Flu-Related Deaths on the Rise

Frigid weather across the United States and low effectiveness of this year’s flu vaccine have been blamed for a jump in the number of flu cases being reported across the country. Epidemiologists in 36 states so far have reported widespread influenza activity to the federal Centers for Disease Control and Prevention (CDC). Of those states, 21 reported a high number of cases.

Worldwide, the estimated number of fatalities caused by seasonal influenza-related respiratory illnesses is also higher than expected, according to the CDC. The agency released a new study in December 2017 with statistics indicating that between 291,000 and 646,000 people die from influenza every year, an increase from the previous estimate of 250,000 to 500,000. The estimates were drawn from a collaborative multinational survey conducted by the CDC and its global health partners.

“These findings remind us of the seriousness of flu and that flu prevention should really be a global priority,” said Joe Bresee, M.D., associate director for global health in CDC’s Influenza Division and a study co-author.

The study, which appeared in The Lancet, excluded data related to pandemics, indicated that poorer nations and older adults are especially at risk. It explained:

People age 75 years and older and people living in sub-Saharan African countries experienced the highest rates of flu-associated respiratory deaths. Eastern Mediterranean and Southeast Asian countries had slightly lower but still high rates of flu-associated respiratory deaths.

One cause for the rise could be that few developing countries have seasonal flu vaccination programs or the capacity to produce and distribute seasonal or pandemic vaccines.

The information was released following the CDC’s National Influenza Vaccination Week, which was held in early December 2017. That also marked what is typically considered the start of the season which continues through February in the U.S., although activity can last as late as May. Flu activity is expected to increase this month, the CDC warned back in December, and the freezing conditions from last week’s “bomb cyclone” may contribute to fully realizing that prediction.

People at high risk include:

  • Pregnant women.
  • Children younger than 5 years old, but especially children younger than 2 years old.
  • People 65 years of age and older.
  • People of any age who have certain medical conditions, such as asthma, diabetes, and heart disease.

The Society for Human Resources Management (SHRM) suggests that employers use this critical time to promote policies and procedures to protect their employees from communicable diseases like influenza, and reinforce that the risks may be greater for certain workers. According to SHRM:

Employers must be open to discuss employee concerns and listen to their ideas and suggestions for ways to help them stay healthy. Employers can encourage employees who are at high risk to talk with their health care provider to determine what, if any, additional measures they should consider to keep themselves healthy and safe at work. Employers should strongly consider doctor’s accommodation requests for high-risk workers.

The Occupational Safety and Health Act (OSHA) web site has a fact sheet and guidelines for companies to follow with regard to the flu and pandemics. Additionally, the National Institute for Occupational Safety and Health (NIOSH) has a page with tips for employers hoping to curb seasonal flu outbreaks in their workplaces and among employees. NIOSH’s suggestions include:

Post-Harvey Lessons For Chemical Plant Managers

One of the many hazards exposed by Hurricane Harvey occurred in Crosby, Texas, when the Arkema chemical plant suffered fires and small explosions on Aug. 31 and Sept. 1. Floodwaters caused the fires by penetrating the facility and shutting down the cooling systems designed to stabilize 500,000 pounds of highly flammable materials inside. This ultimately caused a mandatory evacuation for all residents within a 1.5-mile radius of the plant. Local news outlets reported that Arkema had no plan in place for six feet of flooding and its last risk assessment was submitted in 2013.

With Hurricane Irma being tracked at 175 miles per hour in the Caribbean, it is possible that chemical plants in the path of destruction—including Florida and the southeastern United States—may face a similar scenario. Regardless of the location of your plant, here are some tips that can help reduce potential business interruption and physical injury during a major natural disaster:

Update your risk assessment. Use Harvey as a catalyst to revisit your risk assessment, especially since new information has emerged about the potential for natural hazards or disasters that can trigger a chemical accident. As recently discussed, the best assessments do more than just feature a column of checked boxes to achieve an organization’s objectives and mitigate business interruption. “They prioritize top risks, assign risk ownership, and most critically, integrate risk management and accountability into front line business decision-making,” says Dean Simone, PWC’s U.S., Asia-Pacific, and Americas Cluster Risk Assurance Leader.

Submit the assessment to the EPA or other government-appointed body, like your state’s Commission on Environmental Quality. Your facility needs to be able to withstand significant damage to prevent further incidents and public harm. The feedback will hopefully provide some useful criticism to ensure public safety and business continuity.

According to ABC’s Houston affiliate:

In at least one of Arkema’s hazard mitigation plans filed with the federal government, plant officials acknowledged that flooding is a risk. The site sits in a FEMA “high-risk” floodplain that has flooded in the past, leading to a power failure. That time, the site only had six inches of water, a former plant worker said.

