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Pan-Mass Challenge 2009: Archived tweets and photos

This weekend I participated in the 30th Pan-Mass Challenge, a 200-mile bike ride from Sturbridge to Provincetown, MA that is a fundraiser for the Jimmy Fund and Dana Farber Cancer Institute.  The consolidated archived tweetstream is here.  Below are my tweets from the road this weekend.  Please join me in supporting this important cause.  Thank you.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

Chronic disease prevention and management: How the health reform bills measure up, and how medical home models can help

Ken Thorpe's Partnership to Fight Chronic Disease released a report today providing a side-by-side comparison of leading health reform bills' approaches to chronic disease prevention and management.  From the website linking to the report: 

The publication, "Hitting the 'Bulls-eye' in Health Reform: Controlling Chronic Disease to Reduce Cost and Improve Quality," offers five recommendations for how Congress could better improve quality and reduce spending over the long-term:

• Roll out evidence-based models for nationwide coordination of care in Medicare within the next three years;
• Immediately expand the types of treatments in Medicare that would be paid on a "value," not "volume," basis;
• Aggressively promote chronic disease prevention in the traditional health care system and beyond;
• Remove barriers patients face to avert the development and progression of chronic illness; and,
• Move from a paper-based system to a high-tech system that helps to coordinate care.

OK, we get it.  Ken also participated in the latest White House health care roundtable (this, a medical home discussion around tables arranged in a square ...).

Since chronic disease accounts for 75% of our health care spend, it is reasonable to focus our collective energy on improving prevention and management of chronic conditions.  One of the best approaches to date is the medical home model, and a number of different approaches to implementing this model from around the country were presented at the recent White House roundtable.  The Joint Principles of the Patient Centered Medical Home (PCMH), a 2 1/2 year old consensus document produced by several medical societies, is a key starting point for any discussion of medical home implementation.

As Thorpe noted on a conference call accompanying the release of the report today, the various bills wending their way through Congress address the medical home concept, allocating as much as $1.5 billion over 5 years (in the most generous of the bills).  Thorpe suggests that a $25-30 billion commitment over ten years could yield $100 billion in savings by reducing expenses related to hospital readmissions (though I must point out that if bundled payments for episodes of illness are phased in, these readmissions would not be separately reimbursed, so this savings figure is perhaps not the best argument in favor of medical home funding).

The American Academy of Family Physicians announced the launch of its own social networking site today.  TransforMED, an AAFP subsidiary, is promoting the service as a means for its members (MDs, PAs, NPS and physician office staff) to help primary care practices adopt the PCMH model.

Earlier today, I saw a demo of the site and heard a testimonial from an early adopter doc, and it seems that this could be a useful tool in disseminating information to far-flung smaller practices interested in adopting some or all of the approaches subsumed within the PCMH concept. 

The key issue right now, of course, is who will pay for all this care coordination goodness?  Federal demos are a year or so away, and will be time-limited.  Some integrated and employed-physician systems (the Geisingers and Group Healths of the world) are funding this internally, and as their positive experiences are better understood, payors will be more willing to help foot the bill, understanding that there is a potential ROI on the order of 200-400%.  Key issue for the future: Who gets to pocket the change?

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

The Whole Foods lesson: On-line communications, meaning what you say, saying what you mean, and remembering who you are

Today's health care communications lesson is brought to you courtesy of Whole Foods .... I mean John Mackey.

John Mackey's stepped in it again.  The libertarian CEO of natural-foods behemoth Whole Foods was investigated last year by the FTC and SEC after badmouthing competitor and takeover target Wild Oats in anonymous comments on a Yahoo! forum.  He hung up his blogging shoes for a while; the federales backed off, and he's blogging again.

Last week, Mackey wrote an op-ed piece on health reform for the Wall Street Journal.  (Wanna guess which way this thing leans?)  The Journal published it.  Mack felt it necessary to republish it on his blog because (horror of horrors) Journal editors edited it (ever so lightly), Journal headline writers wrote a catchy headline for it (that's what they do), and Mackey was concerned that folks might attribute some of the sentiment in the piece to the company, not just to the CEO (yeah, people do that).

