Hurricane Devastation Impacts Health Care Supply Chains

The destruction caused by Hurricane Maria in Puerto Rico last month has created major disruptions for the island’s pharmaceutical product and medical device manufacturing facilities. Days of interruption and damage to manufacturing plants are affecting international supply chains for products such as cancer and HIV treatments, immunosuppressants for patients with organ transplants, and small-volume bags of saline, which are necessary for patients who need intravenous solutions.

Puerto Rico is the fifth-largest territory in the world for pharma manufacturing and produces about half of the world’s top-selling patented drugs, according to a 2016 report from Pharma Boardroom. Short-term economic losses are being estimated, while concerns persist about the storm’s long-term effect on employees’ abilities to travel to work, the safety and efficiency of the machinery used and the ability to keep the facilities running on generators. In a statement issued by the Food and Drug Administration (FDA) on Oct. 6, Commissioner Scott Gottlieb detailed plans to help Puerto Rico recover its medical product and manufacturing base, which he said “are a key component of the island’s economic vigor.”

“[..]even the facilities that sustained relatively minor damage are running on generator power. They could be without commercial power for months…Moreover, most of the facilities that we know of, that have resumed production, maintain only partial operations. New shortages could result from these disruptions and shortages that existed before the storms could potentially be extended.”

Citing data from the Bureau of Economic Analysis, Gottlieb said that pharmaceutical products manufactured in Puerto Rico “make up nearly 10% of all drugs consumed by Americans. And that doesn’t even account for medical devices.” He noted that the FDA is keeping a close watch on about 40 critical pharmaceutical and biological drug products which, in the event of a shortage, “could have substantial impact on the public health.”

He added, “In urgent cases, when critical products are at issue, we’ve intervened over the last two weeks to help firms secure fuel to maintain production lines, get clearance to move logistical support into the island or finished goods to their recipients.”

The Washington Post reported that more than four dozen FDA-approved drugmaking facilities are in Puerto Rico, including ones owned by Pfizer Inc., Merck, Eli Lilly, Johnson & Johnson, Bristol-Myers Squibb and Amgen. Baxter International Inc., which the Post cited as being the “dominant player” in the IV market, issued a statement acknowledging the impact of the storm on its operations:

Our sites sustained minimal damage, and we’ve initiated limited production activities in all of our facilities. In addition, we are examining all opportunities to leverage Baxter’s global manufacturing network as we continue efforts to restore operations in Puerto Rico.

As it relates to product supply, in advance of the hurricanes, we implemented our hurricane preparedness plan to help mitigate potential impact. We have also been delivering products to customers in Puerto Rico to help address patient need on the island. And we are continuing to proactively communicate with our customers the actions we are taking to minimize potential disruptions, including closely managing product inventory.

Not all facilities have suffered damage, however. Amgen announced on its site that back-up generators are powering its Puerto Rican site and that, “No product nor in-process inventory has been lost, and … the inventory maintained by the Company and its global distribution network is sufficient to meet patient demand.”

Workplace Safety Tips for the Total Solar Eclipse

On August 21st, a total solar eclipse will be visible from North America for the first time in nearly 40 years. Many employers across the country will host viewing parties or may allow employees to take an extra break to observe the phenomenon, while those who employ outdoor workers can expect employees to have a front-row seat for the big event.

It is important to remember that such eclipses can expose workers to safety and worksite hazards, however. For example, outdoor workers should be sure to turn off any equipment or machinery before sun-gazing.

So what further information can employers pass on to reduce the risk of worksite and on-the-job injuries? NASA’s Total Solar Eclipse safety page suggests the following:

  • Never look directly at the sun.
  • If you are within the path of totality, remove your solar filter only when the moon completely covers the sun’s bright face and it suddenly gets quite dark. Experience totality, then, as soon as the bright sun begins to reappear, replace your solar viewer to look at the remaining partial phases.
  • Use eclipse glasses and handheld solar viewers verified to be compliant with the ISO 12312-2 international safety standard for such products.
  • Always inspect your solar filter before use; if scratched or damaged, discard it. Read and follow any instructions printed on or packaged with the filter.
  • Do not look at the sun through a camera, a telescope, binoculars, or any other optical device while using your eclipse glasses or hand-held solar viewer — the concentrated solar rays will damage the filter and enter your eye(s), causing serious injury.
  • Keep normal eyeglasses on, if normally worn, and place eclipse glasses over them.

