Citing Violations Medicare Ends Contract with Fox Insurance Company Drug Plan

The Centers for Medicare and Medicaid Services has issue an announcement of the immediate termination of Fox Insurance Company.

Members Will Be Provided Access to Drugs While Transitioning to New Plans.

The Centers for Medicare & Medicaid Services (CMS) today terminated its contract with Fox Insurance Company. After an onsite review of the plan and its services, CMS determined that the plan’s significant deficiencies – not meeting Medicare’s requirements to provide enrollees with prescription drugs according to recognized standards of care – jeopardized the health and safety of Fox enrollees. CMS found that Fox committed a series of violations, including improperly denying its enrollees coverage of critical HIV, cancer, and seizure medications. The termination of the contract is effective immediately.

The immediate termination will not impact or delay access to drugs for the more than 123,000 Medicare beneficiaries currently enrolled in Fox plans. Beginning tomorrow, all enrollees will obtain their drugs through LI-NET, a program run by Medicare and administered by Humana, to ensure that beneficiaries receive their Medicare prescription drugs. Fox enrollees will be able to choose a new Medicare prescription drug plan through May 1, 2010. Current enrollees who do not choose a plan will be enrolled into a new plan by Medicare.

“The immediate termination of Fox as a Medicare prescription drug plan demonstrates our commitment to protecting the health of some of their most vulnerable enrollees from getting necessary drugs, in some cases life-sustaining medicines. CMS’s immediate action was essential to protect members’ health and safety – an integral part of our contract with all Medicare beneficiaries,” said Jonathan Blum, acting director of CMS’ Center for Drug and Health Plan Choices. “Fox enrollees also need to know that they are not losing their drug coverage and will continue to have access to needed medicines. We will be sending letters explaining the steps we are taking to ensure they continue to get their medicines. They can also call 1-800-MEDICARE or their local state health insurance assistance programs if they have questions.”

CMS issued an enrollment and marketing sanction to Fox on Feb. 26, 2010, because the organization was not following Medicare’s rules for providing prescription drug coverage to its enrollees. After an onsite audit, which ran between March 2 and March 4, CMS found Fox’s problems persisted and it continued to subject its enrollees to obstacles in getting needed and, in many cases, life–sustaining medicines. CMS also found that many of the obstacles were in place to limit access to high-cost drugs, which could have led to enrollees’ clinical needs not being met. In many cases, Fox enrollees were required to have unnecessary and invasive medical procedures before they were able to obtain drugs. Fox was unable to satisfactorily address these compliance concerns and furnish medicines to its Medicare enrollees.

Among the audit findings CMS found include:

· Failing to provide access to Medicare prescription drugs benefits by imposing unapproved prior authorization and step therapy criteria that made it more difficult for beneficiaries to get drugs that are protected by law.

· Not meeting the plan’s appeals deadlines,

· Not complying with Medicare regulations requiring enrollees to be transitioned to new drugs at the beginning of the new plan year.

· Failing to notify enrollees about prior authorization and step therapy determinations as required by Medicare.

According to CMS auditors, Fox was unable to satisfactorily address compliance concerns cited in the enrollment and marketing sanction and meet contractual obligations to provide medicines to Medicare beneficiaries enrolled in their plans.

“We take our oversight role of Medicare prescription drug plans seriously,” said Blum. “We review and take action on all complaints received about Medicare health and drug plans and will take appropriate and immediate actions wherever necessary.”

CMS encourages Medicare prescription drug plan enrollees having concerns with access to drug coverage to contact 1-800-MEDICARE (1-800-633-4227) or the state health insurance assistance program (SHIP) to help get them resolved. Medicare enrollees, their families and their caregivers can contact a SHIP near them by visiting:http://www.medicare.gov/Contacts/staticpages/ships.aspx

# # #

NOTE: States in which the Fox plan was available were: Arkansas, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Missouri, North Carolina, New Jersey, New York, Nevada, Ohio, Pennsylvania, South Carolina, Texas and West Virginia.

To read more about CMS and workers compensation, click here.

US Supreme Court to Review Employee Privacy Issues

The US Supreme Court has granted certiorari in a case involving the application of the constitutional right to informational privacy to an employee questionnaire. NASA, et al. v. Nelson, Robert M., et al. No. 09-530, March 8, 2010.


The Supreme Court will be reviewing a 9th Circuit Court of Appeals decision involving contract employees of the Jet PropulsionLaboratory (JPL) who filed suit against the National Aeronautics and Space Administration (NASA) and others. The suit claims that contract employees in non-sensitive or “low risk” positions should not be required to submit to in-depth background investigations.