The gist of the piece: health care is not a right, everyone needs to take more personal responsibility for their own health (HSAs, HDHPs, exercise, eating well ... shopping at Whole Foods, perhaps?) and if you want to do something more, make a donation via your tax return to fund public health insurance programs like Medicare, Medicaid or SCHIP.  And he opened with a Margaret Thatcher quote: "The problem with socialism is that eventually you run out of other people's money."  Setting aside the fact that Wall Street (hardly a bastion of socialism) has had to face this same OPM problem this year, and setting aside the question of whether one agrees with Mackey's views on health care reform, one has to question the man's judgment.  He is apparently pretty good at running a Fortune 500 company.  However, his op-ed has resulted in an avalanche of reaction, much of it negative, from comments on the WSJ site, to comments on his own blog (where he republished the piece with its "original" title -- "Health Care Reform" -- which the Journal had replaced with "The Whole Foods Alternative to ObamaCare"), to the blogosphere, to MSM. 

So, what's wrong with this picture?  Mackey should know by now that (a) many, if not most, folks will identify a very public CEO with the major corporation he leads and (b) if he espouses views contrary to those embraced by his company's historical (largely liberal activist) customer base he will get the boycott messages that have been posted online, and more customers than those who post will join the boycott.  As my kids would say, insisting that the op-ed views are his and not his company's is lame.  A couple more on-line missteps, and perhaps Mackey and his company will not be able to so easily recover.

What can a business leader -- in health care as well as in natural foods retailing -- learn from this experience?  That, no matter how forward-thinking one may be, on-line communications must follow a few simple rules, including the following tenets of social media:

• Authenticity is key, but if your authentic self is likely to alienate core constituencies, think again about what you're trying to do.  If you need a cleanup squad ("what he meant to say was ...") maybe you shouldn't be the public face of your organization.  (Sorry, Joe the Veep.)

• Remember that you do not control the message; all on-line communications may be read by anyone and referred to anywhere (even if not initially published in a leading national newspaper).

• Be prepared to engage with your constituencies on their terms, not yours.

• If you have a big megaphone, be sure you use it to enhance, not detract from, your brand.

More rules to add to the list?  Please add to these best practices in the comments.

David Harlow
The Harlow Group LLC

Today's health care communications lesson is brought to you courtesy of Whole Foods .... I mean John Mackey.

John Mackey's stepped in it again.  The libertarian CEO of natural-foods behemoth Whole Foods was investigated last year by the FTC and SEC after badmouthing competitor and takeover target Wild Oats in anonymous comments on a Yahoo! forum.  He hung up his blogging shoes for a while; the federales backed off, and he's blogging again.

Last week, Mackey wrote an op-ed piece on health reform for the Wall Street Journal.  (Wanna guess which way this thing leans?)  The Journal published it.  Mack felt it necessary to republish it on his blog because (horror of horrors) Journal editors edited it (ever so lightly), Journal headline writers wrote a catchy headline for it (that's what they do), and Mackey was concerned that folks might attribute some of the sentiment in the piece to the company, not just to the CEO (yeah, people do that).

The gist of the piece: health care is not a right, everyone needs to take more personal responsibility for their own health (HSAs, HDHPs, exercise, eating well ... shopping at Whole Foods, perhaps?) and if you want to do something more, make a donation via your tax return to fund public health insurance programs like Medicare, Medicaid or SCHIP.  And he opened with a Margaret Thatcher quote: "The problem with socialism is that eventually you run out of other people's money."  Setting aside the fact that Wall Street (hardly a bastion of socialism) has had to face this same OPM problem this year, and setting aside the question of whether one agrees with Mackey's views on health care reform, one has to question the man's judgment.  He is apparently pretty good at running a Fortune 500 company.  However, his op-ed has resulted in an avalanche of reaction, much of it negative, from comments on the WSJ site, to comments on his own blog (where he republished the piece with its "original" title -- "Health Care Reform" -- which the Journal had replaced with "The Whole Foods Alternative to ObamaCare"), to the blogosphere, to MSM. 

