Fleet Safety: Developing & Sustaining an Effective Program With ANSI/ASSE Z15.1.

Millions of U.S. workers are at risk for a work-related motor vehicle crash. Fatality data show that across all industries, motor vehicle crashes are consistently the leading cause of work-related fatalities. Of 43,025 work-related fatalities reported by BLS between 2003 and 2010, 10,202 were the result of single- or multiple-vehicle crashes of workers driving or riding in a vehicle on a public roadway, and 2,707 were pedestrian workers struck by a motor vehicle. During the same period, an additional 2,487 workers died in crashes that occurred off a public roadway or on industrial premises (BLS, 2013).

Confined space entry: mitigating risk in general industry.

Thorough understanding of the hazards, risks, and program and regulatory requirements for confined space entry provides the framework for safe entry procedures. Permit-required confined spaces possess hazardous characteristics that have the potential to cause harm, physical injury, or death. Special procedures are required for entry into a permit-required confined space. This article provides an overview of confined space hazards, permit requirements, and entrant and attendant responsibilities. Rescue requirements and implications are discussed. Understanding the hazards of confined space entry, safe permit-entry procedures, and rescue requirements enables occupational health nurses to support the EHS team in initiating an effective confined space entry program.

Food safety in the workplace: a practical approach.

The occupational health nurse in a large manufacturing facility arrives at work early one Monday morning to find three ill employees in the clinic waiting room and a message from several plant supervisors that multiple employees have called in sick. The supervisors are concerned. The employees have reported similar symptoms, including nausea, vomiting, diarrhea, and fever Furthermore, two supervisors who rarely miss work have also called in sick and other employees are complaining of stomach cramps and diarrhea. The occupational health nurse promptly begins completing a nursing assessment and health history. She discovers that all sick employees attended the company picnic, catered by the facility's food service vendor, the day before. After notifying the local public health department, the occupational health nurse begins to investigate further. The occupational health nurse visits the cafeteria to speak with the manager and inquire about the food served at the picnic. The menu included ham and cheese sandwiches with mayonnaise, hamburgers, potato salad, and cake. The beverages were milk, non-bottled water, and lemonade. All leftover food was discarded, so nothing is available for testing. The manager mentions that yesterday was particularly hot, with a high of 93 degrees F. He states the local health department conducts regular, stringent food inspections. However, he admits they have been short staffed recently and, although he tries to provide adequate training and oversee all food service operations, a few new employees worked at the company picnic. He also mentions his holding temperature logs are "not exactly up-to-date." While talking to the manager the occupational health nurse notices one of the food service employees cutting raw vegetables on a wooden cutting board just used to cut raw chicken. The cutting board was wiped with a damp, visibly soiled sponge, rather than washed, after cutting the meat. It is abundantly clear that food safety training deficiencies exist in this food service. Seventy percent of the employees who attended the company picnic are too ill to work, and absenteeism leads to production shutdown. The culprit? Salmonella. Because of the number of cases, the local health department initiates an investigation and the facility is issued a citation.

Diagnosis: Chronic kidney disease, now what!

The occupational health nurse can play an important role in supporting employees with CKD and ESRD by recognizing risk factors such as diabetes and hypertension associated with CKD. The occupational health nurse should encourage compliance with treatment regimens that retard or delay progression of kidney disease into the next stage, especially blood pressure and glucose control. When employees are in need of diagnostic testing, the occupational health nurse can describe the testing procedures such as laboratory values, ultrasounds, and biopsies, and explain the five stages of CKD. The occupational health nurse can assist employees in Stage 4 or 5 CKD in deciding on a treatment option modality that best suits their individual lifestyles, after they have seen a nephrologist and kidney patient educator. In addition, the occupational health nurse can guide employees with difficult lifestyle changes and provide support during the adjustment process. The occupational health nurse also can play a key role in facilitating and coordinating those changes with the renal social worker. Together they can explore available resources, such as the NKF, the American Association of Kidney Patients, and kidneydirections.com. See the Sidebar on pages 295 to 296 for other available resources. Kidney disease can be a devastating diagnosis. Support and education are key to a successful lifestyle transition. Employees who have CKD and work with an occupational health nurse who is informed about their disease and its stages of progression can benefit from educational processes that create informed choices to delay or retard the progression of their renal disease.