The Circuit Court below held:
We have repeatedly acknowledged that the Constitution protects an “individual interest in avoiding disclosure of personal matters.” In re Crawford, 194 F.3d 954, 958 (9th Cir.1999). This interest covers a wide range of personal matters, including sexual activity, Thorne v. City of El Segundo, 726 F.2d 459 (9th Cir.1983) (holding that questioning police applicant about her prior sexual activity violated her right to informational privacy), medical information,Norman-Bloodsaw v. Lawrence Berkeley Lab., 135 F.3d 1260, 1269 (9th Cir.1998) (“The constitutionally protected privacy interest in avoiding disclosure of personal matters clearly encompasses medical information and its confidentiality.”), and financial matters, Crawford, 194 F.3d at 958 (agreeing that public disclosure of social security numbers may implicate the right to informational privacy in “an era of rampant identity theft”). If the government's actions compel disclosure of private information, it “has the burden of showing that its use of the information would advance a legitimate state interest and that its actions are narrowly tailored to meet the legitimate interest.” Crawford, 194 F.3d at 959 (internal quotation marks omitted). We must “balance the government's interest in having or using the information against the individual's interest in denying access,” Doe v. Att'y Gen., 941 F.2d 780, 796 (9th Cir.1991), weighing, among other things:
“the type of [information] requested, ... the potential for harm in any subsequent nonconsensual disclosure, ... the adequacy of safeguards to prevent unauthorized*878 disclosure, the degree of need for access, and whether there is an express statutory mandate, articulated public policy, or other recognizable public interest militating towards access.”
Id. (quoting United States v. Westinghouse Elec. Corp., 638 F.2d 570, 578 (3d Cir.1980)) (alteration in original).
Both the SF 85 questionnaire and the Form 42 written inquiries require the disclosure of personal information and each presents a ripe controversy."

".....The balance of hardships tips sharply toward Appellants, who face a stark choice-either violation of their constitutional rights or loss of their jobs. The district court erroneously concluded that Appellants will not suffer any irreparable harm because they could be retroactively compensated for any temporary denial of employment. It is true that “monetary injury is not normally considered irreparable,” L.A. Mem'l Coliseum Comm'n v. Nat'l Football League, 634 F.2d 1197, 1202 (9th Cir.1980), and the JPL employees who choose to give up their jobs may later be made whole financially if the policy is struck down. "

Click here to read more about privacy issues and workers' compensation.

Commercial Driver Fatigue Questioned as a Pre-exisiting Condition?

Falling asleep at the wheel is a common cause of accidents for commercial drivers. The Federal Motor Carrier Safety Administration  (FMCSA) of the U.S. Department of Transportation is exploring  the issue that such conditions as excessive  daytime sleepiness should be evaluated by medical examination in an effort to predict future probabilities of having a bad day at the wheel and potential crashes at the wheel because of sleepiness. 

If a sleep disorder can be identified and documented, that condition maybe determined to be a pre-exisiting medical condition. Apart from the third party liability that could be imposed upon an employer for identification and non-identification of the medical condition, the issue of an allocation for a pre-exisitng medical conditions (prior-functional credit) may exist in a workers' compensation claim as well as an event that can be attributed to a risk in the course of employment.

The term "prior functional credit" refers to the credit given to the employer, or to the employer's insurance carrier, for the loss of function of any part of the body which an employee had sustained before a subsequent injury or occupational disease for which the employer in question is responsible.  Over the years there have been dramatic changes enacted by the Legislature accompanied by varying interpretations by the courts with regard to the law addressing credits to be afforded to the employer for both non-work and work connected injuries.

The employer no longer takes an employee as they find them. Belth v. Anthony Ferrante & Son, Inc., 47 N.J. 38, 219 A.2d 168 (1966). An individual suffered from asbestosis and bronchitis, and medical testimony was presented by the petitioner's expert apportioning a percentage of the functional loss to cigarette smoking.  The employer was awarded a credit for the previous loss of function which could be attributed to the employee's cigarette smoking, since the legislatively enacted amendments permitted the employer to receive credit for an employee's prior loss of function involving the same body part affected by the compensable occupational disease regardless of whether compensation was received for the earlier injury.  In effect, the employer no longer takes employees as it finds them.  The court stated that the credit to employers for previous loss of function, whether work-related or not, was an incentive to encourage employers to hire workers with pre-existing disabilities.  Field v. Johns-Manville Sales Corp., 209 N.J.Super. 528, 507 A.2d 1209 (App.Div.1986), certif. denied 105 N.J. 531, 523 A.2d 172 (1986); Dafler v. Raymark Industries, Inc., 259 N.J.Super. 17, 611 A.2d 136 (App.Div.1992).

Additional questions may arise as to whether the risk is actually associated with the employment. The Court may also evaluate the risk associated with the employment task in evaluating compensability.  Where the risk was not enhanced by the business interests of the employer, and there was no exercise of control by the employer over the employee, the event is usually deemed to be non-compensable. If the risk in indeed removed from the course of employment then the employer may be denied the exclusivity bar and liability on the employer could be imposed in a civil action. 

The FMCSA commented, "....measuring an individual’s sleepiness today is not going to predict how sleepy the person will be 6 weeks from now. Several factors influence sleepiness, including prior sleep time, medications, and time of day, so it is a very difficult thing to assess."


Click here to read more about "pre-exisiitng conditions" and workers' compensation.

OSHA is Listening

The Occupational Safety and Health Administration (OSHA) is soliciting suggestions and comments concerning workplace safety. OSHA's concern is that, "No one should have to be injured or killed for a paycheck."