Check out the map below to see if your business is in the path of totality for the upcoming eclipse:

total solar eclipse map

Lessons from Distracted Driving Awareness Month

June is Distracted Driving Awareness Month, and while it is quickly drawing to a close, the message remains: Distracted driving is escalating, with 25% more vehicle accidents resulting from drivers talking or texting on cellphones. More cars on the road, especially during summer months, also translates to more accidents.

Organizations with fleets should take note as motor vehicle crashes are the number-one cause of work-related deaths, accounting for 24% of all fatal occupational injuries, according to the National Safety Council (NSC). On-the-job crashes are also costly, with employers sustaining costs of more than $24,500 per property damage crash and $150,000 per injury crash.

Zurich sums up NSC statistics:
Employers can and are being held liable for damages resulting from employee accidents. “We might expect an employer to be held liable for a crash involving a commercial driver’s license holder who was talking on a cell phone with dispatch about a work-related run at the time of an incident—especially if the employer had processes or a workplace culture that made drivers feel compelled to use cell phones while driving,” the NSC said.

The lines believed to exist between employment-related and personal or private life get blurred in some cases involving:

  • Cell phones owned by employees as well as employer-provided equipment
  • Vehicles that were employee-owned as well as employer-owned or leased
  • Situations where employees were driving during non-working hours or were engaged in personal phone calls

To protect themselves and their employees, the NSC recommended that organizations implement and enforce a total ban policy.

“The best practice is to prohibit all employees from using any cell phone device while driving in any vehicle during work hours or for work-related purposes. Regarding off-the-job hours, precedent has been set by lawsuits. Thus employers may want to extend their policies to cover off-the-job use of company-provided wireless devices, use of personally-owned devices that are reimbursed by the company, and use of devices in company-provided vehicles. All work-related cell phone use while driving should be banned 24/7,” the NSA advised.

Companies should also pay attention to other common distractions that can lead to accidents, Zurich adds:

Preventing Heat Illness: Water, Rest, Shade

With summer comes hot, humid weather and a greater chance of heat-related illness for outdoor workers. How to prevent heat illness? Three words: water, rest and shade, according to the Occupational Safety and Health Administration (OSHA).

MedicalNewsToday

Heat illness is not to be taken lightly—in 2014, 2,630 workers suffered from heat illness and 18 died from heat stroke and other heat-related conditions on the job. Workers most at risk are those exposed to hot and humid conditions, especially those whose jobs require heavy lifting or heavy work tasks and who wear dense or bulky clothing and equipment.

Industries most affected by heat-related illness are construction, trade, transportation and utilities, agriculture, grounds maintenance, landscaping services and support activities for oil and gas operations, OSHA said. Workers who have not built up a tolerance to heat, including new workers, temporary workers, or those returning to work after a week or more off are all at greater risk, and all workers are at risk during a heat wave.

The body normally cools itself by perspiring. During hot weather, however, especially in high humidity conditions, sweating isn’t enough to keep the body cool. To keep body temperature from rising to dangerous levels, OSHA suggests drinking water and resting in the shade to prevent heat exhaustion or heat stroke.

If a worker becomes ill, OSHA recommends:

  • Call a supervisor for help. If a supervisor is not available, call 911.
  • Have someone stay with the worker until help arrives.

According to the Mayo Clinic, heatstroke symptoms include:

  • High body temperature. A body temperature of 104⁰ F or higher is the main sign of heatstroke.
  • Altered mental state or behavior. Confusion, agitation, slurred speech, irritability, delirium, seizures and coma can all result from heatstroke.
  • Alteration in sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel moist.
  • Nausea and vomiting. You may feel sick to your stomach or vomit.
  • Flushed skin. Your skin may turn red as your body temperature increases.
  • Rapid breathing. Your breathing may become rapid and shallow.
  • Racing heart rate. Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
  • Headache. Your head may throb.

The Mayo Clinic urges immediate action to cool the overheated person while waiting for emergency treatment, including:

  • Get the person into shade or indoors.
  • Remove excess clothing.
  • Cool the person with whatever means available—put in a cool tub of water or a cool shower, spray with a garden hose, sponge with cool water, fan while misting with cool water, or place ice packs or cold, wet towels on the person’s head, neck, armpits and groin.