WorkCare

Case Presentation

A 49 year-old lead electrician, who had been employed for six years on an petroleum drilling site, received an unsatisfactory performance evaluation due to lateness. During a counseling session this employee claimed that medical problems were the reason for his lateness.

Clinical Evaluation

In a clinical evaluation on January 7, 1999 the following information was gathered. This employee has been late 6 times in the last year, 4 times in the last 3 months. All latenesses were over 2 hours. Employee was also noted to fall asleep during meetings.

Past medical history was positive for a history of low blood sugar in 1981, and a history of allergies and asthma

Employee denies current drug use. Does drink 2-3 beers/night. Medications include: over-the-counter cold tables, vitamins, antihistamines and asthma inhalers.

The physical exam was unremarkable.

Assessment at medical evaluation

Tardiness to work, drowsiness at work, the etiology is unclear.

Plan

Fasting chemistries

CBC -to rule out medical causes

Thyroid panel

Urine drug screen

Employee was put off work pending results of the above tests.

Results

All blood work was within normal limits.

Drug screen was Positive

Amphetamine: 5474

Methamphetamine: 23577

Confirmed by GC/MS

MRO

Medicine review is significant for Vicks inhaler use. Employee denies drug use. The medical department referred employee to the Employee Assistance Program (EAP) for evaluation and treatment of possible over-the-counter medication abuse.

Follow-up

A return to work drug screen performed by medical on January 21 was negative. Employee returned to work on January 24. The supervisor called for a follow-up medical evaluation on February 6, when the employee was again very sleepy. A repeat drug screen and evaluation were performed.

The physical exam was negative. A repeat drug screen was done on February 6 with the employee off work pending results.

The results of the drug screen registered positive for Methamphetamine: 1734 and Dextroamphetamine: 571. Results could be consistent with inhaler abuse, so a special test for drug isomers was requested. In illegally manufactured amphetamines and methamphetamines the L (levo) forms of the drug are present.

The Isomer results received February 22 were L-methamphetamine – Negative, D-methamphetamine – 1813. The D-isomer is the illegal form

Current Status

Management was notified of the positive drug screen. Employee continued to deny drug use and refused further counseling. He was terminated on March 7.

Importance of medical evaluations

Medical evaluations of performance problems are invaluable because they can help sort out the root cause of employee performance problems. These evaluations can rapidly determine if there is a medical emergency present, and if employees are a danger to themselves or others. Employees can then be quickly routed to appropriate medical intervention. Sometimes, substance abuse is involved. Medical evaluation can make that determination. The medical department can then make appropriate referrals and follow-up for return to work and random drug testing.

The bottom line is: medical evaluations are an integral part of KEEPING THE WORKPLACE SAFE.

McDaniel Lambert, Inc. offers an intensive one-day Community Meeting Workshop. The workshop is designed to assist clients in preparing for the RMP public meetings now required by law or for other community meetings. The one-day course provides hands-on training in the principles and practice of risk communication. Participants learn how to:

· Avoid the pitfalls of presentations

· Plan to avoid crisis–and develop meeting strategies that work

· Establish credibility before, during, and after the meeting

· Set up the meeting space to encourage fruitful exchange

· Explain data with clarity

· Watch body language

· Explain an offsite consequence analysis without scaring the public

· Answer tough questions using a 5-stage model

The course includes videotaping of participants and a community meeting role-play. Sessions are offered on selected dates in an open-enrollment multi-company format or can be conducted upon request at the client’s facility.

The consultants have conducted more than 100 risk communication workshops, including many focused on RMP, for industry, agencies, and the public in the United States. In addition, they have conducted training in Southeast Asia and Europe. They have been very active in providing RMP support to ammonia plants, water districts, oil refineries, and chemical plants, particularly in the western United States. They have helped develop strategies, prepare communications materials, and have assisted at public meetings.

MANAGING EHS INFORMATION IN THE INFORMATION AGE FOR A GLOBAL OIL COMPANY: USING EMAIL SYSTEMS, INTERNET, AND CD-ROM TECHNOLOGY

Rapid Global Electronic communication is becoming the norm, and this provides major challenges and opportunities in the world of EHS. The ability to acquire and process information has lead major corporations to develop and rely on EHS “systems management.” Many companies are creating enterprise-wide EHS systems, but there is a gap between the improved ability to collect the data and the proper utilization of it to enhance the value of an EHS program.

The consultant was asked to assist in two phases of Environment Health and Safety Information Management: direct a contractor to build a global system for collecting and managing EHS incident data and then produce an external report that delivers the incident data and other key EHS performance indicators in a way that maximizes stakeholder interest and acceptance.

The first phase was performed utilizing a major email platform, and was based on several principles that the consultant required of the software contractor. First, use techniques to ensure data entry would not need to be repeated at different stages in the process. Second, data entry must be more than user friendly, it must be absolutely intuitive, and require minimal training, and not in any way be considered excessive burden. Third, the data collected must not be based on what is “easy” to collect, it must be based on broader principles of what is the “right” information to collect, even if some data do not appear to have immediate uses by management. Fourth, field user acceptance is more important in the development than management acceptance, because the field user data input process is ultimately responsible for the system working or failing. And finally, build and test a small scale model of the system wide architecture in a single operating unit because of the impossibility of building enterprise-wide system architecture based on input from a global collection of field users. The consultant coordinated field user needs to allow customization to the extent possible after the basic model of the system architecture is determined.