It was later revealed in an internal company timeline of events that Arkema did not move temperature-sensitive chemicals via refrigerated trucks and instead banked on its two backup systems, which failed. It seems certain that Arkema will have to consider at least six feet of floodwater when it revises its plan.

Institute an emergency plant management system. This may be included in your company’s risk assessment, and it is important that your employees also know the protocol when it comes to disaster prevention. This includes establishing the lines of authority and communication while on-site and during a catastrophe. OSHA provides guidance for chemical plant management in the event of a mass disaster.

Develop public-facing communications plans. Your communications team, led by an executive officer, should have advisory plans in place in anticipation of, during and following an emergency. The good news is that you don’t have to draft them from scratch. The Centers for Disease Control and Prevention (CDC) offers communications worksheets, templates and guides dedicated to water, sanitation and hygiene-related emergencies and outbreaks. You can customize these documents to reflect your organization’s capabilities and to alert nearby residents and businesses.

Be sure to issue advisories through all possible outlets, including social media. One thing Arkema did correctly was send press releases, incident statements and alerts via Twitter in addition to traditional outlets in order to keep as many people informed as possible.

Communicate with local authorities and emergency workers. All energy plants impact their local communities, surrounding areas and ecosystems. Your company’s hazard plans should be communicated to local fire and police departments and hospitals. This ensures that emergency workers know the potential dangers your plant faces in the event of a disaster and the steps you plan to take to mitigate them.

Protecting Workers from Sun Exposure

sun workers
The number of skin cancer cases in the United States continues to increase, with nearly 5 million people treated for it every year, according to the Centers for Disease Control (CDC). Outdoor workers are especially at risk, as they are constantly exposed to ultraviolet (UV) rays, even on cloudy days when they may think they are safe from the sun.

According to the National Institute for Occupational Safety and Health (NIOSH), UV rays, which are a part of sunlight, are an invisible form of radiation. There are three types of UV rays: UVA, which is believed to CDC advicedamage connective tissue and increase the risk for developing skin cancer; UVB, which doesn’t penetrate as deeply into the skin, but can still cause some types of skin cancer; and natural UVC, which is absorbed by the atmosphere and does not pose a risk.

One of the dangers of being out in the sun for prolonged periods is that sunburn is not immediately apparent, NIOSH said. Symptoms usually start about 4 hours after sun exposure, worsen in 24 to 36 hours, and get better in 3 to 5 days. They include red, tender and swollen skin, blisters, headache, fever, nausea and fatigue. Another danger is that eyes can also become sunburned. They become red, dry, painful and feel gritty. Chronic eye exposure can cause permanent damage, including blindness.

The CDC advises organizations to add sun safety to their workplace policies and training programs, as well as to:Include sun-safety information in workplace wellness programs. For example, programs designed to help employees avoid heat illness can be adapted to include information about sun safety.
• Teach outdoor workers about risks of exposure to UV radiation and the signs and symptoms of overexposure.
• Encourage outdoor workers to be role models and discuss the importance of sun protection with clients, and coworkers. Visit the National Cancer Institute’s RTIPs website for more information about sun safety.

NIOSH’s advice to workers:

Protect Yourself

  • Avoid prolonged exposure to the sun when possible.
  • Wear sunscreen with a minimum of SPF 15.
    • SPF refers to how long a person will be protected from a burn. (SPF 15 means a person can stay in the sun 15-times longer before burning.) SPF only refers to UVB protection.
    • To protect against UVA, look for products containing: Mexoryl, Parsol 1789, titanium dioxide, zinc oxide, or avobenzone.
    • Sunscreen performance is affected by wind, humidity, perspiration, and proper application.
    • Throw away sunscreens after 1–2 years (they lose potency).
    • Apply liberally (minimum of 1 oz.) at least 20 minutes before sun exposure.
    • Apply to ears, scalp, lips, neck, tops of feet, and backs of hands.
    • Reapply at least every two hours and each time a person gets out of the water or perspires heavily.
    • Some sunscreens may lose their effectiveness when applied with insect repellents. You may need to reapply more often.
  • Wear clothing with a tight weave or high-SPF clothing.
  • Wear wide-brimmed hats and sunglasses with UV protection and side panels.
  • Take breaks in shaded areas.

First Aid

  • Take aspirin, acetaminophen, or ibuprofen to relieve pain, headache, and fever.
  • Drink plenty of water to help replace fluid losses.
  • Comfort burns with cool baths or the gentle application of cool wet cloths.
  • Avoid further exposure until the burn has resolved.
  • Use of a topical moisturizing cream, aloe, or 1% hydrocortisone cream may provide additional relief.

