• May 3 - 6, 2015

    Hilton Baltimore

    AOHC 2015

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    TUESDAY SESSIONS – MAY 5
    Conference Session / Activity Time Credit Hours
    802: GM Powertrain (Worksite visit) 7:30 am - 11:30 am 3.0 CME / MOC
    301: Integrating Health and Safety in the Workplace 8:30 am - 10:00 am 1.5 CME / MOC
    302: Neurological Fitness-for-Duty 8:30 am - 10:00 am 1.5 CME / MOC
    303: Clinical Advances in Occupational Health and Safety Among Underserved Occupational Populations in the US 8:30 am - 12:00 pm 3.0 CME / MOC
    304: Ebola and Other Emerging Occupational Infections 8:30 am - 12:00 pm 3.0 CME / MOC
    305: MRO Controversies 8:30 am - 12:00 pm 3.0 CME / MOC
    306: The New Beryllium Standard: A Cooperative Effort of Industry and Labor 10:30 am - 12:00 pm 3.0 CME / MOC
    307: Psychological Fitness for Duty Referrals: Clarity, Efficiency, and Effectiveness  10:30 am - 12:00 pm 1.5 CME / MOC
    308: Hexavalent Chromium: Hazard, Standard, Examination: What the Occupational Physician Needs to Know 1:30 pm - 3:00 pm 1.5 CME / MOC
    309: Innovations in Management of Occupational Bloodborne Pathogens Exposures 1:30 pm - 3:00 pm 1.5 CME / MOC
    310: Prescription Drugs and Safety for Transportation Workers: Evidence-based Risk Assessment, Legal and Policy Issues, and Guidelines for Physicians 1:30 pm - 3:00 pm 1.5 CME / MOC
    311: Political Advocacy: A Hands-on Approach 1:30 pm - 5:00 pm 3.0 CME / MOC
    312: Legislative, Regulatory, and Economic Issues Affecting the Health and Safety of Contingency, Immigrant, and Migrant Workers in the US in 2015 1:30 pm - 5:00 pm 3.0 CME / MOC
    313: Managing Infected and Colonized Healthcare Workers 3:30 pm - 5:00 pm 1.5 CME / MOC
    314: Impetus for New Lead (Pb) Levels: The Shots Heard Around the Country 3:30 pm - 5:00 pm 1.5 CME / MOC
    315: Defining Acceptable and Persistent Risk of Sudden Incapacitation Among Transportation Workers in Safety Critical Positions 3:30 pm - 5:00 pm 1.50 CME / MOC
    316: Connecting Onsite Health with the External Healthcare Machine 5:15 pm - 6:15 pm 1.0 CME / MOC
    317: Early Intervention in the Rehabilitation of the Worker with Disabling Pain 5:15 pm - 6:15 pm 1.0 CME / MOC
    318: Federal Workers Compensation Cost Containment and Management Strategies 5:15 pm - 6:15 pm 1.0 CME / MOC  
    319: ACOEM's Maintenance of Certification Part IV Program 5:15 pm - 6:15 pm 1.0 CME / MOC  

     

    802: GM Powertrain (Worksite Visit)
    TRACK: Other

    Faculty:

    Tour the highly green and environmentally friendly General Motors plant. Discuss health and safety challenges in the setting of labor agreements and union collaboration. Attendees should wear long pants, closed-toe shoes (no heels higher than 2 inches). Advanced registration required, additional fee applies.

     

    301: Integrating Health and Safety in the Workplace
    TRACK: Management and Administration in OEM

    Faculty:

    Todd Hohn, CSP, Underwriters Laboratories, Inc, Northbrook, IL
    Ronald R. Loeppke*, MD, MPH, FACOEM, FACPM, US Preventive Medicine, Brentwood, TN

    Integrating traditionally independent health promotion and health protection activities will create synergy, enhancing the overall health and well-being of the workforce while decreasing the likeihood of workplace injury and illnesses. For integration of health and safety programs to succeed as a concept in the workforce, it must go beyond the conceptual. ACOEM, in conjuction with safety organizations, identified successful integrated health and safety practices and translated such that they can be readilty adopted by work forces of all sizes and across industries. This session will review these successful practices/case studies and discuss the road map which has been developed for employers to integrate health and safety activities within their workpalces. These initiatives will move occupational health and safety along the continuum and positively impact overall wellness in the workpalce. This session was organized by the Health and Productivity Special Interest Section.


