CDC Alert to U.S. Hospitals and Long-Term Care Facilities: Patients at Risk of Listeriosis from Certain Blue Bell Brand Ice Cream Products

Blue Bell Creameries has expanded its recall to now include all of its products currently on the market made at any of its facilities. CDC recommends that hospitals and long-term care facilities not serve or sell any Blue Bell brand products. Please check your freezer and inventory for these products. Visit CDC’s Advice to Consumers, Institutions, and Retailers to learn more.

Certain Blue Bell brand ice cream products may be contaminated with Listeria and can cause illness. Some of these products were distributed to institutions.

State and local health officials, CDC, and FDA are collaborating to investigate an outbreak of Listeria monocytogenesinfections (listeriosis) linked to Blue Bell Creameries ice cream products. Information available to date suggests that ill people likely acquired L. monocytogenes infections from ice cream products they consumed while hospitalized for unrelated causes.

As of April 20, 2015, a total of ten patients infected with several strains of Listeria monocytogenes were reported from four states: Arizona (1), Kansas (5), Oklahoma (1), and Texas (3). Illness onset dates ranged from January 2010 through January 2015. The patients with illness onsets ranging from 2010-2014 were identified through a retrospective review of the PulseNet database for DNA fingerprints matching isolates collected from Blue Bell ice cream samples. Since the last update on April 8, 2015, two additional patients, one each from Arizona and Oklahoma, were confirmed to be a part of the outbreak by whole genome sequencing. All ten (100%) patients were hospitalized. Three deaths were reported from Kansas.

One additional isolate from a patient with listeriosis is undergoing further molecular laboratory testing to determine whether this illness may be related to this outbreak. Results of this testing will be reported once they are available. CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify any other ill persons that may be part of this outbreak.

People at higher risk for listeriosis include pregnant women, adults 65 and older, and people with weakened immune systems. Hospitalized patients are at higher risk of listeriosis than the general population because many are immunocompromised and of older age (1).

A recent review article indicates that hospital-acquired listeriosis represents a substantial proportion of overall listeriosis cases that are not associated with pregnancy.

For updates, please visit CDC’s outbreak website.
Silk BJ, McCoy MH, Iwamoto M, Griffin PM. Foodborne listeriosis acquired in hospitals. Clinical Infectious Diseases. 2014 May 20, 2014. doi:10.1093/cid/ciu365.

CDC: Blue Bell Listeria Outbreak Started In 2010

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EEOC Issues Proposed Rule on Application of the ADA to Employer Wellness Programs

Employee wellness is a good thing for workers' compensation, especially when paying physicians baaed on an outcome than than by the hour . The proposed EEOC Rule would permit incentives, emphasize confidentiality

WASHINGTON -- The U.S. Equal Employment Opportunity Commission (EEOC) today published a Notice of Proposed Rulemaking (NPRM) describing how Title I of the Americans with Disabilities Act (ADA) applies to employer wellness programs that are part of group health plans. The NPRM is available in the Public Inspection portion of the Federal Register, and will be officially published on Monday, April 20, 2015. Members of the public have 60 days from that date (or until Friday, June 19) to submit comments.

The EEOC's proposed rule would provide much needed guidance to both employers and employees about how wellness programs offered as part of an employer's group health plan can comply with the ADA consistent with provisions governing wellness programs in the Health Insurance Portability and Accountability Act (HIPAA), as amended by the Affordable Care Act. In addition, the EEOC is also publishing a Fact Sheet for Small Businesses and a Question and Answer document for the general public.

Many employers that provide health insurance also offer workplace wellness programs intended to encourage healthier lifestyles or prevent disease. These programs sometimes use health risk assessments and biometric screenings to determine an employee's health risk factors, such as body weight and cholesterol, blood glucose, and blood pressure levels. Some of these programs offer financial and other incentives for employees who participate or achieve certain health outcomes.

Although the ADA limits the circumstances in which employers may ask employees about their health or require them to undergo medical examinations, it allows such inquiries and exams if they are voluntary and part of an employee health program.

The NPRM further requires that if an employee health program seeks information about employee health or medical examinations, the program must be reasonably likely to promote health or prevent disease. Employees may not be required to participate in a wellness program, and they may not be denied health coverage or disciplined if they refuse to participate

The EEOC's proposed rule makes clear that wellness programs are permitted under the ADA, but that they may not be used to discriminate based on disability. The rule explains that under the ADA, companies may offer incentives of up to 30 percent of the total cost of employee-only coverage in connection with wellness programs. These programs can include medical examinations or questions about employees' health (such as questions on a health risk assessment).

This limit is generally consistent with limits that HIPAA imposes on wellness programs. The rule also makes clear however, that the ADA provides important safeguards to employees to protect against discrimination based on disability. Accordingly, medical information collected as a part of a wellness program may be disclosed to employers only in aggregate form that does not reveal the employee's identity, and must be kept confidential in accordance with ADA requirements.

"The EEOC worked closely with the Departments of Labor, Health and Human Services, and Treasury in developing this NPRM to harmonize the ADA's requirement that medical inquiries and exams that are part of an employee health program must be voluntary, and HIPAA's goal of allowing incentives to encourage participation in wellness programs," said EEOC Chair Jenny R. Yang.