So, what's wrong with this picture?  Mackey should know by now that (a) many, if not most, folks will identify a very public CEO with the major corporation he leads and (b) if he espouses views contrary to those embraced by his company's historical (largely liberal activist) customer base he will get the boycott messages that have been posted online, and more customers than those who post will join the boycott.  As my kids would say, insisting that the op-ed views are his and not his company's is lame.  A couple more on-line missteps, and perhaps Mackey and his company will not be able to so easily recover.

What can a business leader -- in health care as well as in natural foods retailing -- learn from this experience?  That, no matter how forward-thinking one may be, on-line communications must follow a few simple rules, including the following tenets of social media:

• Authenticity is key, but if your authentic self is likely to alienate core constituencies, think again about what you're trying to do.  If you need a cleanup squad ("what he meant to say was ...") maybe you shouldn't be the public face of your organization.  (Sorry, Joe the Veep.)

• Remember that you do not control the message; all on-line communications may be read by anyone and referred to anywhere (even if not initially published in a leading national newspaper).

• Be prepared to engage with your constituencies on their terms, not yours.

• If you have a big megaphone, be sure you use it to enhance, not detract from, your brand.

More rules to add to the list?  Please add to these best practices in the comments.

David Harlow
The Harlow Group LLC

Today's health care communications lesson is brought to you courtesy of Whole Foods .... I mean John Mackey.

John Mackey's stepped in it again.  The libertarian CEO of natural-foods behemoth Whole Foods was investigated last year by the FTC and SEC after badmouthing competitor and takeover target Wild Oats in anonymous comments on a Yahoo! forum.  He hung up his blogging shoes for a while; the federales backed off, and he's blogging again.

Last week, Mackey wrote an op-ed piece on health reform for the Wall Street Journal.  (Wanna guess which way this thing leans?)  The Journal published it.  Mack felt it necessary to republish it on his blog because (horror of horrors) Journal editors edited it (ever so lightly), Journal headline writers wrote a catchy headline for it (that's what they do), and Mackey was concerned that folks might attribute some of the sentiment in the piece to the company, not just to the CEO (yeah, people do that).

The gist of the piece: health care is not a right, everyone needs to take more personal responsibility for their own health (HSAs, HDHPs, exercise, eating well ... shopping at Whole Foods, perhaps?) and if you want to do something more, make a donation via your tax return to fund public health insurance programs like Medicare, Medicaid or SCHIP.  And he opened with a Margaret Thatcher quote: "The problem with socialism is that eventually you run out of other people's money."  Setting aside the fact that Wall Street (hardly a bastion of socialism) has had to face this same OPM problem this year, and setting aside the question of whether one agrees with Mackey's views on health care reform, one has to question the man's judgment.  He is apparently pretty good at running a Fortune 500 company.  However, his op-ed has resulted in an avalanche of reaction, much of it negative, from comments on the WSJ site, to comments on his own blog (where he republished the piece with its "original" title -- "Health Care Reform" -- which the Journal had replaced with "The Whole Foods Alternative to ObamaCare"), to the blogosphere, to MSM. 

So, what's wrong with this picture?  Mackey should know by now that (a) many, if not most, folks will identify a very public CEO with the major corporation he leads and (b) if he espouses views contrary to those embraced by his company's historical (largely liberal activist) customer base he will get the boycott messages that have been posted online, and more customers than those who post will join the boycott.  As my kids would say, insisting that the op-ed views are his and not his company's is lame.  A couple more on-line missteps, and perhaps Mackey and his company will not be able to so easily recover.

