Category Archives: Health

Sick Leave Should Be Accessible to All

Today’s post comes from guest author Emily Wray Stander, from Rehm, Bennett & Moore.

Amid the debate about flu and immunizations and preventable diseases lurks a societal problem that’s getting more attention lately and directly affects the spread of those medical crises: paid sick leave for employees.

Although discussing the consequences of Ebola may be interesting, many people in the United States, including Nebraska and Iowa, are living with the consequences of pertussis (whooping cough), a rampant flu season, and measles outbreaks.

This blog has featured this subject in the past, almost exactly two years ago, when there was a flu epidemic. It was argued then, in one of the firm’s more popular blog posts, that sick people should not be forced to work and spread their germs to their co-workers and customers, in addition that working while sick tends to make people even more ill. Not having sick leave available to take becomes a public health and societal risk. In addition, not being able to provide care for sick children or loved ones results in family struggles and workers worrying, rightfully so, while they should be focused on work at work.

The issue is also affecting children, especially those who are low-income, according to the 2014 Kids Count Report in Nebraska.

A recent Marketplace Morning Report article highlighted the need for policy change through the Healthy Families Act “that would guarantee workers could earn up to seven days of paid sick leave per year.” For example, the Bureau of Labor Statistics is quoted in the story that “24 percent” of those in the restaurant industry and “47 percent of retail workers get paid sick leave.” It also shares the economic burden of the results of people who don’t get paid sick leave coming to work sick. “Underperforming at work, or even damaging equipment or products because of diminished capacity or the effects of medication is known as ‘presenteeism.’” Sickness and presenteeism costs more than $375 billion a year, according to the article.

Esther Cepeda also recently addressed both paid sick leave and presenteeism in a column: “Working while sick even when you can have the time off is a thing. Many workers take great pride in coming to work ill, and there are a fair number of their colleagues who wish they’d stop.”

Although it may be a pretty big challenge in some industries to provide paid sick time, Ms. Cepeda argues that those are the most important industries to have it, as was also argued in the firm’s flu blog post from 2013.

“Food service aside, there are any number of jobs – most of them low-wage, part-time service jobs – where you don’t want the worker to be miserably sick or mentally checked out, worried about their sick loved one, because they can’t afford to call off work and lose the pay or possibly the job.”

Also important to note, being “checked out” can lead to safety incidents and workers’ compensation claims, and having employees mired in presenteeism just isn’t good for anyone.

So as the article in this link mentions, I think it’s very important for both workers and employers to consider the importance of quality of life considerations: keeping healthy people from being exposed to sickness and supporting sick people (or people with sick loved ones) by giving them the chance to stay home and still get paid so they can focus on becoming healthy people again.

Because as Ms. Cepeda argues, it benefits all for people to be as healthy as possible.

“Those of us who have the choice or flexibility to take an available sick day must speak up for those who are penalized for life’s inevitable speed bumps. It’s ultimately in our own best interest.”

Issue is also affecting children:  Report: Nebraskans working hard, but falling behind — and kids are paying the price

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Testosterone Drug Use: Watch Out for Dangerous Side Effects

Today’s post comes from guest author Rod Rehm, from Rehm, Bennett & Moore.

Beware of testosterone drugs. 

Drugs to raise testosterone levels have very dangerous side effects. The drugs come in the form of prescription drugs, patches, creams, gels, deodorant or spray. These heavily promoted drugs have been linked to increased heart attacks, strokes, pulmonary embolism, blood clots, and death. For instance, men older than 65 taking such drugs are two times more likely to have a heart attack during the first 90 days of use than those who don’t take the drug. That is a sobering, if not outright scary, situation. Men younger than 65 with histories of heart disease are also twice as likely to have heart attacks during the first 90 days of use. 

Human nature and the desire to be healthy, strong and youthful appearing will draw many men to these drugs, particularly with the heavy advertising on TV, radio, online and in traditional print that the public is exposed to currently. The lure of a Fountain of Youth is hard to resist but also very dangerous. 

Sadly, there have been many other instances of new drugs that have been heavily promoted that have had dangerous side effects. The law has provided damages for the now millions of people who have been damaged by various dangerous drugs with serious side effects. I recommend looking into your legal rights if you or a loved one suffered a heart attack, stroke, pulmonary embolism, blood clots or death while taking testosterone replacement drugs or after taking such drugs. Feel free to contact me, and I can arrange for a consultation with lawyers with special knowledge, experience and good ethics to help you or your family member.

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Are You Suffering From Symptoms Of Chronic Stress? Take the Stress Test!

Today’s guest post is from Kit Case of the Causey Law Firm in Washington State.