If blistering occurs:

  • Lightly bandage or cover the area with gauze to prevent infection.
  • Do not break blisters. (This slows healing and increases risk of infection.)
  • When the blisters break and the skin peels, dried skin fragments may be removed and an antiseptic ointment or hydrocortisone cream may be applied.

Seek medical attention if any of the following occur:

  • Severe sunburns covering more than 15% of the body
  • Dehydration
  • High fever (greater than 101 °F)
  • Extreme pain that persists for longer than 48 hours

Zika and the Olympics: Business Travel Risks

The Zika virus, and its presumed association with serious birth defects and a paralytic neurological disorder, poses an unusual problem for business leaders and risk managers. While the virus is not currently being spread by mosquitoes in the U.S., Brazil is an important destination for many U.S. business travelers, which will only increase in the build-up to this summer’s Olympic Games. For many companies, health and safety concerns are top priorities, but travel to Brazil may be a business necessity. Before making decisions around these two opposing drives, it is vital that risk managers and business leaders weigh the facts around Zika.

The Risk to Employees

Brazil ranks in the top 10 in the business travel global rankings, making it one of the world’s largest corporate travel markets. With the Olympics, business travel to Brazil is expected to increase considerably this year, yet many Americans are worried about the threats of the virus. Consider the results of a recent survey conducted by my company, On Call International: 64% of Americans and 69% of all women surveyed, said they would cancel their travel plans because of Zika. There is, however, a disparity between these widespread concerns and the ways businesses have actually responded to the virus. A survey by the Overseas Security Advisory Council found that of the 321 businesses that responded, less than 40% are allowing female employees to defer travel to affected countries, and only a fifth are allowing men to opt out. The majority of respondents are only taking steps to inform their employees about the virus.

Should more employers allow their employees to defer travel? In considering this question, business leaders need to turn to authoritative travel health sources such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) to help make informed choices around employee health and safety concerns.

Furthermore, women currently account for nearly half of all business travelers. The virus’s risks around pregnancy-related issues like miscarriages and birth defects will be top of mind for many businesswomen with travel plans to Brazil. Are employee concerns enough reason for businesses to stop travel to Brazil? Turning to authorities such as the CDC—and its recent travel advisory urging women who are pregnant or thinking of becoming pregnant to avoid travel to places like Brazil—provides a compelling reason for business leaders to consider more flexibility.

While women’s apprehensions around Zika seem obvious, the rising concern of the virus being transmitted sexually means that men with pregnant partners, or partners who may become pregnant, also have reason for concern. Notably, the CDC has issued warnings specifically for men traveling to locations like Brazil, which is another reason for businesses to give deferral of travel by men further consideration.

Duty of Care

As part of a company’s Duty of Care—the legal obligation to protect your employees from any reasonably foreseeable harm—your employees’ concerns around the Zika virus should be taken seriously. The virus is a new obstacle for businesses, and its risks require new approaches before any business travel to Zika-affected areas. Through proactive education, there are appropriate and responsible ways organizations can consider responding to the virus that are aligned with their legal and ethical responsibilities to their employees and their business. Organizations should consider meetings with all employees to discuss the virus and the health risks the virus imposes for travel.

If Travel is Necessary

While the symptoms of the virus – which are generally mild – are not immediately life-endangering, it is a good precaution to ensure employees are aware of resources such as doctors or hospitals in the areas where they are traveling. With special events like the Olympics, business leaders can also look into potential resources that are developed to help provide backup services for Rio during the Games. In preparation, Brazil is expected to invest $3.7 million in projects that include improving the medical infrastructure. These are investments that can benefit business travelers, if they have are made aware of them.

As there is no vaccine for the virus, organizations should share protection methods, including:

  • Avoid mosquitos and limit outdoor activities, especially from dawn until dusk when the Aedes aegypti mosquito is most active
  • Stay in accommodations with properly air-conditioned rooms. Netting for beds can also go a long way in protecting against the virus
  • Avoid unnecessary skin exposure by wearing long sleeves and pants
  • Purchase the correct insect spray—specifically those that contain DEET, picaridin, oil of lemon eucalyptus or IR3535

Embracing Flexibility

A sound approach includes weighing the risks and rewards of travel to Brazil and other Zika-affected areas. Where possible, be flexibile. For example, if your organization has employees based permanently in Brazil, or local partners, leverage them for any work that needs to be done in person to reduce the risks of sending additional employees to Zika-affected areas. There are also easy, technology-driven solutions, such as video chats or teleconferences. Be creative in your travel risk management solutions and identify which methods work best for your organization. Building your risk management program from a solid base of proactive education helps empower employees to make informed decisions regarding their travel plans to locations affected by Zika.

For more on this topic, check out our May feature in Risk Management Magazine.