DECEMBER 2005
Chronic obstructive pulmonary disease (COPD) is now the fourth leading cause of death worldwide and, by all reasonable projections, its incidence will increase. The worldwide burden of COPD morbidity and mortality is already large, and will become staggering in this century. A recent study described the impact of COPD in the United Kingdom (UK). In the authors’ review, they point out that while the main cause of COPD in the UK remains cigarette smoking, there is a substantial body of epidemiological evidence linking occupational exposures to dusts, gases/vapours, and fumes to chronic airflow obstruction, with a substantial population attributable risk (15-20%) in non-smokers. There is also evidence for at least additive effects among smokers for a variety of workplace exposures. Epidemiological and pathological studies have linked exposure to coal mine dust, silica, cadmium, and asbestos. In addition, longitudinal studies show that workers with chronic exposure to cotton and grain dusts develop chronic airflow obstruction. A study from the USA, using the National Health and Nutritional Examination Survey (NHANES III), identified a number of occupations with increased odds ratio for COPD. The fraction of COPD attributable to work was estimated at 19.2% overall, and 31.1% among never-smokers. In June 2002, the American Thoracic Society issued an official statement on the occupational contribution to the burden of airway disease. The ATS committee concluded that about 15% of both asthma and COPD is likely to be work related based on international population based studies. A conservative estimate of the annual costs of the occupational components of asthma and COPD is 7 billion dollars.
Occupational and Environmental Medicine, Volume 62, Number 4, April 2005
By William P. Gavin
Gavin Law Firm recently successfully concluded two major occupational disease claims against a Class I western railroad for cancer caused by exposure to toxic substances during the workers’ employment with the railroad.
Lung Cancer: Gavin Law Firm represented a machinist who developed lung cancer after exposure to diesel exhaust, environmental tobacco smoke, and asbestos during twenty-five years of employment with the railroad in two western states. The employee was exposed to diesel exhaust while working around idling engines in the diesel shop and on the service track of the railroad. He was also exposed to the environmental tobacco smoke of his co-workers. The asbestos exposure occurred when the machinist cut, applied, and removed asbestos gaskets.
Bladder Cancer: Gavin Law firm represented the widow of a blacksmith who developed bladder cancer that unfortunately caused the death of the blacksmith. The blacksmith was employed in California and Utah by the railroad for thirty-two years. He also was exposed to diesel exhaust while working around idling engines in the diesel shops and on the service tracks of the railroad. The blacksmith was exposed to environmental tobacco smoke while working near smoking co-workers for many years.
In both cases, Gavin Law Firm developed evidence of the workers’ exposures by interviewing numerous co-workers of the injured machinist and blacksmith. It was also established that the railroad knew that diesel exhaust contains carcinogens as far back as 1955. The evidence was that the railroad established a smoking policy several years after the Surgeon General reported on the hazards of environmental tobacco smoke, but the railroad did not enforce the policy.
OCCUPATION AND RISK OF PANCREATIC CANCER: A POPULATION-BASED CASECONTROL STUDY IN IOWA
Pancreatic cancer is a rapidly fatal malignancy. It is the fourth-leading cause of cancer-related deaths in the United States. Smoking is considered to be the only established nonheritable risk factor for pancreatic cancer, but smoking explains no more than 30% of the cases.
Various industries and occupations have been linked to pancreatic cancer risk, although findings have been inconsistent. Some studies have suggested an increased risk of pancreatic cancer among men and women who worked in chemical industries – whereas others do not. Employment in metals industries also has been associated with an increased risk of pancreatic cancer in some studies, although not others. Working in the rubber and printing industries, as well as working as a leather tanner, glass manufacturer, and mechanic also have been inconsistently associated with a risk of pancreatic cancer.
In a recent study, an increased risk of pancreatic cancer was observed in persons employed in several industries (chemical, transportation equipment, communications, railroad transportation, trucking and warehousing, as well as furniture and home furnishing stores), and occupations (heavy truck drivers, railroad brake, signal and switch operators, purchasing agents and buyers, teachers, supervisor of sales occupations, insurance sales, and textile sewing machine operators and tenders). These associations warrant further investigation, according to the study.
Journal of Occupational and Environmental Medicine, Volume 47, No. 4, April 2005
STUDY: Workplace Air Pollution Drops When
Smoking is Banned
Arlington Heights, IL – Casinos, bars and pool halls pose small risk to hospitality workers and patrons from air pollutants when smoking is banned in these venues, according to a new study published in the Journal of Occupational and Environmental Medicine (Vol. 46, No. 9).
The study measured the level of cancer-causing particles in the air at a casino, six bars and a pool hall in Wilmington, DE, before and after a law banning workplace smoking went into effect. It found secondhand smoke contributed between 90 percent and 95 percent of respirable particle air pollution, and 85 percent to 95 percent of the carcinogenic particulate polycyclic aromatic hydrocarbons. Such indoor air pollution increases the risk of respiratory disease, cancer, heart disease and stroke.
The study concluded workers breathe roughly 90 percent cleaner air after the smoke-free workplace law. These results are even better than what can be attained through ventilation or air cleaning, it said.
