Failures at OSHA Put Workers at Risk

A recently released report from the US Department of Labor reports that the past failures of OSHA under the Bush Administration placed workers at risk. The Labor Department's Office of Inspector General released a repot on March 31, 2009 indicating that failure in inspection, training and enforcement led to the unnecessary deaths of workers.

Injured Workers Without Lawyers - A New Concern

A major decline in the participation of attorneys in workers' compensation claims has accelerated what is already a declining spiral in representation of injured workers. This downward swing, in a formerly recession proof industry, raises the concerns as to whether injured workers are now receiving adequate legal guidance.

Attorneys are joining the unemployment ranks in huge numbers. Last week marked the 10,000th attorney laid off from the major law firms in the last 15 months. The US government reports that over 20,000 lawyers are now unemployed. Sadden Arps announced an offer to it entire associate staff to take a year off at one-third pay. The incentive was valued at an average of $80,000.

The workers' compensation system nationally has been impacted by multiple facts that has accelerated an ongoing decline in the representation of injured workers. State systems have been dismantled, co-ordination of benefit issues and medical reimbursement issue have slowed the system and created a reluctancy in filing of claims. Economic issues exist as to whether costs exceed recovery to make claims viable to handle. Uncertainty exists as whether the claims and the demand for representation will bounce back.

The resulting problem is that injured workers will lack adequate formal representation. Injured workers without lawyers raises new concerns that will need to be addressed.

Asbestos Related Diseases Reflecting a Slight Decline

Asbestosis: Number of deaths, crude and age-adjusted death rates, U.S. residents age 15 and over, 1968–2005

Asbestosis deaths among U.S. residents age 15 and over have increased from 78 in 1968 to 1,493 in 2000 and then decreased slightly to 1,470 in 2004. (Ref. No. 2007F01-01, 2007T01-01). Data from the Occupational Safety and Health Administration (OSHA) and the Mine Safety and Health Administration (MSHA) indicate a trend towards lower asbestos exposure levels from 1979 to 1999, concomitant with mandated reductions in the OSHA permissible exposure limit (PEL). However, data indicate a steady increase in asbestos exposure levels in the mining industry for the years 2000 through 2003 and a slight rise in all other industries in the two years previous to 2003. (Ref. No. 2007F01-05, 2007T01-12).

Residents of California, Florida, New Jersey, New York, Pennsylvania, Texas, Virginia, and Washington together accounted for nearly half of all asbestosis deaths in the 1995 to 2004 period. (Ref. No. 2007T01-04).

There were over 15,000 malignant mesothelioma deaths among U.S. residents age 15 and over accounting for more than 200,000 years of potential life lost to life expectancy in the 1999–2004 period. (Ref. No. 2007T07-01, 2007T07-03). For 1999–2004, nearly 20% of mesothelioma decedents were female. (Ref. No. 2007T07-01). Occupations associated with significantly elevated mesothelioma mortality in 1999 include plumbers, pipefitters, and steamfitters; mechanical engineers; electricians; and elementary school teachers. (Ref. No. 2007T07-09).

The Work-Related Lung Disease (WoRLD) Surveillance System, produced by the National Institute for Occupational Safety and Health (NIOSH), presents up-to-date summary tables, graphs, and figures of occupationally-related respiratory disease surveillance data on the pneumoconioses, occupational asthma and other airways diseases, and several other respiratory conditions. For many of these diseases, selected data on related exposures are also presented.

Raptiva® Withdrawn From Market for High Risk of Fatal Brain Disease

Raptiva® users who have experienced neurological changes including unusual weakness, loss of coordination and changes in vision may have claims against the manufacturer, Genentech.

On April 8, 2009, the drug manufacturer Genentech announced a phased withdrawal of the psoriasis drug Raptiva® (efalizumab) from the U.S. market.

Since October 2008, Raptiva® has been associated with a higher risk for progressive multifocal leukoencephalopathy (PML), a rare, and often fatal neurologic viral disease that affects the central nervous system. The associations between Raptiva® and PML are generally associated with individuals with weakened immune systems.

Symptoms of PML may include:
-Unusual weakness
-Loss of coordination
-Changes in vision
-Difficulty speaking
-Personality changes
-Other neurological changes
-Death

There are no known effective therapeutic options for PML, and no known screening tests that can reliably predict PML. The PML infection often leads to an irreversible decline in neurologic and brain function and death. People who live with PML are severely disabled.

The product withdrawal plans to remove Raptiva® by June 8, 2009. According to the FDA, prescribers should not initiate new Raptiva® treatment.. The phased withdrawal is designed to allow patients time to find other effective treatments for psoriasis so as to avoid severe worsening of the condition or hospitalization.

History of Raptiva®
Raptiva® was approved by the FDA in 2003. It is a once-weekly injection for adults with moderate to severe plaque psoriasis.

Genentech began receiving reports of PML among Raptiva® users as early as September 2008. On October 16, 2008, the Raptiva® label was updated to warn of the risk of life-threatening infections, including PML. A Public Health Advisoryinforming patients and prescribers of the risk of PML in patients taking Raptiva® was issued in February 2009, after four patients developed PML, three of whom died. On March 13, 2009, the FDA approved a Medication Guide for Raptiva® and included additional information in the drug's labeling regarding PML.

Further Information
FDA Notice Withdrawal 4/8/2009

FDA Labeling Notice Updated 10/20/2008

FDA Public Health Advisory 2/19/2009

Medication Guide for Raptiva®

Expanding the Long Arm of CMS

Legislation has been introduced in Congress to phase out the waiting period for Medicare over the next 10 years from 24 months to zero. Under the proposal, "......[i]n 2010, it would be reduced to 18 months and then reduced by 2 months each year until January 2019, when it would be totally eliminated."

Such an expansion would expand the involvement of CMS's roll in the workers' compensation program under the Medicare Secondary Payor Act to seek reimbursement.

Medical Bills of Smokers Reported to be Less Than Expected

It has been recently reported that smokers may actually cost society less for medical treatment than non-smokers. The CDC has reported that since smokers die on the average 10 years earlier, their medical costs are actually less to society that non-smokers.

Jordan Barab Named Acting OSHA Chief

Jordan Barab has been named Deputy Assistant Secretary for OSHA and Acting Assistant Secretary effective April 13, 2009. Barab has been an outstanding spokesperson for injured workers and was author of the well known and influential blog Confined Space. Internationally recognized as a stronger advocate for worker safety, his incredible advocacy for a safer work environment has been a hallmark of leadership. 

The AFL-CIO reported:

Peg Seminario, the AFL-CIO’s director for safety and health, says Barab is an “excellent choice” for OSHA deputy assistant secretary. 

He has decades of experience in safety and health working in the labor movement, at OSHA and in the House of Representatives on a broad range of issues. He has a deep commitment and dedication to protecting workers and will bring to OSHA the kind of energy and leadership that is sorely needed to move the agency in a new direction.