death – Page 27 – SafetyAtWorkBlog

The economic costs of a heart attack

A new Australian report estimates the total costs of heart attack and chest pain (Acute Coronary Syndrome or ACS) to the Australian economy – “total economic cost of $17.9 billion.” This Access Economics report, released in June 2009, has broad application for public policy but has some relevant information for safety and health management in the workplace.

If we take “productivity” as applying to work, as is reasonable, the report states that for 2009

“Indirect [health care system] costs [from ACS] are expected to account for $A3.8 billion, primarily due to lost productivity.”

This is a useful statistic for those workplace health advocates. In fact, the report specifically identified the workplace as

“…an excellent environment to facilitate the ongoing rehabilitation and lifestyle changes to prevent the re-occurrence of ACS event”.

One gap it identified in the treatment and monitoring of ACS was something that many have been advocating for some years, particularly with the aging population and increasing obesity rates:

“a standardised national program to support employees and employers and the extension of rehabilitation practices.”

Much of the report advocates important rehabilitation resources and services for when the patient is discharged from hospital. The report includes the following graphic but also recommends the basic elements of post-hospital care after an ACS event.

Costofheartattackandchestpain-261-2 rehab table

“For rehabilitation to be effective, comprehensive patient follow-up interviews after discharge are essential. At these follow-up interviews, the patient should undergo both physical assessments (e.g. blood pressure, cholesterol tests, ECGs) and emotional and psychological assessments (e.g. signs of depression, anxiety, stress, financial hardships). The psychological impact following an ACS event is an important, but often neglected, area in the management of ACS. Thus, if patients can better understand their conditions, it can empower them to cope with their anxieties caused by ACS.”

In specific reference to workplaces, the report says:

“Returning to work can require an adjustment in duties and the conditions under which the employee works.”

It is up to OHS and return-to-work professionals to determine exactly what strategies should be applied in these circumstances.

There were a couple of references in the report that may be worth following up:

Bhattacharyya MR, Perkins-Porras L, Whitehead DL, and A Steptoe (2007), Psychological and clinical predictors of return to work after acute coronary syndrome, European Heart Journal, Vol 28, Iss. 2, pp. 160-165.

Kovoor P, Lee AKY, Carrozzi F, Wiseman V, Byth K, Zecchin R, Dickson C, King M, Hall J, Ross DL, Uther JB, and AR Denniss (2006), Return to full normal activities including work at two weeks after acute myocardial infarction, American Journal of Cardiology, Vol 97, No. 7, pp. 952-958.

Kevin Jones

Peanut allergy fatality saga to continue

Safety management in the education sector seems to be one of the hardest management challenges. There are overlapping safety obligations through OHS legislation, education department guidelines, public health matters and meeting the demands of parents and students.

A decision in the Federal Court of Australia on 30 June 2009 illustrates the challenges.

A 13 year old boy from Scotch College, in Melbourne, Nathan Francis, died after eating from a ration pack of beef satay on a Defence Forces camp. The school, which was supervising the camp, were aware of the boy’s severe allergy to peanuts.

The Australian Department of Defence was fined over $A200,000.

The full judgement of the court raises several issues that are relevant to the management of safety of people in one’s care. The judge has recommended a State coronial inquest to determine the roles and responsibilities of Scotch College in Nathan’s death.

Justice for Nathan and his family is likely to have many more months to go. [ SafetyAtWorkBlog will follow the issue.]

A fantastic audio report on the decision is available at the ABC website. The payment of the fine back to the government is not dealt with in this blog.

The first section of the judgement (below) indicates what the judge believes are the failures that need to be addressed through an appropriate safety process:

Communication;
Instruction;
Provision of appropriate supplies;
The importance of labelling; and
Following procedures and guidelines

Some readers may find that this prosecution could make an interesting case study for safety management.