The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) held a public meeting, "OSHA Listens," to solicit comments and suggestions from OSHA stakeholders on key issues facing the agency. The meeting was scheduled for Feb. 10 from 9 a.m. to 5 p.m. EST in Washington, D.C.

"Public involvement in the government's activities is a priority for this administration and is important to enhancing OSHA efforts to protect the safety and health of workers," said Assistant Secretary of Labor for OSHA Dr. David Michaels. "This public meeting gives us an opportunity to hear your ideas, suggestions and comments on key issues facing this agency."

Some of the questions OSHA invited public input on included:

1. What can the agency do to enhance and encourage the efforts of employers, workers and unions to identify and address workplace hazards?
2. What are the most important emerging or unaddressed health and safety issues in the workplace, and what can OSHA do to address these?
3. How can the agency improve its efforts to engage stakeholders in programs and initiatives?
4. What specific actions can the agency take to enhance the voice of workers in the workplace, particularly workers who are hard to reach, do not have ready access to information about hazards or their rights, or are afraid to exercise their rights?
5. Are there additional measures to improve the effectiveness of the agency's current compliance assistance efforts and the on site consultation program, to ensure that small businesses have the information needed to provide safe workplaces?
6. Given the length and difficulty of the current OSHA rulemaking process, and given the need for new standards that will protect workers from unaddressed, inadequately addressed and emerging hazards, are there policies and procedures that will decrease the time to issue final standards so that OSHA may implement needed protections in a timely manner?
7. As we continue to progress through a new information age vastly different from the environment in which OSHA was created, what new mechanisms or tools can the agency use to more effectively reach high risk employees and employers with training, education and outreach? What is OSHA doing now that may no longer be necessary?
8. Are there indicators, other than worksite injuries and illness logs, that OSHA can use to enhance resource targeting?
9. In the late 1980s, OSHA and its stakeholders worked together to update the Permissible Exposure Limits (PELs) (exposure limits for hazardous substances; most adopted in 1971), but the effort was unsuccessful. Should updating the PELs be a priority for the agency? Are there suggestions for ways to update the PELs, or other ways to control workplace chemical exposures?

After a written comment period closes on March 30, 2010, a link to the Meeting Transcript will be posted on the Internet. Comments received through March 3rd are now available on line.

Meeting Agenda
9 a.m.  Welcome and Introductory Comments
   David Michaels, Assistant Secretary, OSHA
   Deborah Berkowitz, Chief of Staff, OSHA
9:10-9:50 Panel 1
   Tonya Ford, Uncle killed at ADM facility in 2009
   Katherine Rodriguez, Father killed at British Petroleum in 2004
   Wanda Morillo, Husband killed in a NJ industrial explosion in 2005
   Celeste Monforton, American Public Health Association
   Linda Reinstein, Asbestos Disease Awareness Organization
9:50-10:30 Panel 2
   Marc Freedman, U.S. Chamber of Commerce
   Keith Smith, National Association of Manufacturers
   Frank White, ORC
   Stephen Sandherr, Association of General Contractors
10:30-10:40 Break
10:40-11:20 Panel 3
   Workers United
   Peg Seminario, AFL-CIO
   Scott Schneider, Laborers' Health and Safety Fund
   Mike Wright, United Steel Workers
11:20-11:50 Panel 4
   Chris Patton, American Society for Safety Engineers
   Katharine Kirkland, Association of Occupational and Environmental Clinics
   Aaron Trippler, American Industrial Hygiene Association
11:50-12:30 Panel 5
   Kathleen McPhaul, American Public Health Association, Univ. of Maryland Nursing
   Hestor Lipscomb, Duke University Medical School
   Rick Neitzel, National Hearing Conservation Association
   Matt Schudtz, University of Maryland Law School
12:30-1:30 Lunch
1:30-2:00 Panel 6
   Karen Harned, Nat'l Federation of Independent Business, Small Business Legal Center
   Cynthia Hilton, Institute of Makers of Explosives
   Thomas Slavin, Navistar, Inc.
2:00-2:30 Panel 7
   Andrew Youpel, Brandenburg Industrial Service Company
   Robert Matuga, National Association of Home Builders
   Tom Broderick, Construction Safety Council
2:30-3:00  Panel 8
   Don Villarejo, California Institute for Rural Studies
   Luzdary Giraldo, NY Committee for Occupational Safety and Health
   Roger Cook/Peter Dooley, Western NY Council on Occupational Safety and Health
3:00-3:40 Panel 9
   Rick Engler, NJ Work Environmental Council
   Tom O'Connor, National Council for Occupational Safety and Health
   Norman Pflanz, Nebraska Appleseed Center for Law
   Chris Trahan, Building and Construction Trades Department
3:40-3:50 Break
3:50-4:10 Panel 10
   John Masarick, Independent Electrical Contractors
   Davis Layne, VPPPA
4:10-4:40 Panel 11
   Bruce Lapham, Valcourt Building Services, LC
   Scott A. Mugno, FedEx Express
   Marc Kolanz, Brush Wellman Inc.
4:40-5:10 Panel 12
   Pamela Vossenas, Unite Here! International
   John Morawetz, International Chemical Workers Union Council
   Dinkar Mokadam, Association of Flight Attendants-CWA
5:10-5:50 Panel 13
   Rick Inclima, International Brotherhood of Teamsters
   Jason Zuckerman, Employment Law Group
   Richard Renner, National Whistleblowers Center
   Tim Sharp, Alaska Review Board & Laborer's Council
Click here to read more about OSHA and workers' compensation.

