Workforce Drug Positivity Rate Highest Since 2004

Workforce use of illicit drugs across the board—including cocaine, marijuana and methamphetamine—has climbed to the highest rate in 12 years, a study by Quest Diagnostics found.

Overall positivity in urine drug testing among the combined U.S. workforce in 2016 was 4.2%, a 5% relative increase over last year’s rate of 4%—the highest annual positivity rate since 2004 (4.5%), according to an analysis of more than 10 million workforce drug test results.

“This year’s findings are remarkable because they show increased rates of drug positivity for the most common illicit drugs across virtually all drug test specimen types and in all testing populations,” Barry Sample, senior director of science and technology at Quest Diagnostics Employer Solutions, said in a statement. “Our analysis suggests that employers committed to creating a safe, drug-free work environment should be alert to the potential for drug use among their workforce.”

The positivity rate in urine testing for cocaine increased for the fourth consecutive year in the general U.S. workforce and for the second consecutive year in the federally-mandated, safety-sensitive workforce. Cocaine positivity increased 12% in 2016, reaching a seven-year high of 0.28%, compared to 0.25% in 2015 in the general U.S. workforce, and 7% among federally-mandated, safety-sensitive workers to 0.28% from 0.26% in 2015.

Marijuana positivity continued to climb in both the federally-mandated, safety-sensitive and general U.S. workforces. In oral fluid testing, which detects recent drug use, marijuana positivity increased nearly 75%, from 5.1% in 2013 to 8.9% in 2016 in the general U.S. workforce. Marijuana positivity also increased in both urine testing (2.4% in 2015 versus 2.5% in 2016) and hair testing (7.0% in 2015 versus 7.3% in 2016) in the same population. Among the federally-mandated, safety-sensitive workforce, which only uses urine testing, marijuana positivity increased nearly 10% (0.71% in 2015 versus 0.78% in 2016), the largest year-over-year increase in five years.

In Colorado and Washington, the first states in which recreational marijuana use was legalized, the overall urine positivity rate for marijuana outpaced the national average in 2016 for the first time since the statutes took effect. The national positivity rate for marijuana in the general U.S. workforce in urine testing increased 4% (2.4% in 2015 compared to 2.5% in 2016).

Positivity for amphetamines (which includes amphetamine and methamphetamine) continued a year-over-year upward trend, increasing more than 8% in urine testing in both the general U.S. and federally-mandated, safety-sensitive workforces compared to 2015. According to Quest, this rise over the past decade has been driven primarily by amphetamine use, including certain prescription drugs such as Adderall.

After four straight years of increases, in 2016, urine testing positivity for heroin held steady in the general U.S. workforce and declined slightly among federally-mandated, safety-sensitive workers.

Positivity for prescription opiates—including hydrocodone, hydromorphone and oxycodones—declined in urine testing among the general U.S. workforce. Oxycodones have seen four consecutive years of declines, dropping 28% from 0.96% in 2012 to 0.69% in 2016. Hydrocodone and hydromorphone both showed double-digit declines in both 2015 and 2016 (0.92% in 2015 to 0.81% in 2016) and (0.67% in 2015 to 0.59% in 2016), respectively.

This decline may be due to the fact that state and federal authorities have made efforts in the past few years to place tighter controls on opiate prescribing in order to address the opioid crisis.

Weighing In on Stand-Up Workstations and Exercise Balls

Stand-up workstations and exercise balls used for sitting in place of an office chair are gaining popularity. This has been fueled by reports of workers at Google, Facebook and other companies trading in their chairs to stand, or bounce, while working. They cite studies of the harm that hours of sitting can do.

Even here at the RIMS office several employees prefer sitting (or bouncing) on exercise balls to the familiar rolling desk chair, or working at a stand-up desk. Risk professionals have long been discussing the merits and downsides of these two popular choices.

But are these alternative ergonomic preferences really that beneficial?

Recently in an online discussion, some members of the RIMS Opis community said they were not in favor of exercise balls as ergonomic solutions. A risk manager in Oregon stated it bluntly: “Exercise balls should be limited to fitness programs. Your [workers comp] will own the injury if an employee slips off the ball and hits [his or her] head or has a soft tissue injury from the fall.” Several other commenters agreed that the balls are unstable and their use is discouraged or officially prohibited.

A CEO said: “While great for encouraging engagement of your core muscles during exercise, [balls] are not good for sitting at a workstation and in fact, research shows, increase your risk of ergonomic injury.”

In fact, some research has found their benefits negligible. A study of 28 subjects found that exercise or chair balls offer no advantages over a traditional workplace chair. According to a study by BioMed Central:

Results:

The results showed no significant difference with regard to spinal curvature between seating types. Initial sitting curvature was found to increase significantly over 30 minutes in both the desk chair and stability ball. In addition the results of the usability questionnaire showed a significant difference in three of the eight questions, in favor of the desk chair.