     

    302: Neurological Fitness-for-Duty
    TRACK: OEM Clinical Practice  

    Faculty:

    Jonathan S. Rutchik*, MD, MPH, FACOEM, UCSF, Mill Valley, CA

    Occupational medicine practitioners are often faced with challenging decisions when faced with a patient with a nonindustrial neurological condition who is asking to return to work. Post graduate training and continuing medical education in occupational medicine does not routinely offer courses in the neurological exam or the natural history of neurological conditions to allow the practitioner to address worker fitness. Neuroepidemiology is also not routinely covered in these didactic training. Further complexity arises when the patient is a commercial drivers, police officer, fire fighters, hazardous waste workers, or aviation pilots where there is a potential risk to oneself or others. These issue have a direct impact on public safety. In this presentation, Dr. Rutchik, a physician board certified in both neurology and occupational medicine, will discuss neurological conditions such as seizures, stroke, head trauma, multiple sclerosis, tremor, neuropathy and medication use in patients employed in safety-sensitive positions. Participants will become familiar with the algorithms necessary to evaluate these patients.


     

    303: Clinical Advances in Occupational Health and Safety Among Underserved Occupational Populations in the US
    TRACK: OEM Clinical Practice  

    Faculty:

    Thomas A. Arcury, PhD, Wake Forest School of Medicine, Winston-Salem, NC
    Xochitl Castaneda, MA, Health Initiative of the Americas, School of Public Health, University of California, Berkeley, CA
    Linda Forst*, MD, MPH, MS, University of Illinois at Chicago School of Public Health, Division of Environmental and Occupational Health Sciences, Chicago, IL
    Joseph A. Fortuna*, MD, MACOEM, Prism, New Orleans, LA
    Ismail Nabeel*, MD, MPH, FACOEM, The Mount Sinai Hospital, New York, NY
    Paul J. Papanek*, MD, MPH, FACOEM, Cal/OSHA, Rancho Palos Verdes, CA

    This session will consist of reports from six experts in the field of occupational health and safety for underserved occupational populations. Speakers will present their research as it applies to clinical advancements in: 1) the prevention of a variety of occupational illnesses and injuries; 2) the treatment and/or management of selected occupational illnesses and injuries in these populations; 3) expanding access for these populations to occupational and non-occupational health care; and 4) the use of novel, innovative technologies in the delivery of health care services to these working underserved population. This session was organized by the Underserved Occupational Populations Special Interest Section.


     

    304: Ebola and Other Emerging Occupational Infections
    TRACK: Management and Administration in OEMh

    Faculty:

    Marianne Cloeren, MD, MPH, FACOEM, Managed Care Advisors, Bethesda, MD
    Okon Akiba*, MBBS PGCOH, NNPC/Olokola LNG, Largos, Nigeria
    T. Warner Hudson III, MD, FACOEM, FAAFP, UCLA, Los Angeles, CA
    Paul J. Papanek, MD, MPH,FACOEM, Cal/OSHA, Rancho Palos, CA
    Professor Robert L. Quigley, MD, DPhil, International SOS Assistance, Inc., Trevose, PA
    Michael Sauri*, MD, MPH&TM, FACP, FACPM, FACOEM, FRSTM&H, CTropMed, Occupational Health Consutlants, Rockville, MD

    The Ebola outbreak is spreading and poses a risk to the global workforce. This session will address protecting first responders, laboratory, and health care personnel; managing risks to workers in Africa; quarantine, transport, and evacuation of expatriate employees; and data on outbreak evolution.