Alice in Wonderland - A Lesson in Occupational Illness

Alice in Wonderland has been released in the movie theaters today. The National Institute of Occupational Safety and Health (NIOSH) has been quick to remind us of the Mad Hatter and mercury exposures.

"Society has made great progress in recognizing and controlling industrial hazards since Lewis Carroll's day. For example, nearly 70 years ago, on December 1, 1941, the U.S. Public Health Service ended mercury's use by hat manufacturers in 26 states through mutual agreements. The kinds of conditions that put hat-makers and other industrial workers at risk in 1865 are no longer tolerated," said John Howard, M.D., Director of the National Institute for Occupational Safety and Health (NIOSH).

"However," Dr. Howard emphasized, "the Hatter remains a cautionary figure, since exposures to mercury and other hazardous industrial substances can still occur in the workplace. Symptoms from chronic exposures to mercury, lead, and other neurotoxic substances, even at low levels, may be subtle in early stages. Sometimes, they may be mistaken for symptoms that can arise from other causes. Similar concerns exist about other adverse effects that are associated with exposures on the job. It is important to be vigilant about work-related illness, and to act decisively to protect workers' health."

In 1911, New Jersey adopted the Workers' Compensation Act.  The original Act did not recognize any occupational diseases as compensable events.  In 1924 there were early amendments to the Act which enumerated 9 diseases as compensable.  Those disease were: anthrax, lead poisoning, mercury poisoning, arsenic, phosphorous, benzene, wood alcohol, chrome and caisson disease. 

A utility man who was required to pour sixty pounds of mercury each day and who had mercury dust both on his face and his clothes developed muscular weakness.  The expert doctor testified that the disease was either caused by mercury poisoning or myasthenia gravis.  Even though his supervisor testified that daily showers were available to all employees, the treating doctor indicated that, as a result of positive clinical findings, diagnostic tests, and a history of exposure, the exposure was the cause of the petitioner's illness, namely muscular weakness, and was compensable.  Jackson v. Mallinckrodt Chemical Works, 25 N.J.Misc. 33, 50 A.2d 106 (Com.Pl.1946).

A hatter who was required to come into contact with furs that had been treated with mercury was awarded total permanent disability benefits as a result of his having contracted the occupational disease of mercurial poisoning during the course of his employment.  Horowitz v. Rothenberg Hat Co., 19 N.J.Misc. 284, 18 A.2d 852 (Dept. of Labor 1941), N.J.S.A. 34:15-31, L.1924, c. 124 (Sec. 1) 22b, p. 231.

An employee in the hat industry who had suffered from symptoms of mercury poisoning and who had notified the insurance carrier was deemed to have notified the employer as well, and compensation was allowed.  Yurow v. Jersey Hat Corporation, 131 N.J.L. 265, 36 A.2d 296 (1944), judgment aff'd 132 N.J.L. 180, 39 A.2d 371 (Err. & App.1944).

The Division of Epidemiology, Environmental and Occupational Health Services requires that treating physicians report to the State Department of Health any occupational or environmental diseases within 30 days of diagnosis or treatment.  These diseases include: lead toxicity, arsenic toxicity, mercury toxicity, cadmium toxicity and pesticide toxicity. N.J.A.C. 8:57-3.2.

Mad Hatter: "No wonder you're late. Why, this watch is exactly two days slow."

...

Click here to read more about occupational disease and workers' compensation.

Possible Vaccine for Mesothelioma

A vaccine has been demonstrated as safe for potential use against mesothelioma. The research, conducted by Netherlands scientists was reported in an advance publication of  the American Journal of Respiratory and Critical Care.


The scientists concluded that, This study demonstrated that autologous tumor lysate-pulsed dendritic cell-based therapy is feasible, well-tolerated, and capable of inducing immunological response to tumor cells in mesothelioma patients."

Mesothelioma is a rare and fatal  malignant tumor associated with asbestos exposure. Asbestos was mined and its fiber used for fire-retartant insulation properties. Asbestos use has resulted in an a legacy of illness and death decades following exposure because of the latent and progressive nature of the disease. Asbestos production is not yet banned in the United States.

Findings indicated that, "Administration of dendritic cells pulsed with autologous tumor lysate in mesothelioma patients was safe with moderate fever as the only side effect.There were no grade 3 or 4 toxicities associated with the vaccines or any evidence of autoimmunity. Local accumulations of infiltrating T cells were found at the site of vaccination. The vaccinations induced distinct immunological responses to KLH, both in vitro and in vivo. Importantly, after three vaccinations, cytotoxic activity against autologous tumor cells was detected in a subgroup of patients."