The consultant was also presented with the second level challenge. How to assemble and present externally the EHS incident related data collected for internal EHS management systems, along with additional key indicators of environmental performance. The consultant applied two main principles to the approach. The body of EHS information needed to be presented in a way that broadened stakeholder appeal and the report needed to use a format that matched the company’s culture of technology leadership.

Electronic collection and analysis also means there are no real physical restrictions to externally reporting any data. The process required both identifying key performance indicators, and determining both the stakeholder audience and the best technology to make the highest impact presentation. While a company committee determined the key performance indicators it preferred, the stakeholder audience and format technology issues were addressed by the consultant.

The consultant answered a series of key questions for the Global Oil Company beginning with: Why do an external EHS Report? What is the audience for a report? What does the report really say about the company? How can the internet and multimedia technology be best used to present EHS information? And finally, how does aggressive external EHS reporting enhance the value of the EHS program in the company?

The consultant is expert in the latest internet and multimedia technologies. Using the latest CD-rom based format, a multimedia presentation was produced that not only provided in depth data reporting, but also impressive video stories of the company’s most interesting environmental and safety achievements of the year. The multimedia presentation on the CD-rom enabled the statistical data to be presented with voice over captioning. The

CD-rom also provided an internet up-link directly to the company website which allows the user to access real-time updates of data.

The consultant created and produced for the client an effective external report that builds a wider external audience for this information. He provided detailed examples of the range of stakeholders who now are seeking EHS information from companies and how the new presentation technology reaches them. Many of these stakeholders react positively to the multimedia presentation of key EHS successes and achievements through strong visual media. The client is finding that improving the stakeholder response to the information enhances the value of the entire EHS program both internally and externally.

Environmental Health Decisions

Environmental Health Decisions has prepared a number of Material Safety Data Sheets for clients in United States and Canada. These MSDSs are in full compliance with WHMIS regulations. Since requirements for preparation of MSDSs in Canada are specific to each province, it was necessary for this consultant to become familiar with a variety of regulations. MSDSs prepared to be compliant with WHMIS regulations provide companies in the United States with the ability to sell their product in Canada. This consultant has extensive experience in the preparation of MSDSs for solvents, pesticides, fertilizers, metals, and petroleum hydrocarbon products.

Environmental Health Decisions has performed and managed several hundred human health risk assessments for local and national clients. Site experience includes federal and state Superfund sites, manufactured gas plant sites, RCRA sites, former gasoline station sites, and Brownfields sites. Using risk assessment, the consultant has successfully negotiated risk-based remedial investigations, cleanup levels, no action alternatives and remedial action plans, translating into millions of dollars in reduced remediation requirements.

Environmental Health Decisions has been involved in the investigation and analysis of legal and regulatory issues and controversial claims regarding chemical causation of diseases in humans. The consultant’s solid technical background coupled with frequent involvement in risk and hazard evaluation projects provides the client with a broad perspective on the technical, economic and regulatory considerations for human health hazard evaluation work. The consultant has served as an expert witness, providing depositions and court room testimony. She has testified on issues regarding health effects of ammonia and solvents, and risk assessment as a basis for site closure.

This consultant has prepared hundreds of Material Safety Data Sheets (MSDSs) for petroleum hydrocarbons, solvents, fertilizers, plastics, metals, fabric protectors, and pesticides. The consultant currently administers the MSDS program for several multinational companies in the oil and gas, fertilizer, and metals industries. Expertise is provided in U.S. and Canadian regulations. As part of the MSDS program, the consultant tracks regulatory information pertinent to the preparation of MSDSs, including Proposition 65, CERCLA, RCRA, and DOT.

McDaniel Lambert, Inc

International Environmental Strategy and Media Program

Major Energy Resources Company

Thailand

Occupational medical physician and toxicologist developed a communication strategy and media program to answer questions raised in the press about the safety of fish around oil platforms in the Gulf of Thailand. Consultants trained and advised upper management and frontline personnel in working with the press and public. The media strategy included an editorial board presentation to The Bangkok Post as well as press tours of the platforms. They also designed and oversaw health and ecological risk assessments designed to determine the potential for human health effects from mercury in the Gulf and assisted with the scientific presentation of the study results. The program resulted in improved relationships with Thai oversight agencies and provided positive media coverage for the company.

McDaniel Lambert, Inc

Overseas Community Outreach Program

Major Energy Resources Company

The Philippines

Occupational medical physician and toxicologist developed a risk communication and outreach strategy to assist a geothermal operation in The Philippines located in a region where people were living in geothermal fields and regularly blockading roads leading to geothermal wells to express their displeasure with the operation. The consultants initiated proactive communications with the local community and the national utility, which buys the energy produced at the geothermal wells to sell to the public. The team conducted sensitivity training for frontline employees and participated in several meetings with local residents and community leaders. The effort led to the establishment of a community notification system to facilitate the exchange of information between the facility and local residents.

McDaniel Lambert, Inc

Crisis Planning and Response

Agricultural Chemicals Company, Alaska

Occupational medical physician and toxicologist provided risk communication training and assisted with crisis response planning for large agricultural chemicals company. The plan and other preparatory work allowed the facility to quickly resolve issues following the capsizing of a barge carrying 12,500 tons of urea granules. The consultant team worked with the Coast Guard to develop safe urea exposure levels following the spill and assisted with communications for both internal and external audiences, including emergency responders. The effort effectively managed the crisis and mitigated its impacts on the organization. The effort was so successful that local residents took out a newspaper advertisement thanking the company for its prompt and thorough response.