     

    305: MRO Controversies
    TRACK: Regulatory, Legal, Military, and Governmental OEM

    Faculty:

    Karl Auerbach*, MD, MS, MBA, FACOEM, Pulse Occupational Medicine, Greece, NY
    Natalie Hartenbaum*, MD, MPH, FACOEM, OccuMedix, Dresher, PA
    Douglas W. Martin*, MD, FACOEM, FAAFP, FAADEP, UnityPoint Clinic, Sioux City, IA
    Kent W. Peterson*, MD, FACOEM, Occupational Health Strategies, Charlottesville, VA
    Donna R. Smith, PhD, EDPM, Inc., Birmingham, AL
    Robert Swotinsky*, MD, FACOEM, Consultant, Occupational Medicine, Sudbury, MA

    The MRO Controversies session has become a staple of AOHC, where topics are discussed that go beyond what is typically covered in the various MRO training courses sponsored by ACOEM and other training organizations. Challenging issues including medical and recreational marijuana use, alternative testing methodologies, use of drug testing as a surrogate for fitness for duty and designer drug use are examples of topics that are discussed. The session concludes with the “MRO Jeopardy”" game show that invites audience member participation as a fun and unique method to review and update their MRO knowledge base. This session was organized by the Medical Review Officers Special Interest Section.


     

    306: The New Beryllium Standard: A Cooperative Effort of Industry and Labor
    TRACK: OEM Clinical Practice

    Faculty:

    Jonathan Borak*, MD, FACOEM, Yale University, New Haven, CT
    Terence M. Civic, CIH, Materion Corporation, Mayfield Heights, OH
    David C. Deubner*, MD, MPH, FACOEM, Materion, Inc, Elmore, OH
    James Frederick, United Steelworkers (USW), Pittsburgh, PA
    Michael J. Wright, CIH, United Steelworkers (USW), Pittsburgh, PA

    It has been recognized for more than 15 years that the current OSHA PEL for beryllium is not adequately protective, but the OSHA regulatory process can be slow and the road to rulemaking often takes years. To facilitate development and adoption of more protective beryllium regulations, industry and labor have worked cooperatively to develop a comprehensive standard that would include lower exposure limits and medical surveillance. This cooperative approach provides a novel model that may allow OSHA to be increasingly effective in updating its current regulations and in pursuing future regulations. This session will discuss the history of the current beryllium occupational exposure limit, review the evidence that the current limit is not adequate, detail the joint industry-labor proposal, and describe the practical cooperative process that allowed this regulatory breakthrough. This session is organized by the Council of Scientific Advisors.


     

    307: Psychological Fitness for Duty Referrals: Clarity, Efficiency, and Effectiveness
    TRACK: OEM Clinical Practice

    Faculty:

    Michael Coupland, CPsych, RPsych, CRC, IMCS, Williamsburg, VA
    Michael J. Levine*, MD, MPH, FACOEM, Occupational Physician, Williamsburg, VA

    This session, taught by a practicing occupational physician and a clinical and forensic psychologist, will describe the process of psychological fitness-for-duty evaluation in detail. Reasons for evaluation, selection of evaluators, and identification and communication with stakeholders in the evaluation will be reviewed. Methods of evaluation will be described. Concepts will be illustrated with a selection of case studies.


     

    308: Hexavalent Chromium: Hazard, Standard, Examination: What the Occupational Physician Needs to Know
    TRACK: OEM Clinical Practice

    Faculty:

    Michael J. Levine*, MD, MPH, FACOEM, Occupational Physician, Williamsburg, VA

    This presentation reviews what the occupational provider needs to know to meet the preventive health needs of chromium exposed workers, and to competently perform medical surveillance examinations under the OSHA standards.