The Study: J. P Hegmans, J. D. Veltman, M. E Lambers, I. J. M. de Vries, C. G. Figdor, R. W Hendriks, H. C. Hoogsteden, B. N. Lambrecht, and J. G. Aerts , Consolidative Dendritic Cell-Based Immunotherapy Elicits Cytotoxicity Against Malignant Mesothelioma, Am. J. Respir. Crit. Care Med. 2010 0: 200909-1465OCv1-


More articles about this research:
Health Day: Vaccine for Asbestos-Related Cancer Looks Safe. In tests, novel immunotherapy appears to combat mesothelioma tumors.

Science News: Possible Vaccine for Mesothelioma Proven Safe.

Clinical Trials: Dendritic Cell-based Immunotherapy in Mesothelioma

................

Click here to read more about asbestos and workers compensation.
Click to read more about asbestos litigation.

Making a Fatal Circus Out of Safety

The terrible and tragic death of Daum Brancheau, the trainer who was attacked at SeaWorld by a killer whale, provides striking evidence that the present system, to make the workplace safer, is not working. The corporate incentive to maintain a safe workplace unfortunately only can be induced by economics.

Two things need to happen so that workplaces become safer. The Occupational Safety and Health Act (OSHA) need to be strengthened, and the workers' compensation system needs to remove the exclusivity bar that prevents liability claims against employers.

Workers' compensation has been in place since 1911 and limits recovery for an employee injured at work and shields employers from liability claims by injured workers. The system provides for a limitation of recovery and economic caps that shield employers from threatening damage claims. Without an economic incentive employers just won't do what's necessary to prevent accidents and injuries to employere.

Legislation, Protecting America's Workers Act H.R. 2067 S.1580 and Protecting Workers From Imminent Dangers Act of 2009 H.R.2199 ,  is presently under consideration to put teeth back into OSHA. Those pending changes, sadly will not help Dawn, they would be a good first step in preventing injuries and deaths like what occurred at SeaWorld in Florida.

Click here to red more about OSHA and workplace accidents and illnesses.

Novel Approach-Eliminate the Need to Go To Court

Scotland is working on a way to speed up compensation benefits in wrongful death compensation cases. Bill Butler, Minister from Glasgow has proposed that in admitted cases the parties should not have to appear in court.Joe O'Neill, of the Clydebank Asbestos Group, said: "This is welcome news for the people we represent.

"Too often protracted legal proceedings place undue strain on families and I would urge all MSPs to get behind these proposals and ensure that justice can be accessed as quickly as possible."

Speeding up the process is something that Nebraska does already also through the elimination of court appearances. Nebraska allows resolution of lump sum dispositions by merely filing a release.

To read more about fatal cases and the quest for benefits click here.

Trauma of Job Loss Often Includes Health Problems

Occupational heart attacks are notorious issues in workers' compensation claims. The New York Times reviews the phenomenon cardiovascular episodes attributed to work related stress due to plant closings.

A "....paper, published last year by Kate W. Strully, a sociology professor at the State University of New York at Albany, found that a person who lost a job had an 83 percent greater chance of developing a stress-related health problem, like diabetes, arthritis or psychiatric issues."

The Occupational Disease Pilot Program & Healthcare

Health Care reform continues to be at the forefront of the Obama administration’s agenda.   Legal Talk Network Host and Attorney Alan S. Pierce welcomes Jon L. Gelman to discuss health care and workers’ compensation and the Occupational Disease Pilot Program: a close look at the delivery of  medical benefits when it comes to occupational disease and how workers' compensation may or may not fit into the big picture of universal health care or health care reform.


Click here to listen to the interview (duration 27:58): http://tinyurl.com/ycxee3y
MP3 Link: http://tinyurl.com/ybanu3v (20.6MB)


To read more about the Libby MT Pilot Project click here.

To read more about workers’ compensation and universal health care solutions click here. 

Taking Aim At Carcinogenic Cosmetics

The fragrance and cosmetic industry is now the target of potential regulation as the State of Colorado is considering legislation to ban cosmetics that contain cancer producing substances. Legislation has been introduced by Senator Betty Boyd and Representative Dianne Primavera to ban the products.The proposed legislation is entitled "Colorado Safe Personal Care Products Act." [HB 1248]


Recently the NJ Courts upheld a workers' compensation claim of a worker who suffered a medical condition as a result of merely sustaining a bystander exposure to perfume. 


The cosmetic and fragrance industry is largely self-regulated. The proposed Colorado legislation comes as a new national effort is being made to create a safer environment in the workplace.


The read more about occupational exposures and workers' compensation click here.

Asbestos Deaths Predicted to Continue for Decades

The National Institute for Occupational Safety and Health (NIOSH) has released a draft Intelligence Report concerning asbestos and mesothelioma in an effort to create a "road-map for research."

"Asbestos has been a highly visible issue in public health for over three decades. During the mid- to late-20th century, many advances were made in the scientific understanding of worker health effects from exposure to asbestos fibers and other elongate mineral particles (EMPs). It is now well documented that fibers of asbestos minerals, when inhaled, can cause serious diseases in exposed workers. However, many questions and areas of confusion and scientific uncertainty remain. For instance, due to the mineralogical complexity of the asbestos minerals, the scientific literature contains various inconsistencies in the definition and application of the term asbestos for health protection guidance and regulatory purposes."

