DAOHN Government Affairs Update September 2008

· Workplace Exposure to Synthetic Fragrance on Wednesday
· Health care coverage projected to increase at double-digit rates into 2009.
· NIOSH Posts New Indoor Environmental Quality Topic Pages
· Regulation Proposed to Help Protect Health Care Providers from Discrimination
· Researchers link BPA exposure to health concerns
· mosquito-borne illness for FL 2nd adult case of West Nile virus (WNV) was confirmed.
· OSHA is accepting public comments on Personal Protective Equipment (PPE)
· NIOSH is hosting the "No Fit Test" Respirator Research Workshop on November 6, 2008.


The American Association of Occupational Health Nurses Inc. has partnered with the Asthma and Allergy Foundation of America, Decatur Memorial Hospital in Illinois, the Massachusetts Nurses Association, the Alabama State Nurses Association, and the University of Maryland School of Nursing, Environmental Health Education Center to offer a webcast titled Reducing Workplace Exposure to Synthetic Fragrance on Wednesday, Oct. 15, from 2 p.m. to 3:30 p.m. EST. Supported in part by a grant from the Nurses Work Group of Health Care Without Harm (HCWH), the webcast will identify the pertinent chemistry and common adverse reactions to perfumes and other fragranced products; discuss the concept of individual sensitivity as it relates to occupational and environmental health and worker safety; and list the key components of a policy that addresses a fragrance-free work environment.
"Our partners for this webcast join us in supporting and promoting the importance of a fragrance-free workplace as just one of many health and safety programs that can benefit workers and ultimately have a positive impact on productivity and a company’s bottom line,” said AAOHN President Richard Kowalski.

NIOSH Posts New Indoor Environmental Quality Topic Pages
The agency has posted three new indoor environmental quality "topic pages" that discuss these issues and provide answers to frequently asked questions, along with suggestions for things you can do, resource links to follow, and other references on each of the following:
§ Dampness and Mold in Buildings Topic Page--Dampness results from water incursion either from internal sources (e.g. leaking pipes) or external sources (e.g. rainwater). Dampness is a problem in buildings because it provides the moisture that supports the growth of bacteria, fungi (i.e., mold), and insects
§ Building Ventilation Topic Page--Building ventilation is the circulation of air throughout a building. The ventilation or the heating, ventilating, and air-conditioning (HVAC) system of a building supplies and removes air either naturally (windows) and/or mechanically to and from a space. Building ventilation may be an important factor determining the relationship between airborne transmission of respiratory infections and the health and productivity of workers.
§ Maintaining Indoor Environmental Quality (IEQ) during Construction and Renovation Topic Page--Construction and renovation projects in office settings can adversely affect building occupants by the release of airborne particulates, biological contaminants, and gases. Careful planning for IEQ and the prevention of exposure during these activities is essential.
You can find the new topic page links at www.cdc.gov/niosh/topics/indoorenv/default.html



Health Plan Rates Projected to Continue Double-Digit Increase into '09
September 16, 2008
According to the results of a survey released by the ACS company Buck Consultants, a human resource and benefits consulting firm, costs for the most popular types of health care coverage are projected to increase at double-digit rates through the remainder of 2008 and into 2009.
In its 19th National Health Care Trend Survey, Buck Consultants found that health insurers reported an average prescription drug trend of 11.4 percent, down slightly from the 11.7 percent reported in the prior survey. The most popular types of health plans continue to increase more than 10 percent. They include Preferred Provider Organization (PPO): 11.1 percent; Point-of-service (POS): 10.8 percent; Health Maintenance Organization (HMO): 11.1 percent; High Deductible Consumer Driven: 10.7 percent.