     

    309: Innovations in Management of Occupational Bloodborne Pathogens Exposures
    TRACK: OEM Clinical Practice

    Faculty:

    Amy J. Behrman*, MD, FACP, FACOEM, University of Pennsylvania, Philadelphia, PA
    Francesca K. Litow*, MD, MPH, FACOEM, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
    Melanie Swift*, MD, FACOEM, Vanderbilt Health and Wellness, Nashville, TN

    Exposure to patients’ blood or body fluids is an ongoing hazard for health care and research personnel despite national efforts to reduce sharps injuries. Occupational medicine physicians must manage these highly stressful events according to national guidelines, within the constraints of state and federal mandates, and while attempting to minimize exposed workers’ medical risk, lost productivity, and anxieties about bloodborne pathogen infection. Individual medical centers have created custom pathways to meet their employees’ needs. Faculty will present innovative protocols, electronic tools, and other approaches to improve care, reporting and compliance after exposure. The session will invite audience collaboration to design and share additional novel solutions for improving exposure evaluation and management within current legal and operational constraints. If appropriate, the concepts will be submitted to the ACOEM Idea Marketplace™. This session was organized by the Medical Center Occupational Health Special Interest Section.

    310: Prescription Drugs and Safety for Transportation Workers: Evidence-based Risk Assessment, Legal and Policy Issues, and Guidelines for Physicians
    TRACK: OEM Clinical Practice

    Faculty:

    James H. Diaz*, MD, DrPH, FACOEM, FACMT, Louisiana State University, School of Public Health and Medicine, Metairie, LA
    Kurt T. Hegmann*, MD, MPH, FACP, FACOEM, University of Utah, Rocky Mountain Center for Occupational and Environmental Health, Salt Lake City, UT
    John P. Holland*, MD, MPH, FACOEM, Union Pacific Railroad, Olympia, WA
    Donald C. Sinclair II*, JD, Steptoe & Johnson PLLC, Wheeling, WV

    Many prescription drugs can impair mental and/or physical function, creating significant safety risks at work for employees in transportation and other safety critical jobs. The explosive growth in the use of opioids and psychiatric drugs in recent years make this an important public health and safety issue. This session summarizes the substantial recent epidemiological and experimental evidence about work safety risks from use of prescription drugs, including opioids and other pain drugs, sedatives, stimulants and other psychiatric medications. Newer methods to assess safety of drugs are discussed, such as on-road driving studies. Legal and regulatory issues, the impact of increased public awareness and media attention, and considerations for corporate safety policies will be discussed. Practical guidance will be provided for physicians making fitness-for-duty determinations for workers in safety critical positions who use potentially impairing prescriptions drugs. This session was organized by the Transportation Special Interest Section.


     

    311: Political Advocacy: A Hands-on Approach
    TRACK: Management and Administration in OEM

    Faculty:

    Phyllis A. Gerber*, MD, FACOEM, Biomotionlabs, Inc., Osprey, FL
    Bill Gilmour, Biomotion Labs, Inc., Richmond, VA
    Kathryn L. Mueller*, MD, MPH, FACOEM, University of Colorado Anschutz Medical Campus, Denver, CO
    Patrick C. O’Connor*, Kent & O’Connor, Inc., Washington, DC

    The current health care environment presents OEM physicians and providers with ample opportunities to promote the causes that they personally champion. hone your advocacy skills under the tutelage of seasoned advocacy professionals, a spokesperson for a national missing persons organization, a former corporate risk manager, a mayor and county manager, and a professional lobbyist, who will guide you through the steps from conceptualization of your issue, all the way to the steps of the highest courts. We will provide attendees with an issue relevant to the practice of OEM and our professionals will help you craft your position papers and letters to your local politicians, and will provide you with the valuable insights that comes from first-hand experience. As seating will be limited, early registration is strongly encouraged.


     

    312: Legislative, Regulatory, and Economic Issues Affecting the Health and Safety of Contingency, Immigrant, and Migrant Workers in the US in 2015
    TRACK: Regulatory, Legal, Military, and Governmental OEM

    Faculty:

    Kathleen Fagan*, MD, MPH, FACOEM, OSHA, Washington, DC
    Bruce Goldstein, JD, Farmworker Justice, Washington, DC
    Tee Guidotti*, MD, MPH, DABT, FACOEM, Medical Advisory Services, Rockville, MD
    Patrick Marius Koga, MD, MPH, FRSPH, UC Davis School of Medicine, San Francisco, CA
    Amy K. Liebman, MPA, MA, Migrant Clinicians Network, Salisbury, MD, MD
    Scott D. Morris*, MD, MPH, FACOEM, Valley Medical Center, University of Washington, Renton, WA
    Daniel Rothenberg, Arizona State University, Tempe, AZ