Signs of Chronic Stress:

Cognitive symptoms

  • Memory problems
  • Inability to concentrate
  • Poor judgment
  • Pessimistic approach or thoughts
  • Anxious or racing thoughts
  • Constant worrying

Emotional symptoms

  • Moodiness
  • Irritability or short temper
  • Agitation, inability to relax
  • Feeling overwhelmed
  • Sense of loneliness and isolation
  • Depression or general unhappiness

Physical symptoms

  • Aches and pains
  • Diarrhea or constipation
  • Nausea, dizziness
  • Chest pain, rapid heartbeat
  • Loss of sex drive
  • Frequent colds

Behavioral symptoms

  • Eating more or less
  • Sleeping too much or too little
  • Isolating oneself from others
  • Procrastinating or neglecting responsibilities
  • Using alcohol, cigarettes, or drugs to relax 

Take the Stress Test for Adults:

Thomas Holmes and Richard Rahe in 1967, examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive correlation was found between their life events and their illnesses.

Their results were published as the Social Readjustment Rating Scale (SRRS), known more commonly as the Holmes and Rahe Stress Scale.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Note: the table, below, is from the Wikipedia page on this subject.  For a fee of $5.00, you can go directly to Dr. Rahe’s website and obtain the full test materials as well as background information and details of this and other products and services available.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Life event Life change units
Death of a spouse 100
Divorce 73
Marital separation 65
Imprisonment 63
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Dismissal from work 47
Marital reconciliation 45
Retirement 45
Change in health of family member 44
Pregnancy 40
Sexual difficulties 39
Gain a new family member 39
Business readjustment 39
Change in financial state 38
Death of a close friend 37
Change to different line of work 36
Change in frequency of arguments 35
Major mortgage 32
Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Child leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Spouse starts or stops work 26
Begin or end school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in working hours or conditions 20
Change in residence 20
Change in schools 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Minor mortgage or loan 17
Change in sleeping habits 16
Change in number of family reunions 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violation of law 11

Score of 300+: At risk of illness.

Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).

Score 150-: Only have a slight risk of illness.

 

Recommended methods for relieving chronic stress include exercise (which can be modified to accommodate physical restrictions after an injury), meditation, music therapy, breathing techniques, and such simple things as companionship – from a pet, friend or family member.

 

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Cancer Risk, Workplace Carcinogens and a Government Report

Today’s post comes from guest author Rod Rehm from Rehm, Bennett & Moore.

Our law firm recently completed successful litigation involving eight families against various chemical companies. A member of each family got cancer from working at a local plant where industrial solutions were used to make rubber products.

Stating the obvious, cancer is universally bad, regardless of how much money a person has; what their religious or political views are; how old they are; or how/where/why they got cancer. That being said, I think workers especially need to be aware of the dangers and exposures to carcinogens that can occur because of chemicals in the workplace. According to a United States Department of Labor Occupational Safety and Health Administration (OSHA) website, “Carcinogens are agents that can cause cancer. In industry, there are many potential exposures to carcinogens. Generally, workplace exposures are considered to be at higher levels than for public exposures. Material safety data sheets (MSDSs) should always contain an indication of carcinogenic potential.” 

Respected colleague Jon Gelman from New Jersey shares his thoughts on the subject in this blog post at http://workers-compensation.blogspot.com/2012/10/romney-regulation-risk-of-cancer.html. And I thank him for sharing the op-ed resource from a recent Sunday’s edition of The New York Times. 

According to the Times piece, lobbyists associated with the chemical industry want to “shoot the messenger” by limiting or getting rid of the U.S. government’s Report on Carcinogens. Because if workers don’t know about carcinogens in their workplace, they won’t get cancer? Or more accurately, at least they won’t be able to tie that cancer to their workplace? Tell that to the American Cancer Society, whose web site includes a page specific to carcinogens and uses various sources, both national and international, to determine what carcinogens are.

Mr. Gelman also mentions in his blog post that certain lobbyists and politicians want to limit the regulation of these chemicals, which the Times story calls “scientific consensus” for their listing as cancer-causing carcinogens. It’s very challenging for consumers to know what substances, either naturally occurring or made by humans are safe to eat and use. To take that confusion into the workplace by limiting the information available to workers to be as safe as possible in their jobs, especially when long-term consequences like cancer are a possibility, is a shame.

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Chronic Stress: The Cascade Effect (Part 2 Of The Biology of Stress)

Today’s second post in this series about the biology of stress comes to us from the Causey Law Firm in Washington. We encourage anyone who suffers from stress, whether it is acute or chronic, to seek professional assistance to manage the symptoms and, if possible, develop strategies to alleviate the underlying causes.