What can a business leader -- in health care as well as in natural foods retailing -- learn from this experience?  That, no matter how forward-thinking one may be, on-line communications must follow a few simple rules, including the following tenets of social media:

• Authenticity is key, but if your authentic self is likely to alienate core constituencies, think again about what you're trying to do.  If you need a cleanup squad ("what he meant to say was ...") maybe you shouldn't be the public face of your organization.  (Sorry, Joe the Veep.)

• Remember that you do not control the message; all on-line communications may be read by anyone and referred to anywhere (even if not initially published in a leading national newspaper).

• Be prepared to engage with your constituencies on their terms, not yours.

• If you have a big megaphone, be sure you use it to enhance, not detract from, your brand.

More rules to add to the list?  Please add to these best practices in the comments.

David Harlow
The Harlow Group LLCv

The costs of prevention, and the coming boom in comparative effectiveness research

Today's Boston Globe revisits the question of whether screening (vs. other forms of prevention) is a cost-effective approach to improving health care.  Obama has called for more screenings; the CBO and folks like Peter Neumann, Director of the Tufts Center for for the Evaluation of Value and Risk in Health, continue to point out that increased screenings alone will increase, not decrease, health care expenditures in the long run, thus running against the President's budget-neutrality mantra. 

But prevention is about more than screenings.  See my recent post regarding the value of prevention, citing Ken Thorpe (also quoted in today's Globe article).  Prevention would not be at the core of employee health programs at companies like IBM if it didn't save some serious money. Best estimates peg the ROI at about 400%. 

Neumann and Thorpe are both right; they're just answering different questions.  A key issue for the future will be defining effectiveness for purposes of comparative effectiveness research.  Key issues in that exercise include valuation of human life (never an easy task).  See my post on the QALY issue following up another article in which Neumann was quoted, over two years ago.

Finally, tort reform is a red herring: The cost of medical errors is about three to five times the cost of all malpractice insurance premiums, so where's the malpractice crisis (other than in MSM headlines)?

Update August 19, 2009:  See more discussion on tort reform in the comments, and see also The Washington Independent's roundup of reasons why tort reform is unlikely to cut health care costs. 

The challenge with screenings is to mandate or cover only those which are highly predictive, have few false positives (which lead to additional testing for someone who turns out to be healthy), and screen for disease we can treat effectively.  Oh, there it is again, the "e" word.  Let's hope the comparative effectiveness research structure is adequately funded in whatever health reform legislation gets enacted (well beyond the pittance allotted in ARRA), so that this can be addressed in a meaningful way.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

A Massachusetts health reform reading list from RWJF VP David Colby; Massachusetts payment system reform recommendations up next

David Colby, VP, Research and Evaluation at the Robert Wood Johnson Foundation, offers his summer reading list on Massachusetts health care reform.  His intro:

Hopefully, many of you are relaxing this month at one of the nation's real beaches. I'm spending most of August in the backyard, maybe with my feet in an inflatable pool.  While the closest I'll get to Cape Cod is the potato chips I'm eating, Massachusetts is on my mind. I'm sure when President Obama arrives on Martha's Vineyard later this month he'll get plenty of advice from the locals on how Massachusetts managed to pass health reform and whether it's working or not.

There's a lot to be learned from Massachusetts – the first state to pass comprehensive health care reform and guarantee insurance coverage for all its residents. With that in mind, the following are a few select reports about what happened in Massachusetts (and how it happened… and why it happened … and what it means … that offer particularly salient lessons).

One key element I would add to this reading list involves a peek into the future of Massachusetts health care reform: the global payment initiative that has been greenlighted by the Special Commission on the Health Care Payment System established under part 2 of the Massachusetts health care reform law, which could result in wide-ranging payment reform in Massachusetts being phased in over a five-year period. 