"The purpose of the Roadmap is to outline a research agenda that will guide the development of specific research programs and projects that will provide a broader and clearer understanding of the important determinants of toxicity for asbestos and other EMPs. NIOSH recognizes that results from such research may impact environmental as well as occupational health policies and practices. Many of the issues that are important in the workplace are also important to communities and to the general population.Therefore, NIOSH envisions that the planning and conduct of the research will be a collaborative effort involving active participation of multiple federal agencies, including the Agency for Toxic Substances and Disease Registry (ATSDR), the Consumer Product Safety Commission (CPSC), the Environmental Protection Agency (EPA), the Mine Safety and Health Administration (MSHA), the National Institute of Environmental Health Sciences (NIEHS), the National Institute of Standards and Technology (NIST), the National Toxicology Program (NTP), the Occupational Safety and Health Administration (OSHA), and the United States Geological Survey (USGS), as well as labor, industry, academia, health and safety practitioners, and other interested parties, including international groups. This collaboration will help to focus the scope of the research, to fund and conduct research, and to develop and disseminate informational materials describing research results and their implications for establishing new occupational and public health policies."

Asbestos Deaths Predicted to Continue for Decades

"NIOSH has annually tracked U.S. asbestosis deaths since 1968 and malignant  mesothelioma deaths since 1999 using death certificate data in the National Occupational  Respiratory Mortality System (NORMS). NORMS data, representing all deaths among  U.S. residents, show that asbestosis deaths increased almost 20-fold from the late 1960s  to the late 1990s (Figure 6) [NIOSH 2007b]. Asbestosis mortality trends are expected to substantially trail trends in asbestos exposures (see Section 2.4.2) for two primary  reasons: (1) the latency period between asbestos exposure and asbestosis onset is 2 typically long, commonly one or two decades or more; and (2) asbestosis is a chronic disease, so affected individuals can live for many years with the disease before succumbing. In fact, asbestosis deaths have apparently plateaued (at nearly 1,500 per year) since 2000 (Figure 3) [NIOSH 2007b]. Ultimately, it is anticipated that the annual  number of asbestosis deaths in the United States will decrease substantially as a result of  documented reductions in exposure. However, asbestos usage has not been completely  eliminated, and asbestos-containing materials remain in place in structural materials and  machinery, so the potential for exposure remains. Thus, asbestosis deaths in the United  States are anticipated to continue to occur for several decades."

Mesothelioma Strongly Linked to Occupational Exposures

"Malignant mesothelioma, an aggressive disease that is nearly always fatal, is known to be  caused by exposure to asbestos and some other mineral fibers [IOM 2006]. The occurrence of mesothelioma has been strongly linked with occupational exposures to asbestos [Bang et al. 2006]. There had been no discrete International Classification of Disease (ICD) code for mesothelioma until its most recent 10th revision. Thus, only seven years of NORMS data are available with a specific ICD code for mesothelioma (Figure 4); during this period, there was a 9% increase in annual mesothelioma deaths, from 2,484 in 1999 to 2,704 in 2005 [NIOSH 2007b]. A later peak for mesothelioma deaths than for asbestosis deaths would be entirely expected, given the longer latency for mesothelioma [Järvholm et al. 1999]. One analysis of malignant mesothelioma incidence based on the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program data found that an earlier steep increase in incidence had moderated and 1 that mesothelioma incidence may have actually peaked sometime in the 1990s in SEER-2 covered areas [Weill et al. 2004]. In contrast to NORMS data, which represents a census 3 of all deaths in the entire United States, the analyzed SEER data were from areas in 4 which a total of only about 15% of the U.S. population resides."

NIOSH  has invited Public Comment Until April 16, 2010 5:00pm EDT

Click here to read more about asbestos and workers compensation.

Click to read more about asbestos litigation.

Defense Expert Found Contradictory in Psych Claim

The NJ Appellate Division affirmed the trial decision of Judge Kovalcik who ruled that the testimony of the defense expert was "contradictory and inconsistent and cannot credit his conclusion that Petitioner no longer suffers from post traumatic stress disorder."

The injured worker was struck from behind by two co-workers who had threatened to kill him.

Sormaz v. Alpha Moving & Storage, Inc. .. JERSEY APPELLATE DIVISION DOCKET NO. A-3482-08T33482-08T3  Decided 2.18.2010

Click here to read more about psychiatric claims and workers' compensation.

Camp Lejeune Toxic Exposure

Newly reported information is now demonstrating that the water at Camp Lejeune NC military base may have been  contaminated as a result of a toxic spill. Marines, sailors, their families and other civilian contractors may be been exposed to benzene, a human carcinogen.

Benzene was reported in the well water used for drinking on the base. The substance has been causally linked to cancer.It has been alleged that a dry cleaners leaked the toxin into the water for over three decades. Benzene has been liked to childhood cancers and birth defects.



Representative Brad Miller (D-NC) has requested an investigation into the exposure and possible concealment of information. As many as 1 million may have been exposed.

Click here to read more about claims arising out of benzene contamination.

