Occupational and Environmental Medicine

Power Company and PCB's (Polychlorinated Biphenyls)

Challenge:

Employees working on the gas lines for a New England power company were encountering a white powder in the gas lines. Concerned that they were exposed to PCB's (a common finding in gas lines), they were refusing to work on the lines.

Solution:

We took samples of the white powder and also obtained blood samples from twenty employees to measure PCB's. The white powder was determined to be an innocuous particulate which normally occurs in gas lines. The levels of PCB's in the employees' blood were low (background levels). We shared these data with the employees in a meeting, explaining the presence of the white particulate and the lack of any health threat. The employees were reassured and returned to work.

Reflection:

Properly recognizing and addressing workers' concerns, treating them with dignity and performing objective tests to address their concerns were essential components of this effective undertaking in enterprise risk management. Health-based, factual communication with the workers, in which objective data were shared and questions were answered, was the essential link to promote functional employee-employer relationships.

Occupational Health Clinics

Challenge:

A number of federal agencies housed in Washington, DC had no in-house medical facilities to evaluate and treat their employees. Based on our physicians' hospital and emergency room experience, we were consulted to develop occupational health clinics to address acute health concerns, chronic problems and wellness programs for the employees of these organizations.

Solution:

We developed a unique plan for each agency which addressed the size of the target population, the physical plant, needed equipment, required staff and breadth of services to be offered. Following agency approval, we interviewed and hired physicians and ancillary staff to implement the occupational clinics as designed.

Reflection:

Significant cost savings were realized because of a resultant reduction in emergency room care and reduction in lost time due to on-site, available intervention for minor, acute problems. Wellness programs with fitness equipment and counseling staff, novel for the time, were enthusiastically received by employees. A surprise benefit was a reduction in absent days which, according to a follow-up survey we conducted, was the result of employees' perception that the workplace was more "worker friendly," because of active promotion of employee health.

Hazardous Waste Treatment Facility and Medical Monitoring

Challenge:

A hazardous waste treatment facility was about to go online in a Midwest city. Despite EPA approval, the community had staged massive protests which included celebrities chaining themselves to a fence surrounding the facility. A particularly vexing issue for the community was that the facility was poorly located, and the stack discharge was at the same elevation as an elementary school, albeit one-half mile away on a hill.

Solution:

In town meetings, we explained the risk assessments which had been performed and detailed the expected airborne emissions from the stack. Then, working with the state Department of Public Health, we devised a medical monitoring program that included measuring blood lead levels for the children. In addition, based on our conservative predictive models of the stack emissions, we proposed reasonable modifications to the location and height of the stack to avoid exposures to the elementary school children.

Reflection:

Addressing the very real health concerns of the residents for their children and for themselves, we were able to reassure them that emissions from the stack would be carefully controlled, redirected and monitored to eliminate unsafe exposures. We were also able to reassure them that the medical monitoring would produce objective health evaluations of the children and would immediately uncover any unexpected or untoward exposure event.

Metal Washing Fluid – Hypersensitivity Pneumonitis, Occupational Asthma

Challenge:

Several employees of a large manufacturing plant alleged that their exposure to metal washing fluid caused them to develop respiratory and neurological health problems. We were contacted to conduct a thorough analysis of the occupational and environmental conditions at the plant and assist the plant managers and attorneys to address the matter.

Solution:

We used a team of physicians and technical staff to research the nature of metal working fluids and their health effects, the primary diseases at issue, the response of the company, the state of knowledge and regulatory activity, and the actual nature of the medical disorders in the claimants. A comprehensive timeline of events was developed and presented graphically. We determined that some of the workers were not diagnosed appropriately. Furthermore, many of the worker complaints did not involve specific occupational exposures. Some alleged effects had no known or plausible relationship to the environment. Others were likely related to hazard perceptions and attendant emotionally-based symptoms.

Reflection:

The final conclusion of our analysis was that the plant acted reasonably and properly, consistent with industry standards. The objective data and our expertise in strategy development for addressing opposing experts provided our client with valuable information for moving forward through the matter.

Other Case Studies