Kevin Jones

Justice North found that the Federal OHS Act was breached by the Commonwealth government through the Chief of Army. The respondent

(a) supplied Cadet Nathan Fazal Francis, Cadet Nivae Anandaganeshan and Cadet Gene van den Broek with one-man combat ration packs (CRP’s) containing a satay beef food pouch which contained peanuts or peanut protein for their consumption despite having been informed that the said cadets were allergic to peanuts;
and, in so doing, it failed to:

(b) warn parents of the [Australian Army Cadets] AAC cadets about the contents of the CRP’s;

(c) warn AAC cadets about the contents of CRP’s;

(d) warn AAC cadets with pre-existing food allergies of the contents of CRP’s;

(e) make appropriate use of information provided by AAC cadets and parents of AAC cadets regarding pre-existing or known allergic conditions and correlate that information with the potential risk of being exposed to allergies through the supply of food contained in CRP’s;

(f) ensure that the contents of CRP’s allocated to AAC cadets did not include food products or allergens that may have triggered allergic responses by removing or requiring the removal of peanut-based food products from CRP’s;

(g) prevent distribution or provision of peanut-based food products to AAC cadets with pre-existing allergic reactions by:

i. inspecting the contents of CRP’s to be allocated to those individual AAC cadets who had given notice of allergic conditions;

ii. isolating cadets with pre-existing medical conditions and/or notified food allergies at the time of distribution of CRP’s and issuing them with CRP’s that did not contain peanut products or other food allergens;

iii. removing all CRP’s known to contain peanut protein or other food allergens from circulation amongst AAC cadets;

iv. requiring all AAC cadets with notified allergic conditions to provide their own food supplies;

(h) issue any or any adequate instructions or provide adequate supervision regarding distribution of CRP’s;

(i) issue any adequate instructions or provide adequate supervision regarding consumption of contents of CRP’s;

(j) prevent the consumption of CRP’s containing food allergens by AAC cadets with food allergies;

(k) distribute CRP’s after consulting or considering pre-existing medical conditions; and

(l) take into consideration the findings of a report dated 22 November 1996 by the Australian National Audit Office entitled ‘Management of Food Provisioning in the Australian Defence Force’.

OHS crime alert

In late June 2009, WorkSafe Victoria tried a new approach to raising the awareness of the criminal status of OHS breaches through producing a formatted media alert and placing an ad in the daily newspapers.

It is unclear how else the “flyer” will be distributed other than through the WorkSafe website. Indications are that a hard copy of the alert for distribution through WorkSafe offices is not planned.

The ad, pictured right, refers to the prosecution of Rapid Roller over the second serious lathe incident at that workplace in 12 months, the most recent resulting in a death.

Kevin Jones

UK workplace fatality data

New UK workplace fatality data was released by the Health and Safety Executive (HSE) this week. It provides an interesting comparison to the recent Australian data.

The HSE says that

“The provisional figure for the number of workers fatally injured in 2008/09 is 180, and corresponds to a rate of fatal injury of 0.6 per 100 000 workers.

The figure of 180 worker deaths is 22% lower than the average for the past five years (231). In terms of the rate of fatal injuries, the latest figure of 0.59 per 100 000 workers is 23% lower than the five-year average rate of 0.77.

Comparison with data from other EU countries over a number of years reveals that the fatal injury rate for Great Britain is consistently one of the lowest in Europe.

There were 94 members of the public fatally injured in accidents connected to work in 2008/09 (excluding railways-related incidents).”

The industries with the highest number of fatalities, in descending order, are:

Services sector 63
Construction 53
Manufacturing 32
Agriculture 26

Agriculture has the highest rate of death per 100,000 workers at 5.7

Kevin Jones

New Australian OHS statistics

Safe Work Australia released two OHS statistical reports in June 2009 – Mesothelioma in Australia, Incidence 1982 to 2005, Deaths 1997 to 2006 and Notified Fatalities Statistical Report, July 2008 to December 2008.

Both reports are recommended for those statistic junkies out there as the analysis and trends are sadly illustrative, however some of the highlights, if they can be called that, are:

In 2005, the age-standardised rate of new cases of mesothelioma was 2.8 per 100 000 population.
In 2006, the age-standardised rate of death due to mesothelioma was 2.3 deaths per 100 000 population.

The death rate has remained stable.

MESOTHELIOMA IN AUSTRALIA

INCIDENCE 1982 TO 2005

DEATHS 1997 TO 2006

More detailed information is available in the fatalities report however below are some main findings

There were 88 notified work-related fatalities.

The majority of fatalities were male.

Workers aged 55 years and over accounted for one-fifth (20%) of worker fatalities.

Four industries accounted for over three-quarters of all notified work-related fatalities, in descending order:

Agriculture, forestry and fishing,

Construction;

Transport and storage;

Manufacturing

The most common causes of work-related fatalities were, in descending order:

Vehicle accident;

Being hit by moving objects;

Being hit by falling objects;

Drowning/immersion; and

Falls from a height.