Safety + Health, November 2004
EXPOSURE TO WELDING
FUMES IS ASSOCIATED WITH
ACUTE SYSTEMIC
INFLAMMATORY RESPONSES
The process of welding involves joining metal parts by heating the pieces to melting temperatures. Welding generates high levels of metal fume, which is comprised primarily of fine and ultrafine particles. Epidemiological studies have shown that exposure to welding fumes is associated with metal fume fever and increased respiratory symptoms. In addition, welders experience an increased prevalence of inflammatory lung diseases such as asthma and chronic bronchitis. Chronic exposure to welding fumes also is associated with a significant reduction in lung function; however, this association often is observed only in smoking welders, suggesting a possible interaction between welding fume and tobacco smoke on pulmonary responses.
In addition to causing adverse pulmonary effects, there is growing evidence that welding fume exposure also may be associated with increased cardiovascular events. Several studies have found that welders experience increased mortality from ischaemic heart disease. The observed increase in cardiovascular mortality most likely is not attributable solely to smoking. A recent Swedish census found that welders had a 10% excess risk in mortality from ischaemic heart disease compared to the general population, even after adjusting for smoking. Although the exact mechanisms are unknown, systemic inflammation resulting from occupational exposure to welding fume may be partially responsible for the increased cardiovascular risk in welders.
Occupational and Environmental Medicine, Volume 62, Number 3, March 2005
THE TRUE STORY OF THE McDONALD’S COFFEE CASE How twelve everyday Americans decided Stella Liebeck’s case was not a joke.
79-year old Stella Liebeck of Albuquerque, New Mexico was in the passenger seat of her grandson’s stopped car when she was severely burned by spilled McDonald’s coffee. Stella suffered 3rd -degree burns over 6% of her body, including her inner thighs, genitals, and buttocks. She was hospitalized for eight days, undergoing skin grafts.
Stella, a Republican who had never filed a lawsuit in her life, didn’t want to go to court. She offered to settle with McDonald’s for the cost of her medical expenses, but the company refused – even after a mediator suggested they should settle. Once in court, it was revealed that McDonald’s deliberately kept its coffee 20 degrees hotter than industry standards and was aware from 700 prior incidents that this practice could result in severe burns. The company decided not to reduce its temperature and did not warn its customers of any risk.
In the end, McDonald’s behavior outraged jury members who were skeptical of the case. Even the judge - who reduced the jury verdict by more than 80% - called McDonald’s conduct reckless, callous, and willful.
Stella Liebeck’s case is a prime example of why cases are tried in a courtroom and not newspaper headlines. Yet cases like Stella’s are repeatedly misused by Members of Congress as excuses to interfere with the courts. In fact, almost 20 bills are pending that would restrict ordinary Americans’ access to the courthouse and the right to trial before a jury. Members of Congress should not use one-sided half truths to limit people’s rights. ATLA eNews, Protecting Your Rights, May 10, 2005
BACK PAIN AND CHIROPRACTIC By Dr. Kathleen Roche
Back injuries are a part of everyday life. They are the second most common reason for visits to the doctor’s office, out-numbered only by upper-respiratory infections. In fact, experts say, up to 80% of the population will experience a back problem at some time in their lives.
Back pain can cause a sharp pain or a dull ache. A tingling, numbness, or burning sensation can accompany it. You may also feel weakness, pain, or tingling in your pelvis, and/or down a leg. This is known as sciatica pain.
The causes of injury and pain vary widely from patient to patient. The most common cause of pain include disc bulge or herniation, muscle spasm, nerve irritation, facet pain, spinal rotations, misalignments resulting from scoliosis, degeneration, arthritis and trauma.
The American Chiropractic Association recommends the following tips for back pain prevention:
- Maintain a healthy diet and weight.
- Remain active.
- Avoid prolonged inactivity or bed rest.
- Warm up or stretch before exercising or other physical activities.
- Wear comfortable, low-heeled shoes.
- Sleep on a mattress of medium firmness to minimize any curve in your spine.
- Lift with your knees, keep the object close to your body, and do not twist when lifting.
- Stop smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues. Smokers are more prone to back problems.
- Work with your doctor of chiropractic to ensure that your workstation is ergonomically correct.
If you experience back pain, consult a chiropractor. More than 30 million Americans sought chiropractic care last year alone.
With a thorough knowledge of the structure and function of the human body, chiropractors will take a history, do an exam, take x-rays, if necessary, and render a diagnosis. They will prepare a treatment plan and using spinal adjustments, various types of physical therapies, dietary and lifestyle advice, correct the problem and eliminate the pain.
Spinal adjustments, the treatment method used by chiropractors, are a recommended option for back pain rated as such by many state and workers’ compensation guidelines. Research showed that manipulative therapy or adjustments to the spine are not only safe but also highly effective.
In a recent informal survey, the American Chiropractic Association rated the occupations which they consider to cause the most stress and strains on the muscles of the back. They are as follows: (1) heavy truck and tractor-trailer drivers, (2) construction workers, (3) landscapers, (4) police officers, (5) farmers, (6) shingle roofers, (7) firefighters/EMTs, (8) delivery drivers, (9) nursing home workers, and (10) auto mechanics.