Since bending the cost curve will be a key component of any successful health reform, this is another Massachusetts development to be sure to watch.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

Florida Health care grants

The American Recovery and Reinvestment Act effective in February through the Health Resources Services Administration was granted an extra $851 million in June. Health centers in the state of Florida received $41,038,000 in CIP funding. The grants were dispersed to 50 federally authorized health center grantees in Florida and 1,100 across the nation. These funds will be used for the desperately needed repair and renovation for thousands of health care centers nationwide. The funds will also be used to purchase updated equipment. Because more Americans are losing their health insurance or cannot afford insurance they are turning to these health centers for care. Should these health care centers receive all of these grants?

 

Misunderstanding about health insurance

According to a White House spokesperson President Obama's administration has not and will not deviate from the original set of goals on the health care reform. Nor will the administration dissociate itself from a government run public health insurance option. The news media has insisted that Obama and his administration were ready to ditch the public health insurance option. These news reports were misunderstood and exaggerated. The reports state that the President mentioned that he was open to health care cooperatives as an alternative not that he eliminates the entire idea of the public proposed plan. Are you open to health care cooperatives or are you convinced that public health insurance is the answer? 

HSE Could Add Safety Rules to Building Regulations in Crackdown

In order to reduce the construction industry's death toll, the Health
and Safety Executive may introduce strict safety criteria to local
building regulations and step up its publicising of convictions.
The chair of the HSE, Judith Hackitt and the chief executive Geoffrey
Podger confirmed that the HSE was considering a range of proposals in
a bid to tackle the in industry's death toll.

In 2008/09, early indications show that fatalities within the
construction industry may have declined by more than 20% to
approximately 55. Despite the percentage drop, the HSE remains adamant
to crackdown even more and prevent an increase in fatalities when
activity in the sector picks up.

New Rules

Ms Hackitt told the Work and Pensions Select Committee that one way of
clamping down on bad practice, could be strict new rules within the
building regulations.

Ms Hackitt said: "We want to look at the practicality of doing that
because... we think there is a sound logic to the notion that says not
only should [an] extension be built to last and to not put at risk
those who are going to live in it, it should be built in a way that
doesn't put at risk the people who have to build it in the first
place."
However, she did caution the committee that the cost of pressures
within local authorities could have an affect on any possible further
proposals.

Mr Podger told the committee that the HSE was also looking at ways of
increasing publicity about firms convicted of health and safety
offences.

He said: "Often for companies it is not the fine that is the
punishment, but the publicity around it. This is an area where we want
to try and do more.

"We want to try and publicise some of these cases nationally, as well
as regionally and locally."

Committee chair Terry Rooney, who was scathing of the regulator's
enforcement levels, called on the HSE to re-examine the fines being
handed down by courts around the country.

He said it was concerning that companies were still fined less for
fatalities than for anti-competitive behaviour, and said "something
needs to be done" about geographical differences in fines.

"There is concrete evidence of widespread geographic differences in
penalties. For example, in the South-west you will get fined a lot
more than you will in the North-east," he said.

Ms Hackitt assured him: "I think both of those things need to be addressed.

"We should not rest where we are, but continue to press for a more
equitable viewing of different offences."
Committee criticisms

The regulator, however, shrugged off criticisms from the committee
that enforcement notices were down for the fourth year running.

Mr Podger said: "I don't accept at all that there is a downward trend
that is just going to manifest itself forever."

Meanwhile, the relationship between the HSE and construction union
Ucatt deteriorated further amid a row over the recording of the
employment status of construction workers killed at work.
Ucatt raised serious concerns about the collection of what it called
"vital evidence" following fatalities, including data on whether
victims were members of the Construction Industry Scheme.

Committee member Tom Levitt asked Ms Hackitt and Mr Podger why CIS
data was still not being thoroughly collected, despite a pledge to do
so in September 2007.

Mr Podger hit back, claiming CIS data was not relevant to the HSE's
work and that the regulator simply got "the best data that we can". He
said the nature of construction sites made "it more difficult to get a
grip of what is going on".

He added: "From our perspective, which is different to Ucatt's, we
would have the data we need and we would act on it."