Prophet and Loss – review

I bought tickets to the Jane Woollard play Prophet & Loss in almost total ignorance of the play and, as a result, sat in the old church on a cold Winter’s night wondering what I was in for. The program was detailed but I hadn’t time to read it. I knew the play was about issues related to workplace death. That’s the “loss”. The “prophet” was Isaiah and that was the element that I could not understand without later reflection.

However, finding out about Isaiah could wait till we got home and then we could research a further dimension to what we saw. The stories that told of the impact of workplace fatalities on families and workmates were compelling although a couple were familiar to me. They told of bureaucratic confusion, the disinterest of insurance company call centre staff, the psychological legacy of a traumatic death and the inability to understand the survivor experience without having experienced it firsthand.

The venue was small but high and so the actors were close and the pain and grief was well presented. All of the actors were very good even though I was sure I had seen one of them before somewhere. It wasn’t till I looked at the program that the actor who looked like Helen Morse was indeed Helen Morse.

The stories’ subjects were frustrating and bleak, there is little opportunity for humour on this topic, but there was opportunity for theatricality and motion. Fanny Hanusin broke the rhythm with her portrayal of Merpati who was hyperventilating in panic over the lack of understanding of her situation. As Glynis Angell, the grief counsellor, Merrilyn, began breathing slowly to decrease Merpati’s panic, most of the audience were breath along.

All of the actors interchanged roles, with each taking a turn as an overcoated Isaiah writing on the wall and speaking ancient Hebrew (I later found out). The role changes worked well on reflection but I could not work out the thematic structure of the play until three-quarters in. The different outfits, the stories, Isaiah, were all confusing because the pairing of the characters with the stories took too long to establish. I am not a great wearer of hats but the different characters could have been more readily identified by the audience with hats, as well as the changing of clothing. Hats are more visible and illustrate different identities more clearly. It may have shortened my confusion.

What differentiated this play from a series of monologues, given that I didn’t understand the Isaiah context, was the music. The soloist, Deborah Kayser, the seraphim, sang beautifully and the acoustics of the venue were ideal although the 13^th century language was totally lost on me. (A sample of Kayser’s singing can be heard online) I have never heard a double bass played to such beautiful effect as was played by Nick Tsiavos. The depth of sound from a bow on bass could be felt in one’s chest and how he was able to pluck and stroke those strings at the same time was a mystery until he came into the light in the second half.

Kayser and Tsiavos, the seraphim, were a musical Greek chorus to the tales of grief and frustration. This role was perhaps emphasized by their wings which were effective but initially confusing. Kayser introduced the play in character with words that were cryptic but set the tone for the play.

The staging was effective in its industrial appeal and the use of 44-gallon drums as props and seats worked. Early on the actors slowly rotated these drums to provide a chilling sound which I was hoping for more of throughout the play.

Each character laid out the clothes or uniform of their deceased loved one through the play, providing a useful personal profile that complemented each story. I recall one character had worn her partner’s clothes for three days in a grieving intimacy. She would only relinquish the clothes when they no longer smelt of her partner but now of her.

The play was being performed at the Centre for Theology and Ministry near the University of Melbourne for a limited season and as a lead-in to a major theological conference. The play was supported by the Creative Ministries Network that provides a counselling service for those affected by workplace fatalities.

Prophet & Loss could travel well with its combination of an occupational/social theme, beautiful music and faith. Please look out for it.

Kevin Jones

Panic in disaster planning

Three years ago I had the privilege of arranging for Dr Lee Clarke of Rutgers University to attend the Safety in Action Conference in Australia. Lee had a book out at the time, Worst Cases, and spoke about the reality of panic. Lee’s studies have continued and are, sadly, becoming more relevant.

Recently, Rutgers University posted a video interview with Lee on Youtube.

Shortly after the World Trade Center collapse in 2001, I asked Lee to write something about the event from his experience and perspective. He wrote a piece for a special edition of Safety At Work magazine. The article has been available through his website for some time and is now available through here by clicking on the image below.

I strongly recommend Lee’s books. As he says in the video, they’re quite fun, in a sad sort of way.

Kevin Jones

Tag: death

The economic costs of a heart attack

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Peanut allergy fatality saga to continue

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OHS crime alert

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UK workplace fatality data

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New Australian OHS statistics

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Prophet and Loss – review

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Panic in disaster planning

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