Canadian Asbestos Hypocrisy

Despite the fact that asbestos is a know cancer producing agent, Quebec liberals have won their battle to continue asbestos mining. In 2008 asbestos amounted to a $100 Million dollars business in Canada. Canada exports the majority of its asbestos to developing counties which amounts to 175,000 tons per year. 


Over 100 scientists from 28 nations had written a letter in support of a ban on asbestos production in Canada.  “We appeal to you to respect the overwhelmingly consistent body of scientific evidence and the considered judgment of the World Health Organization (WHO) that all forms of asbestos have been shown to be deadly and that safe use of any form of asbestos has proven impossible anywhere in the world,” the letter began. “Under Canadian law, chrysotile asbestos is classified as a hazardous substance, but the Quebec government has successfully lobbied to prevent it being recognized as such under international environmental law, thus creating a double standard of protection as if some lives were less deserving of protection than others.”


The Canadian Journal of Medicine had also endorsed a ban on Canadian asbestos production. "Canada's government must put an end to this death-dealing charade. Canada must immediately drop its opposition to placing chrysotile under the Rotterdam Convention's notification and consent processes and stop funding the Chrysotile Institute. More importantly, Canada should do its part in alleviating the global epidemic of asbestos-related disease by ending the mining and export of chrysotile, as the WHO recommends."


Asbestos causes multiple diseases including: asbestosis, lung cancer and mesothelioma. For decades US victims of asbestos related disease have sought benefits under the workers' compensation system from employers. They have also filed claims under the civil justice system against suppliers, manufacturers and distributors of asbestos products. Due to the latency of the disease from exposure to manifestation, despite the reduction in the use of asbestos fiber, the disease continues to be very prevalent in the US and throughout the world.


Click here to read more about efforts to ban asbestos production in the US.

CMS Postpones Production Date for Mandatory Reporting

CMS has postponed first production date until January 1, 2011:
"CMS advises all NGHP RREs that the date for first production NGHP Input Files is changed from April 1, 2010 to January 1, 2011, effective immediately.

• NGHP File data exchange testing will continue.  All NGHP RREs should now be registered with the COBC, and either in or preparing for file testing status.  NGHP file data exchange testing may continue during 2010, as needed.
• All NGHP file data exchange testing will be completed by December 31, 2010.  NGHP RREs that have completed file data exchange testing at any time are encouraged to proceed to production file data exchange status.

During the week of February 22, on this Website CMS will post the next version of the "Section 111 NGHP User Guide" and a number of Alerts relating to particular NGHP policy issues.
Also during the week of February 22, on this Website CMS will post an alert for NGHP RREs describing the steps those RREs can take to assure their ongoing compliance with the Section 111 reporting requirements."


Click here to read more about CMS and workers' compensation.

Time to Collect the Salt Shakers

The reduction of factors contributing to cardiovascular disease would make any workplace a lot healthier. Recently, Mayor Bloomberg equated the deadly effects of asbestos exposure with salt intake.

Now comes a recent study reported in the New England Journal of Medicine (NEJM) that illustrates that even a minor reduction of salt intake would produce a significant reduction in cardiovascular events.

NEJM states in an editorial, "The large potential benefits of reducing salt intake observed by Bibbins-Domingo and colleagues may even represent an underestimate. Salt reduction is associated with reduced blood pressure in children and an attenuated age-related rise in blood pressure in adults. Neither of these benefits was modeled in the present analysis. There is also evidence that salt reduction may reduce the risk of gastric cancer, end-stage kidney disease, left ventricular hypertrophy, congestive heart failure, and osteoporosis."

As employers have eliminated other co-exisitng contributing factors such as tobacco smoke, they would be indeed wise to also consider the reduction of other factors, such as salt intake. Such action could only make the workplace a healthier environment.

Click here to read more about salt intake and possible workers' compensation consequences.

Senators Call for Toxic Substances Act Update

The New York Times today reports that Senator Frank Lautenberg (D-NJ.) is anticipated to introduce new legislation to modernize The Toxic Control Substances Act (TSCA) originally enacted in 1976. 


"There's no question that chemicals are essential to our modern lives ... but when we use these products, the chemicals in them can end up in our bodies," Lautenberg said. "And when the chemicals used in flame retardants, plastics or rocket fuel show up in our children's bodies, we have a potentially dangerous situation."


Click here to read more about toxic exposures and workers' compensation.

Meso for Miles - Supporting Mesothelioma Research

A Walk/Run in support of research to treat and cure mesothelioma was successfully held in South Florida today. Hundreds were in attendance to support the research effort and demonstrate to ban the use of asbestos in the United States.

The legacy of disease caused by the innocent exposure to asbestos exposure continues in epidemic proportion. Asbestos, a known carcinogen, exposure results in asbestosis, lung cancer and mesothelioma.

......

Click here to read more about asbestos and workers compensation.

Zurich May Face a Surge in European Asbestos Claims

It has been reported that Zurich Insurance in Britain may be facing a huge increase in asbestos disease claims.The British House of Lords may act on legislation permitting recovery for asbestos disease claims where there is evidence of scarring called pleural plaque.


Bloomberg News reported, “There could be a material deterioration in prior year profitability,” said David Masters, a London-based credit analyst at Moody’s. “There remains a risk that pleural plaques claims costs could spiral over time.”