Regulation Proposed to Help Protect Health Care Providers from Discrimination
A new proposed regulation would increase awareness of, and compliance with, three separate laws protecting federally funded health care providers’ right of conscience. This proposed rule was placed on public display at the Federal Register today by the U.S. Department of Health and Human Services (HHS).
“This proposed regulation is about the legal right of a health care professional to practice according to their conscience,” HHS Secretary Mike Leavitt said. “Doctors and other health care providers should not be forced to choose between good professional standing and violating their conscience. Freedom of expression and action should not be surrendered upon the issuance of a health care degree.”
Over the past three decades, Congress has enacted several statutes to safeguard these freedoms, also known as provider conscience rights, and the proposed regulation would increase awareness of and compliance with these laws. Specifically, the proposed rule would:
Clarify that non-discrimination protections apply to institutional health care providers as well as to individual employees working for recipients of certain funds from HHS;
Require recipients of certain HHS funds to certify their compliance with laws protecting provider conscience rights;
Designate the HHS Office for Civil Rights as the entity to receive complaints of discrimination addressed by the existing statutes and the proposed regulation; and
Charge HHS officials to work with any state or local government or entity that may be in violation of existing statutes and the proposed regulation to encourage voluntary steps to bring that government or entity into compliance with the law. If, despite the Department’s efforts, compliance is not achieved, HHS officials will consider all legal options, including termination of funding and the return of funds paid out in violation of the nondiscrimination provisions.
“Many health care providers routinely face pressure to change their medical practice – often in direct opposition to their personal convictions,” said HHS Assistant Secretary of Health, Admiral Joxel Garcia, M.D. “During my practice as an OB-GYN, I witnessed this first-hand. But health care providers shouldn’t have to check their conscience at the hospital door. This proposed rule will help ensure that doesn’t happen.”
While it would strengthen provider conscience rights, the proposed regulation would in no way restrict health care providers from performing any legal service or procedure. If a procedure is legal, a patient will still have the ability to access that service from a medical professional or institution that does not assert a conflict of conscience. For example, the proposed regulation does not affect the ability of private clinics to provide abortion services in accordance with the law.
Congress has enacted three separate statutes to protect provider conscience rights. First, in the 1970s, the Church Amendments were enacted at various times in response to debates over whether receipt of federal funds required recipients to provide abortions or sterilizations. The Amendments also protected health care providers and other individuals from discrimination by recipients of HHS funds on the basis of their refusal, due to religious belief or moral conviction, to perform or participate in any lawful health service or research activity.
Second, in 1996, section 245 of the Public Health Service Act was enacted to prohibit the federal government and state or local governments that receive federal financial assistance from discriminating against individual and institutional health care providers, including participants in medical training programs, who refused to, among other things, receive training in abortions; require or provide such training; perform abortions; or provide referrals for, or make arrangements for, such training or abortions.
Third, the Weldon Amendment to the Department’s fiscal year 2005 appropriations act, and to subsequent years’ appropriations acts, prohibited the provision of HHS funds to any state or local government or federal agency or program that discriminates against institutional or individual health care entities on the basis that the entity does not provide, pay for, provide coverage of, or refer for abortion.
Despite this, many in the health care industry, and members of the general public, are unaware of these provider conscience rights. For example, an ethics opinion put forth several months ago by the American College of Obstetricians and Gynecologists appeared to disregard these laws. Subsequent action by the American Board of Obstetrics and Gynecology, which appeared to adopt the opinion, had the potential to force physicians to either violate their conscience by referring patients for abortions (or taking other objectionable actions) or risk losing their board certification. This case and others illustrate the need for the proposed rule to increase awareness of, and compliance with, the three statutes protecting provider conscience rights.

Researchers link BPA exposure to health concerns
In the first large-scale human study of the chemical, some found with bisphenol A in their urine had more than double the normal risk of heart disease and diabetes.
The first large-scale human study of a chemical widely used in plastic products, including baby bottles and tin can linings, found double the risk of cardiovascular disease, diabetes and liver problems in people with the highest concentrations in their urine, British researchers reported Tuesday.The findings confirm earlier results obtained in animals, increasing pressure on the Food and Drug Administration to limit use of the chemical Bisphenol A, commonly called BPA.
By Thomas H. Maugh II, Los Angeles Times Staff Writer September 17, 2008



PENSACOLA – Escambia County Health Department Director Dr. John Lanza today issued a mosquito-borne illness advisory for Escambia County after the county’s second adult human case of West Nile virus (WNV) was confirmed. This is the county’s second case since 2006.Symptoms of West Nile virus disease may include headache, fever, fatigue, dizziness, weakness and confusion. Physicians should contact their county health department if they suspect an individual may meet the case definition for a mosquito-borne illness. Department of Health (DOH) laboratories provide testing services for physicians treating patients with clinical signs of mosquito-borne disease.The health department reminds residents and visitors to avoid being bitten by mosquitoes that may cause encephalitis disease. Escambia County Mosquito Control and the health department continue surveillance and prevention efforts and encourage everyone to take basic precautions to help limit exposure by following the department of health recommendations.Your personal mosquito protection efforts should include the “5 D’s” for prevention: - Dusk and Dawn: Avoid being outdoors when mosquitoes are seeking blood. For many species, this is during the dusk and dawn hours. - Dress: Wear clothing that covers most of your skin. - DEET: When the potential exists for exposure to mosquitoes, repellents containing DEET (N,N-diethyl-meta-toluamide, or N,N-diethyl-3-methylbenzamide) are recommended. Picaridin, oil of lemon eucalyptus, and IR3535 are other repellent options. - Drainage: Check around your home to rid the area of standing water, which is where mosquitoes can lay their eggs. - Screens: Cover open windows and doors with screens. Check screens regularly for tears and openings that need to be repaired. OSHA seeks approval for proposed rule on remedies for violations of personal protective equipment and training standards

WASHINGTON -- The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) is accepting public comments on a Notice of Proposed Rulemaking (NPRM) on Personal Protective Equipment (PPE) and training standards. The proposal clarifies that when an OSHA standard requires an employer to provide PPE, such as respirators, or training to employees, the employer must do so for each employee subject to the requirement. Each employee not protected may be considered a separate violation for penalty purposes."We want employers to understand the importance of complying with OSHA’s PPE rule for each and every one of their employees," said Assistant Secretary of Labor for OSHA Edwin G. Foulke, Jr. "Without question, providing PPE for all employees will reduce costs, save money and, most importantly, save lives."

NIOSH is hosting the "No Fit Test" Respirator Research Workshop on November 6, 2008. The workshop aims to examine how the latest material technology (shape-changing polymers, adhesives, etc.) may be leveraged to improve current and future respirator designs including the long-term possibility of moving away from current fit-testing requirements, while preserving user protection. We would like your input as we finalize the workshop agenda.
An estimated 5 million workers wear respirators in 1.3 million U.S. workplaces to provide protection against various airborne hazards. Respiratory protection is critically dependent upon the fit of the respirator to the user's face. A fit test is required to assure that a given respirator fits an individual. Reports from the National Academies' Institute of Medicine (IOM) recommend research toward better-fitting respirators, with the ultimate goal of finding a way to obviate the need for initial and annual fit testing