    This session will explore the legislative, regulatory, and economic issues affecting and/or determining the occupational health and safety of contingency, immigrant, and migrant workers in the U.S. in 2015. It includes updates on positive and negative legislation and their impact, an update on OSHA initiatives for underserved occupational populations, and the results of recent studies on occupational health and safety conducted by prominent researchers. Each presenter will outline the potential impacts of their material for the OEM physician and occupational health provider.


     

    313: Managing Infected and Colonized Healthcare Workers
    TRACK: Management and Administration in OEM 

    Faculty:

    Anthony Biascan*, MD, MS, US Naval Hospital, Sigonella, Sicily
    Lawrence D. Budnick*, MD, MPH, FACOEM, Rugers University New Jersey Medical School, Newark, NJ
    Melanie Swift*, MD, FACOEM, Vanderbilt University Medical Center, Nashville, TN

    This session will explore the management of health care workers with occupationally or non-occupationally acquired infectious diseases. Through case studies, including health care workers with bloodborne pathogen infections and a hospital-based MRSA outbreak, we will discuss evidence-based guidelines, ethical and legal aspects, and operational considerations for managing such situations. This session was organized by the Medical Center Occupational Health Special Interest Section.


     

    314: Impetus for New Lead (Pb) Levels: The Shots Heard Around the Country
    TRACK: Regulatory, Legal, Military, and Governmental OEM

    Faculty:

    Desmond I. Bannon, PhD, DABT, Army Institute of Public Health, Aberdeen Proving Ground, MD
    Michael E. Creel*, MD, MPH, Medical Command, Occupational Health, Fort Bragg, NC
    Michael Kosnett, MD, MPH, University of Colorado, Denver, CO
    Raul A. Mirza*, MS, DO, MPH, United States Army Public Health Command, Aberdeen Proving Ground, MD
    Warren Scott Monks, MPAS, PA-C, Army Institute of Public Health, Aberdeen Proving Ground, MD
    R. Todd Niemeier, MS, CIH, CDC/NIOSH, Cincinnati, OH
    Paul J. Papanek*, MD, MPH, FACOEM, Cal/OSHA, Rancho Palos Verdes, CA
    Alice K. Weber, CIH, MHS, Army Institute of Public Health, Aberdeen Proving Ground, MD

    This session will focus on how different entities determined more protective blood and air lead (Pb) standards than those set by OSAH and the experience of a multi-departmental working group at the Army Institute of Public Health and CalOSHA. Also, blood lead and air lead will be discussed with the diverse AIPH group will outline long and short term health effects of blood leads below the OSHA removal level as well as confounders. Specifics will be reviewed on blood lead and associated recommendations table which have become widely accepted. CalOSHA’s efforts will be summarized.


     

    315: Defining Acceptable and Persistent Risk of Sudden Incapacitation Among Transportation Workers in Safety Critical Positions
    TRACK: Regulatory, Legal, Military, and Governmental OEM

    Faculty:

    Kurt T. Hegmann*, MD, MPH, FACP, FACOEM, University of Utah, Rocky Mountain Center for Occupational and Environmental Health, Salt Lake City, UT
    John P. Holland*, MD, MPH, FACOEM, Union Pacific Railroad, Olympia, WA
    Donald C. Sinclair II*, JD, Steptoe & Johnson PLLC, Wheeling, WV

    International regulatory agencies have adopted various definitions of acceptable absolute risk per annum for sudden incapacitation among transportation operators. The majority of such regulations have either adopted or inferred a 1% threshold especially for commercial pilots. Some have deemed greater risk thresholds may be acceptable for some standard aviation pilots and private passenger and commercial motor vehicle operators. This presentation will examine the acceptable absolute annual risk of sudden incapacitation associated with cardiological, neurological, and idiopathic etiologies for sudden incapacitation and the persistence of risk after an incident, based on a systematic review of the epidemiological literature. This session was organized by the Transportation Special Interest Section.


