disease with which safety and health professionals should be familiar are: ----State laws: control of communicable diseases is typically considered to be the province of the individual state ----Federal laws and regulations: the laws protecting an individual's right to privacy and due process apply to AIDS testing; these laws fall within the realm of constitutional law; they represent the primary federal contribution to the testing issue ----Civil suits: case law serves the purpose of establishing precedents that can guide future decisions ----Company policy: the testing component of a company's AIDS policy should include at least the following: a strong rationale, procedures to be followed employees groups to be tested, the use and dissemination of results, and the circumstances under which testing will be done --2 sides of the testing controversy issue: one side considers the issues of fairness, accuracy, and confidentiality (the rights of the individual) while the other side are the issues of workplace safety and public health; The following are recommended guidelines for establishing testing programs that satisfy the concerns of both sides of the issue: ----The purpose of screening must be ethically acceptable ----The means to be used in the screening program and the intended use of the information must be appropriate for accomplishing the purpose ----High-quality laboratory services must be used ----Individuals must be notified that the screening will take place ----Individuals who are screened must have a right to be informed of the results ----Sensitive and supportive counseling programs must be available before and after screening to interpret the results, whether they are positive or negative ----The confidentiality of screened individuals must be protected

Legal Concerns

--The legal concerns relating to AIDS in the workplace grow out of several pieces of federal legislation including the Rehabilitation Act, the Occupational Safety and Health Act, and the Employee Retirement Income System (security?) Act --The Rehabilitation Act: enacted in 1973 to give protection to people with disabilities (then referred to as handicaps), including workers; makes discrimination on the basis of a disability unlawful; a person with a disability is "otherwise qualified" when he/she can preform the essential functions of the job; any agency, organization, or company that receives federal funding falls within the purview of the act; if the disability is a contagious disease such as AIDS, it must be shown that there is no significant risk of the disease being transmitted in the workplace; if there is a significant risk, the person is not considered "otherwise qualified"; employers are required to make reasonable accommodations to help the worker; however, they are not required to make fundamental changes that alter the nature of the job or result in undue costs or administrative burdens in making reasonable accommodations --The Occupational Safety and Health Act (OSH Act): requires that employers provide a a safe workplace free of hazards; also prohibits employers from retaliating against employees who refuse to work in an environment they believe may be unhealthy (some employees may use this provision as a reason for refusing to work with employees with AIDS; however, this fear is generally irrational and is not usually successful as the basis for refusing to work) --The Employee Retirement Income Security Act (ERISA): protects the benefits of employees by prohibiting the actions taken against them based on the eligibility for benefits; employers cannot terminate an employee with AIDS or suspected of having AIDS as a way of avoiding expensive medical costs; with this act, it is irrelevant whether the employee's condition is considered a disability because the act applies to all employees regardless of condition

Safety and Health Professionals' Role in Ethics

--Their role has 3 parts: responsible for setting an example of ethical behavior; responsible for helping employees make the right decision when facing ethical questions; and responsible for helping employees follow through and actually undertake the ethical option once the appropriate choice has been identified --In carrying out their roles, they can adopt one of the following approaches: ----*Best-Ratio Approach*: pragmatic approach; says that people are basically good and under the right circumstances behave ethically; can behave bad under certain circumstances; S&H professional should promote ethical behavior; when hard decisions must be made, the appropriate choice is the one that does the most good for the most people; aka situational ethics ----*Black-and-White Approach*: right is right, wrong is wrong, and circumstances are irrelevant; S&H professional's job is to make ethical decisions and carry them out, as well as help employees choose the ethical route ----*Full-Potential Approach*: S&H professionals make decisions based on how the outcomes affect the ability of those involved to achieve their full potential; underlying philosophy is that people are responsible for realizing their full potential within the confines of morality; choices that can achieve this goal without infringing on the rights of others are considered ethical

Ethics and Whistle-Blowing

--When an employer is being unethical or violating the law, the first option should be to bring it to the attention of appropriate management executives --*Whistle-blowing*: the act of informing an outside authority or media organ of alleged illegal or unethical acts on the part of an organization or individual --Problems with Whistle-Blowing: there is often a "don't-tell" mentality that causes whistle-blowers to be shunned and viewed as outcasts; retribution (employee may be fired, transferred to an undesirable location, or reassigned to an undesirable job); damaged relationships and hostility; loss of focus (whistle-blowers often find that their time, energy, and attention are overtaken by the events surrounding the claim); scapegoating --OSHA and Whistle-Blowing: adopted regulations governing the employee protection provisions of section 211 of the Energy Reorganization Act (ERA); makes it illegal for an employer covered by the act to discharge or discriminate against an employee in terms of compensation, conditions, or privileges of employment because the employee or any person acting at an employee's request performs a protected activity; employees covered include licensees of the Nuclear Regulatory Commission or an agreement state, a contractor or subcontractor of a licensee or applicant, and a contractor or subcontractor of the Department of Energy; Key provisions of the ERA are as follows: Right to raise a safety concern, unlawful acts by the employers, complaint, enforcement, relief --Noncovered Whistle-Blowing: most employers are not covered under the ERA; employees in many organizations have no protection when they blow the whistle on an unethical employer; S&H professionals should encourage employers to develop safety and health policies; key element of such a policy should be a mechanism that allows employees to raise questions about safety and health concerns