The century old workers compensation programs have become stagnated in processing occupational claims. Huge delays in compensating victims of asbestos disease in Britain have been reported. This mirrors what is occurring in the US. Workers' Compensation systems that have also been dilatory in with the disposition of these claims for numerous reasons.


Rating agencies have indicated that costs for asbestos related disease through Europe may have significant impact upon the reserves of insurance carriers including large one like Zurich.


Asbestos exposure is a cause of latent and fatal diseases such as asbestosis, lung cancer and mesothelioma. 


Click here to read more about asbestos and workers compensation.

Click to read more about asbestos litigation.

Malignant Pleural Mesothelioma and Occupational Exposure to Asbestos

A strong relationship has been reported between industrial uses of all forms of asbestos is generating an increase in mesothelioma-related diseases and deaths among Mexican workers.

"Environmental and occupational exposure to asbestos in Mexico in the past has been a cause of deaths and health damages. Its magnitude is unknown to date. Our objective was to identify the proportion of cases of malignant pleural mesothelioma (MPM) that can be attributed to and occupational exposure to asbestos."

"As a public health policy, Mexico should the use of asbestos in all production processes with the aim of controlling the epidemic and preventing the occurrence of new cases of MPM."

"Case-control study of pleural mesothelioma in workers with social security in Mexico", Am. J. Ind. Med. , Jan. 28,2010.

Click here to read more about asbestos and workers compensation.

Click to read more about asbestos litigation.

US Department of Labor’s OSHA cites C.A. Franc $539,000 for willful fall hazard violations

The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has fined the C.A. Franc construction company $539,000 following the investigation of a roofing worker who fell 40 feet to his death at a Washington worksite. The Valencia, Pa.-based roof installer – whose owner is Christopher A. Franc – was cited for 10 per instance willful citations for failing to protect workers from falls.

“Mr. Franc knowingly and willfully failed to protect his workers from falling to their death,” said Assistant Secretary of Labor for OSHA Dr. David Michaels. “Despite repeated requests from workers that he provide fall protection, on this step roof, Mr. Franc refused to provide readily available protection. We will not tolerate this type of blatant and egregious disregard for the health and safety of workers.”

OSHA began its investigation immediately following the worker’s death on Aug. 15, 2009, and found the C.A. Franc company had failed to provide any fall protection to its employees working on a pitched roof 40 feet off the ground. In addition, Mr. Franc failed to train a newly hired college student in hazards and the necessary safety measures for roofing work. As a result of the investigation, the company has been cited for 10 alleged per-instance willful violations, one for each employee working unprotected on the roof, with a proposed penalty of $490,000, and one additional alleged willful violation for failing to train the new employee, with a penalty of $49,000.

General contractor Hospitality Builders Inc. also has been cited with one willful violation and a proposed penalty of $70,000 for failing to ensure that C.A. Franc workers had fall protection.

“This fall fatality was one of five that occurred during a 15-day span in the Pittsburgh area,” said John M. Hermanson, OSHA’s regional administrator in Philadelphia, Pa. “Falls are the leading cause of fatalities in the construction industry. Failure to provide employees with fall protection is unconscionable. We urge construction companies to take the necessary action to ensure their workers are protected.”

OSHA defines a willful violation as one committed with intentional, knowing or voluntary disregard for the law’s requirements, or with plain indifference to employee safety and health. Detailed information about fall hazards and safeguards is available on OSHA’s Web site athttp://www.osha.gov/SLTC/fallprotection/construction.html.

The company has 15 business days from receipt of the citations to comply, request an informal conference with OSHA’s area director, or contest the citations and proposed penalties before the independent Occupational Safety and Health Review Commission. The investigation was conducted by OSHA’s Pittsburgh Area Office; telephone: 412-395-4903. To report workplace accidents, fatalities or situations posing imminent danger to workers, call OSHA’s toll-free hotline at 800-321-6742.

In a related criminal charge, Christopher A. Franc today entered a guilty plea in federal court to a violation of 29 U. S. C. Section 666(e). Sentencing is scheduled for June 18.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to assure these conditions for America’s working men and women by setting and enforcing standards, and providing training, outreach, education and assistance. For more information, visit http://www.osha.gov.

Click here to red more about OSHA and workplace accidents and illnesses.

New 911 Photos Dramatically Illustrate Toxic Cloud

The horrific tragedy of the attack on the World Trade Center on 911 and the toxic cloud of fumes and dust are vividly portrayed in newly released photos. The massive extend of the spread of toxic substances has given rise to resultant disease and illness to emergency first responders and residents of lower Manhattan.

ABC secured the release of the photos by a Freedom of Information Act Request to the New York Police Department (NYPD). The photos were taken  from an NYPD helicopter immediately following the attack when two large jet liners, loaded with fuel and passenger, were seized by terrorists and crashed into the buildings.

The fight to secure adequate medical care for medical conditions flowing from the exposures has been very problematic. While several local agencies have attempted to provide medical care, the lack of funds and a unified program has left many without appropriate medical care.

Click here to read more about 911 and medical care programs.