Crane Hire Firm Fined Over Deaths

A crane hire company has been fined after two workers fell to their
deaths when a crane collapsed.

Gary Miles, 37, and Steven Boatman, 45, from Berkshire, died in 2005
as the 118ft (36m) tower crane was being dismantled in Durrington,
West Sussex.

They were working for Eurolift (Tower Cranes) Ltd, which was taken
over by WD Bennett Plant & Services Ltd in 2003.

Eurolift was fined £50,000 for health and safety breaches and £1,000
in costs, at Chichester Crown Court.

The Hampshire-based company had admitted the breaches of the Health
and Safety at Work Act 1974 at an earlier hearing.

Judge William Wood said the company deserved to be fined up to
£200,000, but he accepted it would not be able to afford it as it had
ceased operations since the accident.

WD Bennett, based in Gloucestershire, is currently in administration
and will be sentenced when financial information becomes available.

It had denied both health and safety breaches but was found guilty
following a trial at the same court in March.

The crane had been used in the construction of a school in Durrington
before it collapsed.

A third man, Dave Smith, suffered broken bones in the incident.

During the trial, he told the court he had been asked to loosen the
bolts of the crane's tower despite having no training.

Witnesses described hearing "a noise like pistol shots" as the crane
collapsed while Mr Miles and Mr Boatman were still up it.

Both men were flung off, and died of multiple head and chest injuries.

Jurors heard there had been a "management vacuum" at the site because
the person in charge of health and safety was off sick on the day of
the accident.

Corporate Killing Case Referred to Crown Court

Company director Peter Eaton has appeared before magistrates in Stroud
to hear a charge of corporate manslaughter against his company,
Cotswold Geotechnical Holdings.

The prosecution is the first to be brought under the new Corporate
Manslaughter and Corporate Homicide Act. Eaton, 60, also faces a
charge of gross negligence manslaughter, and both he and the company
are accused of breaching the Health and Safety at Work Act.

The charges relate to the death of 27-year-old Alexander Wright, a
junior geologist who was killed in September 2008 when he was buried
beneath several tonnes of mud as he collected soil samples in a
trench. It took rescue workers two days to recover his body.

No pleas were entered and Stroud magistrates referred the case to
Bristol Crown Court, where Eaton will appear on 23 June.

Eaton, who told the court his position in the company was "principal
or sole director", was granted unconditional bail.

Coroner Warns of Hotel Fire Risks as Penhallow Inquest Returns Open Verdict

In 2007, a fire at the Penhallow Hotel in Newquay took three lives.
The coroner leading this inquest, has warned of a risk of further
deaths and calls for government support for hotels and guest houses to
invest in fire safety to ensure compliance with the law.

The comments were made by Dr Emma Carlyon at the conclusion of the
inquest in Truro, when she directed the jury to return an open
verdict.

She said: "I... intend to write to the minister for tourism to
highlight to her the concerns raised by those at the inquest about the
change in fire legislation and to self regulation in 2006 and the
risks of future deaths, in particular of hotels and guesthouses, if
sufficient measures are not provided to support the investment in fire
safety or to ensure compliance."

Dr Carolyn reminded the owners of hotels and guesthouses that they are
the only ones responsible for complying with the provisions of the
Fire Safety Order, particularly regarding regular fire risk
assessments and taking general fire precautions.

Investigators were unable to clarify how the fire at the Penhallow
Hotel began, however there was evidence to suggest that the fire
started from a naked flame.

Four people who were previously arrested in connection with the
investigation into the fire last year have been released without
charge.

Detective chief inspector Darren Lockley, speaking after the verdict
said that the speed and spread of the fire was exceptional. "The
inquest goes some way to explaining the tragic loss of lives; however
we now wish to appeal for any information that will enable the
families to fully understand what happened."

A statement on behalf of the bereaved families said they were
satisfied with the evidence that had been given at the inquest but
were disappointed with the open verdict.