Stress is how the body reacts to a real or imagined stressor — a stimulus that causes stress. Acute stressors affect a bodily organ in the short term; chronic stressors over the longer term. Chronic stress is the state of prolonged tension from internal or external stressors which may cause various physical manifestations such as asthma, back pain, arrhythmias, fatigue, headaches, irritable bowel syndrome, ulcers, and suppression of the immune system. Chronic stress takes a more significant toll on the body than acute stress. It can raise blood pressure, increase the risk of heart attack and stroke, and induce symptoms of anxiety and depression.

The Three Stages of Stress – From Acute to Chronic

  • Alarm: In this first stage, when the threat or stressor is first identified or realized, the body’s stress response is in a state of alarm. During this stage, adrenaline is produced in order to bring about the flight-or-fight response, causing sweating, raised heart rate, etc. The body’s resistance to the stressor drops temporarily below the normal range and some level of shock may be experienced. There is also some activation of the HPA Axis, producing cortisol, as discussed in our last post.
  • Resistance: If the stressor persists, the body must find some means of coping with the stress. Although it begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.  As it attempts to cope with the condition that is causing the stress, the mind may try to focus on the problem, which can actually exaggerate the awareness of the problem and make it seem difficult to overcome.
  • Exhaustion: third stage. At this point, all of the body’s resources are eventually depleted and the body is unable to maintain normal function. The initial symptoms may reappear (sweating, raised heart rate, etc.). Long-term damage may result, as the body’s immune system becomes exhausted, and bodily functions become impaired. The result can manifest itself in obvious illnesses such as ulcers, depression, diabetes, digestive system problems or cardiovascular problems.  It can also manifest as a chronic pain syndrome, guarding/avoidance behavior, and/or sleep disturbance.  Hopelessness can set in.

Chronic Stress and Cortisol

When the body’s HPA-axis cannot overcome a challenge and/or is chronically exposed to a threat, this system becomes overtaxed and can be harmful to the body and brain. An increased level of cortisol is one of the most dangerous outcomes of chronic stress.

Cortisol is an important hormone in the body, secreted by the adrenal glands and involved in some of the following functions: proper glucose metabolism, regulation of blood pressure, insulin release for blood sugar maintenance, immune function and inflammatory response. Normally, cortisol is present in the body at higher levels in the morning and is at its lowest level at night. Although stress is not the only reason that cortisol is secreted into the bloodstream, it has been termed “the stress hormone” because it’s also secreted in higher levels during the body’s ‘fight or flight’ response to stress, and is responsible for several stress-related changes in the body. Small increases of cortisol have some positive effects: a quick burst of energy for survival reasons, heightened memory functions, a burst of increased immunity, lower sensitivity to pain, and helping to maintain homeostasis in the body.

People are biologically ‘wired’ to react differently to stress.

While cortisol is an important part of the body’s response to stress, it is important that the body’s relaxation response be activated so the body’s functions can return to normal following a stressful event. Unfortunately, in our current high-stress culture, the body’s stress response is activated so often that the body doesn’t always have a chance to return to normal, resulting in a state of chronic stress, thus producing high chronic cortisol levels.

Higher and more prolonged levels of cortisol in the bloodstream like those in chronic stress have been shown to have negative effects, such as:

  • Impaired cognitive performance (loss or poor concentration, inability to complete tasks or heightened confusion in mildly stressful situations
  • Suppressed thyroid function
  • Blood sugar imbalances such as hyperglycemia
  • Decreased bone density
  • Decrease in muscle tissue
  • Higher blood pressure
  • Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences
  • Increased abdominal fat, which is associated with a greater amount of health problems than fat deposited in other areas of the body

When people feel stressed, stress hormones can be over-secreted, dramatically affecting the brain. Cortisol also plays a large part in post-traumatic stress disorder (PTSD) and memory. In a 2002 article in Biological Psychiatry regarding cortisol, PTSD and memory1, cortisol was noted to work with epinephrine (adrenaline) to create memories of short-term emotional events.  This effect may serve as a means to help a person remember what situations to avoid in the future. However, long-term exposure to cortisol damages cells in the hippocampus and can create impaired learning ability. It has been shown that cortisol inhibits memory retrieval of already stored information.

Cortisol secretion varies among individuals. People are biologically ‘wired’ to react differently to stress. One person may secrete higher levels of cortisol than another in the same situation. Studies have shown that people who secrete higher levels of cortisol in response to stress also tend to eat more food, and food that is higher in carbohydrates, than people who secrete less cortisol.

1“Depression. What happens in the brain?” Biological Psychiatry, 2002

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James Zadroga 9/11 Health and Compensation Act Now Covers Many Types Of Cancer

Today as we reflect on the tragic events which took place 11 years ago, we are relieved to learn of the news that the Federal Government is finally  acknowledging what we, as representatives of many of these injured workers have suspected for many years-  that exposure to the toxins around Ground Zero can cause cancer.  We pray for all those who are sick and have died and for those who will continue to become ill as a result of this horrible attack.