     

    316: Connecting Onsite Health with the External Healthcare Machine
    TRACK: Management and Administration in OEM

    Faculty:

    Melissa A. Bean*, DO, MPH, MBA, FACOEM, Coventry Workers' Compensation Services, St. Louis, MO
    Steven J. Serra*, MD, MPH, FACOEM, Aetna, Castle Rock, CO
    Jay J. Shen, PhD, University of Nevada, Las Vegas, NV
    Peter Vasquez*, MD, Premise Health, Brentwood, TN
    E. Lee Washington, MD, MPH, Aetna, Chicago, IL

    Today’s status quo reveals that employers are utilizing numerous on-site resources to support health promotion, productivity, and performance and control medical cost trend. On-site clinics staffed by clinicians powered by EMRs, wellness programs, and ambassadors and health coaches are just a few examples of approaches that corporate decision-makers are using to supplement the health care management activities traditionally performed by their health, disability, and workers’ compensation carriers. Benefit plan and incentive design, biometrics testing, medical homes and ACOs, and HRAs are now the media through which employers seek to shape the health of their workforce. Frequently, there is insufficient or no process collaboration, and minimal to no data integration, of onsite programs with payor care management activities. This session will arm the OEM physician with an approach on how to inculcate corporate leadership on values of merging both data and work-processes from their internal and external efforts.


     

    317: Early Intervention in the Rehabilitation of the Worker with Disabling Pain
    TRACK: OEM Clinical Practice

    Faculty:

    Russell Gelfman*, MD, MS, Mayo Clinic, Rochester, MN
    James E. Hughes, PT, Mayo Clinic, Rochester, MN

    Medical providers are often involved in the care of workers with painful injuries or illnesses. Many of these workers recover with routine care and return to work without difficulty. However, a small number experience prolonged pain and disability, often to the frustration of the employer, the physician and the therapist. This course will discuss the approach utilized in a specialized work rehabilitation center, including specific examples and benefits of early team intervention, to effectively reduce work disability due to pain.


     

    318: Federal Workers Compensation Cost Containment and Management Strategies
    TRACK: Regulatory, Legal, Military, and Governmental OEM

    Faculty:

    Sheryl A. Bedno*, MD, MPH, Womack Army Medical Center, Fort Bragg, NC
    Michael J. Hodgson*, MD, MPH, OSHA/DOL, Washington, DC
    Jennifer Lipkowitz-Easton*, MD, MPH, Veterans Health Administration, Office of Public Health, Occupational Health Group, Washington, DC
    Timothy M. Mallon*, MD, MPH, FACOEM, Uniformed Services University, Bethesda, MD
    Cameron J. L. Nelson*, MD, MPH, US Naval Hospital, Yokuska, Japan

    This session will present a descriptive analysis of current trends in epartment of Defense and VA workers compensation (WC) injury prevention and cost containment efforts. The results of an evaluation of leadership strategies aimed at improving understanding of, reporting about and preventing workplace injuries and reducing costs will be presented. The session will also include a discussion on the VA Workers’ Compensation Employee Choice/Quality model and a review of VA WC program metrics and management indicators highlighted by a recent GAO audit of the VA's WC program. This session was organized by the Federal and Military Occupational and Environmental Medicine Special Interest Section.


     

    319: ACOEM's Maintenance of Certification Part IV Program
    TRACK: Other 

    Faculty:

    Clare Bonnema, American Board of Preventive Medicine, Chicago, IL
    William W. Greaves*, MD, MSPH, American Board of Preventive Medicine, Chicago, IL
    Denece Kesler*, MD, MPH, FACOEM, University of New Mexico, Albuquerque, MN

    As one of the four parts required for recertification under Maintenance of Certification, ABPM diplomats are required to complete a practice performance assessment – also known as Part IV. This component utilizes a quality improvement model with opportunities for assessment of practice performance and improvement activities available in clinical practice, teaching, research, and administration. This session will cover ACOEM’s Part IV program.