Landlords Imprisoned for Fire Safety Breaches

Two landlords have been sentenced to six months in prison and ordered
to pay £5,000 in costs for breaching the fire safety legislation.

The prosecution followed a fire on 31st March 2007 at a house
converted into bedsits on Hampden Road, North London.

Previous to the sentencing at Wood Green Crown Court on 12th June
2009, Michael de Havilland and Sally Fox of Muswell Hill had pleaded
guilty to several breaches of the Regulatory Reform (Fire Safety)
Order 2005. These breaches included:

* Inadequate fire detection systems;
* A lack of proper fire doors for bedrooms or the communal kitchen;
* No emergency lighting in the building's stairway;
* A lack of fire fighting equipment i.e. fire extinguisher / fire blankets;
* No fire risk assessment available for inspection.

A further inspection was arranged where an enforcement notice was
issued, explaining that the breaches needed to be dealt with. But
after further contact with the co-owners and further inspections over
a number of months, inspecting officers found that no remedial work
had been completed.

"This is our second prosecution resulting in a custodial sentence and
again sends out a strong message to landlords and building owners,"
said Brian Coleman, chairman of the London Fire and Emergency Planning
Authority. "Our role is to keep Londoners safe, and where we see that
you are not taking your legal fire safety responsibilities seriously,
we will take action."

Heat Exhaustion Kills Worker

A worker has died of heat exhaustion inside a feed silo. Paul Sharp,
31, who worked for Silocheck UK had not been trained in access and
egress in confined spaces, nor provided with adequate equipment.

The incident occurred when Mr Sharp was removing fatty acids from a
silo at an animal feeds factory in Wiltshire, in August 2006.

To clean the inside of the silo, Mr Sharp had to enter the container
through a hatch in the roof. He was asked to abseil into the silo
unaccompanied even though he had not been trained in rope work. His
supervisor and another colleague remained on the roof. Once inside the
container, a pressure washer was used to steam the walls and
subsequently scrape off the fat acid residue.

Whilst cleaning, he complained to his colleagues about the heat inside
the container, and moments later, his colleague heard a bang from
inside the silo and shouted down to Mr Sharp to check that he was OK.
After no response Mr Sharp was pulled up unconscious. He had not been
provided with the correct breathing apparatus or air blowers. No winch
had been provided, which resulted in some difficulty in getting the
worker's body through the small hatch.

Another worker abseiled down to Mr Sharp to straighten out his body so
that he could be lifted out of the silo. As none of the workers had
received any first aid training, CPR could only be administered on the
advice of the emergency services over the phone. Mr Sharp was
pronounced dead on arrival at the hospital. The cause of death was
heat exhaustion, which triggered an underlying heart condition.

At Swindon Crown Court on 5th June 2009, Silocheck UK pleaded guilty
to breaching regulation 4(2) of the Confined Spaced Regulations 1997
for failing to provide a safe system of work, and regulation 5(1) of
this same legislation for insufficient emergency arrangements. The
company was fined £15,000 for each breach and ordered to pay costs of
£15,000 also.

The firm commented in mitigation that they had no previous convictions
and following the incident, they voluntarily ceased operations to
review its work methods. Additional safety equipment has been
purchased and all employees have now been provided with rope-work and
first aid training.

Ian Whittles, HSE Inspector said: "This tragic incident highlights the
importance of appropriate training and emergency arrangements,
especially when working within confined spaces. In this case, there
were no appropriate systems of work, particularly with regard to
access. For example, had there been a winch available, then rescuing
Mr Sharp from inside the silo would have been much quicker and
easier".

Employers Urged to Keep Staff Cool During Hot Weather

With the heat wave in full swing, employers are reminded that staff
need to be protected from the hazards of the hot weather. This is
especially so, as the law is hazy on what a reasonable workplace
temperature is.

Temperatures are expected to climb to 32°c in the UK, and with no
legal limit on the maximum workplace temperature, there is an
increased risk of employees suffering from heat-related illnesses such
as headaches and dehydration.