Conclusion:

No benefits were found through sitting on a stability ball over that of a desk chair in prolonged sitting as both seating types were found to replicate a poor sitting position through a kyphosed [outwardly curved spine] and slumped posture. The clinical implications of this study serve to benefit any healthcare professional considering use of the stability ball as a replacement desk chair.

In another online comment, a Missouri risk manager suggested a compromise, elaborating that while his organization allows their use, “They cannot be free-standing balls… they must be part of a chair ball with wheels and a seat backing.”

Stand-up desks received more positive feedback. Several risk professionals cited research equating excessive sitting and sedentary lifestyles with serious chronic health problems. A number of commenters shared anecdotes about how stand-up workstations have helped employee health issues. Several users noted that in their newly renovated, or soon-to-be-renovated, offices, stand-up workstations are de rigueur.

Who pays for these workstations? Most who commented said, or implied, that their companies foot the bill for stand-up desks if an employee requests them. Most seem willing to make the investment based on reports that providing ergonomic options can reduce workers comp claims.

Not all are sold on the benefits, however. A commenter from Chicago said, “As odd as it sounds, stand-up desks may not be wholly safe…. People get tired and fall down using them. And there is no confirmation standing is less stressful than sitting. Folks very quickly started to complain of sore hips, knees, feet and spines.”

A Virginia risk manager shared the wisdom of moderation and the middle ground, saying, “While sitting is bad—and the motive for getting a standing desk—standing all day can cause myriad lower back, leg and feet issues. It would be similar to what risk managers at grocery stores have to deal with their cashiers on their feet all day. Interspersing standing with sitting is key.”

Some researchers agree with this conclusion. A New York Times article reported that 15 minutes per hour at a standing workstation is recommended over standing all day.

Flint Water Investigation Leads to Felony Charges for Mich. State Employees

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A driving effort to save the state money was said to be the reasoning behind the Flint, Michigan water crisis, which has been tied to lead poisoning in children, among other issues. On Tuesday the state announced felony charges against former state emergency managers, Darnell Earley and Gerald Ambrose, accused of false pretenses and conspiracy to commit false pretenses. The two were said to have been focused on balance sheets rather than the welfare of citizens when they made the decision in 2014 to switch the city’s water supply from treated water in Lake Huron to water from the Flint River.

A state investigation, which began in January, had led to charges against eight state officials and an employee of the Flint water facility.

According to the New York Times:

Charges of false pretenses, conspiracy to commit false pretenses, misconduct in office and willful neglect of duty lodged against the former managers were lauded by Flint leaders, some of whom said they had feared that blame for the city’s contaminated water might ultimately be pinned only on low-level workers.

The claims also reopened a longstanding debate in Michigan over the state’s emergency management provision, reviving questions about whether the system removes power and control over local issues from those residents who come under state oversight.

For years, governors here have appointed emergency managers as a way to efficiently cut debts and restore financial stability in the most troubled cities. But residents of some majority-black Michigan cities, including Flint, argue that the intense state-assigned oversight disenfranchises voters, shifts control from mostly Democratic cities to the state’s Republican-held capital and risks favoring financial discipline over public health.

After the decision was made to use water from the Flint River, Flint residents had began to notice a peculiar odor, color and taste in the water that flowed from their taps. Some reported skin rashes, hair loss and other physical problems. But they did not know why. Water from the Flint River was used by Flint residents for 18 months, but because it was not treated to reduce corrosion, lead from old plumbing leached into the water. Testing revealed dangerous levels of lead.

Residents soon discovered they had been lied to. Public officials had known about the lead but kept quiet. As a result, between 6,000 and 12,000 children were exposed to the contaminated water, which will likely have serious consequences for their health.

Meanwhile, efforts to fix the problem are underway. State officials switched back to the original water source in October. Michigan Gov. Rick Snyder has estimated that replacing the more than 15,000 lead service lines in Flint would take $60 million and up to 15 years.

Cyberattacks a Growing Threat for Healthcare

Because of the high value of medical records and healthcare databases to criminals, they pose ever more attractive targets. In fact, a number of reports have shown that cyberattacks are costing the healthcare industry billions of dollars annually, with a median loss of $150,000 per incident. Cybersecurity risks in healthcare have also drawn attention to the vulnerability of hospitals, clinics and other healthcare providers.

The infographic below, which is part of a series by Advisen and Hiscox, looks at:

  • The frequency of Health Insurance Portability and Accountability Act (HIPAA) violations over the past five years
  • The median loss in healthcare cyberattacks
  • The percentage increase of protected health information (PHI) losses between 2006 and 2011 for printed records, servers, laptops, desktop, website, portable data storage devices, and other sources.

It also examines which revenue groups suffered more PHI losses and the size of breaches that occurred more frequently.
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The majority of losses involve printed records, which have increased to 45% since 2011 compared to 3% by email.
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While some may think that the majority of breaches are large, in the past five years, almost 50% of breaches have been small, with fewer than 100 records lost.
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