Employers also may not subject employees to interference with their ADA rights, threats, intimidation, or coercion for refusing to participate in a wellness program or for failing to achieve certain health outcomes. Finally, individuals with disabilities must be provided with reasonable accommodations that allow them to participate in wellness programs and to earn whatever incentive an employer offers.

In addition to setting a limit on incentives, the NPRM, which includes interpretive guidance that will be published along with the final rule, requires that employers provide employees a notice that describes what medical information will be collected, with whom it will be shared, how it will be used, and how it will be kept confidential. The interpretive guidance also includes an extensive discussion of both legal requirements and best practices that ensure confidentiality of employee medical information.

The Commission looks forward to receiving comments on the NPRM that will shape the final regulation. In addition, the Commission has asked a number of specific questions in the preamble to the NPRM on which it seeks comment before finalizing the rule. Methods for commenting are specified in the notice in the Federal Register.

One of the six national priorities identified by the Commission's Strategic Enforcement Plan is for the Commission to address emerging and developing issues in equal employment law, including issues involving the ADA among other possible issues.

The EEOC enforces the federal laws prohibiting employment discrimination. More information about the EEOC is available at www.eeoc.gov.

Health and Compensation Programs Passed Into Law After Almost Decade Long Fight Set to Expire This Year – Participants in 9/11 Health Program Living in All 50 States and 429 of 435 Congressional Districts

After nearly a decade long fight to stand by our first responders who answered the call of duty on September 11th, Congress finally fulfilled its moral obligation in late 2010 and provided our 9/11 heroes with the health care and financial compensation they deserved by passing the James Zadroga 9/11 Health and Compensation Act. With the Zadroga bill’s two critical programs – the World Trade Center (WTC) Health Program and the September 11th Victim Compensation Fund – set to expire in October 2015 and October 2016 respectively a bipartisan group of lawmakers from across the country today introduced the James Zadroga 9/11 Health and Compensation Reauthorization Act to permanently extend these programs. Last month, the U.S. Senate unanimously passed an amendment to the Senate budget resolution that will facilitate future legislation to renew and extend the Zadroga Act.

It is not "How," It is "When"

Judge David Langham wrote a very enlightening blog post today about how advancing technology is impacting the world and more particularly the workers' compensation arena. As usual, he is right on target with the issue that is going to have the most influence over our changing world.

The Judge mentioned the advent of driverless technology. Ironically, it is national Distracted Driving Awareness Month. If you are driving about the State of New York with a phone in your hand you'll most likely get a ticket for sure this week. The driverless car is already under development with a target for production by major corporations such as Apple by the year 2020. In California Google already has test vehicles on the road.

On the job safety extends to space travel

The Space-X launch today illustrates that space travel remain a very hazardous occupation. The launch went well, but the attempt to land the spent rocket stage back of the platform failed. It has been a tough year for NASA, Orbital and Space-X as the mission to privatize space exploration continues.

On-Call Employment: Uber on Steriods

The NY Attorney General took action yesterday to rein in the growing emergence of "on-call staffing." The new dynamic of on demand staffing continues to be a growing trend in the employment arena. It is sort of an Uber on steroids.

The historic legal concepts that determine compensability in workers compensation cases have traditionally been defined by the concept of "arising out of and in the course of employment." Those parameters are indeed going to be challenged by the concept of "on-call employment."

Exporting Illness Worldwide: Heavy Metal Contamination From a U.S. Owned Smelter in Peru

English: The La Oroya train station 1921
(Photo credit: Wikipedia)

Today's post is shared from Occupational Knowledge International okinternational.org

The town of La Oroya, Peru - the site of an American owned smelter - is suffering from decades of unregulated emissions from the plant which continue to this day. According to the Peruvian Ministry of Health, blood lead levels among local children are dangerously high averaging 33.6 micrograms/deciliter, triple the World Health Organization limit of 10 micrograms/deciliter, while the vegetation in the surrounding area has been destroyed by acid rain. Limited environmental sampling has revealed lead levels exceeding public health standards in almost 90 percent of the homes, extensive soil contamination, and excessive airborne emissions throughout the town.

Lead causes a range of health effects, but primarily effects neurological development in children resulting in reduced school performance, lower scores on standardized tests (such as IQ), mental retardation and can even cause death. A significant portion of those tested by the Ministry of health should have received immediate medical attention to remove lead from the body, but no follow-up was ever initiated.

To plan for remediation and to examine the potential for ongoing exposure from the lead and other metals already deposited in La Oroya, further testing of dust lead levels inside homes was required. We therefore brought the equipment and supplies and trained our partners at the Asociación Civil Labor to collect dust wipe samples. We then arranged for half the samples to be analyzed at a laboratory in the U.S. as a donated service. After obtaining the results, we worked with our Peruvian partners to prepare a report, and conduct education and outreach about the health risks associated with the exposure to lead and other pollutants.

Full report in PDF format: [English] [Spanish]

….

Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thompson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson-Reuters). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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