Your chiropractor has the knowledge, training and expertise to help you understand what is causing your pain, and the best method for treatment. Give Chiropractic a try.
Dr. Kathleen Roche is a chiropractor whose practice, Back Doctors Chiropractic, is located at 3915 West Main Street, Belleville, Illinois. Dr. Roche can be reached at (618) 234 1455.
When it comes to lifting and bending, employees aren’t always as careful as they should be. The American Academy of Family Physicians, Leawood, KS offers the following tips to keep your back healthy:
- Pace yourself. Take small breaks between lifts if you are lifting a number of items.
- Don’t overdo it by trying to lift some thing too heavy for you. If you have to strain to carry the load, it’s too heavy.
- Make sure you have enough room to
- lift safely. Clear a space around the object before lifting it.
- Look around before you lift, and look as you carry. Make sure you can see where you are walking so you don’t trip and fall. Know where you are going to put down the load.
- Get help before you try to lift a heavy load. Use a dolly or a forklift if possible.
- Avoid walking on slippery, uneven surfaces while carrying something.
- Don’t rely on a back belt to protect you. It hasn’t been proven that back belts can protect you from back injury.
Safety + Health, November 2004
CANCER SEEN IN FAMILY
MEMBERS OF ASBESTOS
WORKERS
People who were exposed to asbestos through a family member who worked with the material appear to run the risk of developing the asbestos-related cancer mesothelioma many years later. A new study found 32 cases of mesothelioma diagnosed since 1990 among family members. Wives and daughters were most often affected, with the lag time between asbestos exposure and cancer development topping 40 years in most cases. The findings are published in the May issue of the American Journal of Industrial Medicine.
ATLA Law News Digest – June 2,
2005
TORT CRISIS OVERBLOWN, TILLINGHAST STUDIES FAULT
CLAIMS ECONOMIC THINK TANK
There is no credible evidence to link the tort system either to the economics ills its critics claim or to the benefits they argue would be produced by altering it, according to a new study by the Economic Institute.
The EPI analysis by economist, Lawrence Chimerine, and attorney, Ross Eisenbrey, claims that the so-called tort litigation crisis is based on “wildly overstated cost estimates that have been widely cited by lawmakers and the media as support for calls for legal change.”
The authors maintain that economic trends of the past 10-15 years are completely inconsistent with the claim that higher legal costs have hurt the economy. They find, to the contrary, that “draconian change to the tort system is more likely to hurt than help job creation.”
The EPI report, The Frivolous Case for Tort Law Change, examines reports prepared by Tillinghast-Towers Perrin, a consulting firm whose clients include many of the world’s largest insurance companies. TTP’s reports are cited by President George Bush and his Council of Economic Advisors in arguing for tort reform.
“The insurance consultants have spun a few high-profile but unrepresentative incidents into a horror story that is almost entirely unsupported by the facts,” said Chimerine. “It is cobbled together out of gross exaggerations, shreds of fact plucked out of context, and ‘secret’ data that cannot be examined by anyone but them. The result is a mishmash that bears little resemblance to actual research.”
Tillinghast, or TTP, argues that the country is in the midst of a tort litigation crisis that costs the economy nearly a quarter of a trillion dollars a year, but the EPI authors counter that TTP’s argument is not supported by the available evidence and is, in fact, often contradicted by it.
For example, the EPI analysts claim:
Tort lawsuits have actually fallen significantly, despite continuing population growth. According to the National Center for State Courts, there was a four percent drop in cases from 1993 to 2002 in the 35 states that include 77 percent of the population. Rising insurance premiums are not a result of increased tort litigation. Rather they are caused by a combination of economic factors: the collapse of the stock market, record low long-term interest rates; the recession and rising medical costs. Indeed, premiums are now declining because these economic factors have shifted in the past year or two.
Most of the $246 billion price-tag that TTP puts on the tort system is made up of components that have little or nothing to do with the legal system or are indefensible guesswork, according to the EPI analysts. For example, they say that about half of the total is made up of legitimate payments by a wrongdoer of the victim’s costs, such as medical bills, which have little or no economic impact. It also includes billions of dollars in insurance industry costs, such as insurance company administrative and overhead expenses, which add up to almost 22 percent of the total.
Much of the total cost TTP alleges is unverifiable, because it is based on data and methodology that it insists on keeping secret.
“TTP has succeeded in alarming the public and the media by making a manageable situation seem like a crisis,” said Eisenbrey. “Their numbers do not stand up to analysis and neither do the promises about the economy that the administration has based on them.”
The co-author of the EPI study, Dr. Lawrence Chimerine, is president of Radnor International Consulting, Inc. and former chairman, chief executive, and chief economist of Chase Econometrics and WEFA Group.
Ross Eisenbrey, the other author, is vice president and policy director of the Economic Policy Institute.
The Economic Policy Institute is an independent, nonprofit, nonpartisan research institute – or “think tank” – based in Washington, D.C. Insurance Journal, May 17, 2005
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