The following article from NBC New York written by Brynn Gingras and Greg Cergol details the new coverage that those suffering from cancer are entitled to receive: 

The federal government will now officially add dozens of cancers to the list of illnesses linked to the Sept. 11 attacks, making those who lived or worked near ground zero and later became sick eligible for financial payments, authorities said Monday.

Fourteen categories of cancers, a total of 50, will be added to the illnesses covered in the James Zadroga 9/11 Health and Compensation Act, the National Institute for Occupational Safety and Health announced.

The Zadroga Act — named after NYPD Detective James Zadroga, who died at 34 after working at ground zero — passed into law two years ago. Despite the hundreds of sick responders, the act did not cover cancer because of a supposed lack of scientific evidence linking cancer to ground zero toxins.

“We have urged from the very beginning that the decision whether or not to include cancer be based on science,” said Mayor Bloomberg in a statement, adding that the decision “will continue to ensure that those who have become ill due to the heinous attacks on 9/11 get the medical care they need and deserve.”

Eighteen-year FDNY veteran Jeff Stroehlein spent several weeks working at ground zero, and is certain the brain cancer he has been fighting for a year is linked to his work there. The father of three welcomes the financial help the federal government will now be offering first responders with cancer, but says it should have arrived much earlier.

“The fact is, the government has turned their back for 11 years now,” he said. “I saw no politicians digging on the pile. If you saw a politician that was sick or on the pile, or their kid was sick or on the pile, this would have been solved months ago.”

Two more scientific studies are expected to be released shortly, which will determine whether more cancers should be added to the list, Senators Charles Schumer and Kirsten Gillibrand said in a statement.

“Today’s announcement is a huge step forward that will provide justice and support to so many who are now suffering from cancer and other illnesses,” they said.

About 400 residents and rescue workers have died from cancer since 9/11, according to the New York Post.

With cancer included in the program more victims are likely to seek compensation, which could cause individual awards to be reduced as officials divide up the $2.77 billion fund.

“They’re going to add cancers, but are they going to add more money to the fund?” Thomas “T.J.” Gilmartin, who suffers from lung disease and sleep apnea, said to the Post. “It’s crazy. Every time, we gotta fight. It’s two years since Obama signed that bill, and nobody’s got 10 cents.”

Stroehlein is now cancer-free and feeling well. But at 48, after being forced to give up a job he loved and facing an uncertain future, he’s focusing on speaking to lawmakers for his lost comrades, many of whom lost their life savings in their fight to survive after 9/11.

He’s also troubled by the uncertainty future first responders may face.

“Do you want to give up your life for a government that turned around and didn’t support you?”

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The Biology of Stress (Part 1)

Today’s post comes from the Causey Law Firm in Washington.

Today’s post is the first in a multi-part series about stress, covering first the biology of stress and the effects of chronic stress on the body.

Stress is a term that is commonly used to explain — or explain away — much in our world. We live in a time of multifactorial stress: the economy; keeping, losing or getting jobs; housing, food, medical and dental care; personal and familial safety; fear or anger over political or governmental decisions; injuries and/or disabilities. At times, stress can be overwhelming when it seems we are losing control over our lives and our futures.

The following is an overview of the biology of stress to help better understand how stress can control such a large part of our health. There are many types of stress and those will be investigated after first laying out a basic understanding of what stress is and the physiologic mechanisms of stress.

The term stress is derived from the Latin word stringere, “to draw tight.”

The term stress is derived from the Latin word stringere, “to draw tight.” It had been used almost solely in the field of physics to define the internal distribution of a force exerted on a material body, resulting in strain — or stress — such as a rubber band pulled tautly. In the 1920s, stress started to be used in both biology and psychology, referring to a mental strain or a harmful external agent that could cause illness. Interestingly, in an early example, researcher Walter Cannon used the term strain/stress in 1926 to refer to external factors that disrupted homeostasis.1

The idea of stress and homoeostasis is intriguing for it is widely known that the incredible human system strives to maintain homeostasis, or equilibrium. So, it makes great sense that maintaining equilibrium is central to the idea of stress. This is true with all biological and most biochemical processes. The body always attempts to maintain this steady state of being; however, environmental factors, internal or external, continually challenge and disrupt this equilibrium (homeostasis) causing the body to constantly strive for balance. Environmental factors causing the body continued strife are generally called stress. Stress can be simply moments or events from which the body returns to equilibrium or it can turn into chronic stress where the body is constantly trying to reach homeostasis against resistance.

The balance of our body systems can be disrupted (stressed) by events from such disparate sources as a life-threatening situation or a simple insult, resulting in disequilibrium. Stress can bring on a cascade of biological reactions Continue reading →

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