If workplaces are too hot, problems such as dizziness and nausea can
be expected. Excessive heat can also mean a less effective workforce
due to a lack of concentration and a higher number of mistakes being
made.

As no clear guidelines exist as to what is a reasonable temperature,
employees have no ground to claim that their workplace is too hot.
However, a reasonable temperature will be different for each
individual.

The HSE states that indoor temperature should be 'reasonable'
depending on the nature of the work i.e. this would be different for
kitchens, offices and coldstores. The HSE states that these minimum
temperatures are 16°c, or 13°c where work involves physical effort.
However, no maximum limit has been defined.

The HSE states that all reasonable steps should be taken to achieve a
comfortable temperature. Some of these are:

* Insulating hot pipes or plants;
* Shade windows;
* Site workstations away from areas which are subject to radiant heat;
* Use of fans and ventilation systems;
* Ensure a supply of cool drinking water;
* Relax dress codes if possible.

These measures can help to avoid the risk of dehydration, which will
therefore keep concentration levels up and sickness levels down.

Road Deaths at Record Low, But Safety Still Needs Improving

The Department for Transport (DfT) has recently announced that the
number of people killed in road accidents in Britain in 2008 is the
lowest since records began. A total of 2,538 people died on the roads
last year - which is a drop of 14 per cent from the previous year's
total, which was the previous record low (2946 deaths).

The number of pedestrian deaths fell below 600 for the first time to
572, while there were also decreases in the numbers of cyclists,
motorcycle users, and children.

The Government announced a new road safety strategy in 2000 in which it aims to:

* reduce casualties by 2010, including a 40-per-cent reduction in
the number of people killed or seriously injured on the roads;
* 50-per-cent reduction in the number of children killed or
seriously injured.

The Institute of Advanced Motorists (IAM) say that the 2008 figures
represent a great achievement, but the aim to make Britain number one
in the world for road safety by 2020 - as stated in the Government's
proposed road safety strategy published in April this year – will be a
struggle. Currently the country is sixth in the world for road safety.

The statistics do not include a breakdown of fatalities involving
at-work drivers, however the DfT has previously estimated that every
week, 200 road deaths and serious injuries involve someone at work.
With approximately three million company cars on the roads, roughly
one in three will be involved in an accident each year. Road accidents
which are work-related account for between 800 and 1000 deaths a year,
making them the biggest cause of work-related accidental death, the
Department has said.

HSE Warns of Dangers of Not Maintaining Plant Equipment After Driver's Death

A telescopic forklift truck driver has died after he was crushed
between the descending arm and side of his vehicle. Subsequently, the
HSE has warned of the danger of not maintaining plant equipment.

MB Plastics Ltd and Birse Integrated Solutions Ltd were both
prosecuted in relation to the incident which occurred in September
2003 at the Davyhulme Waste Water Treatment Works, Rivers Lane,
Trafford, Greater Manchester. The two companies were sentenced on 30th
June 2009 at Manchester Crown Court.

MB Plastics Ltd of Warrington, who employed the deceased, pleaded
guilty to an offence under health and safety legislation and was fined
£150,000 and ordered to pay costs of £24,323.

Birse Water Ltd of Cheadle Hulme, who was the principal contractor for
the project also pleaded guilty and was fined £50,000 with costs of
£41,073.

The vehicle's off side cab window usually acted as a guard, however it
had been damaged in a lifting operation five weeks previous to the
fatality, the court was told. The cab window was completely gone at
the time of the incident.

Judge Peter Lakin, commented that while there were no witnesses to the
incident, the most likely explanation is that the deceased leant out
of the cab window, coming into contact with joystick, which brought
the arm of the forklift truck down onto him.

MB Plastics Ltd was charged with failing to ensure the safety of
employees under Section 2(1) of the Health and Safety at Work Act
1974, while involved in operating and working with, or in the vicinity
of a telescopic forklift truck.

Under Section 3(1) of the Health and Safety at Work Act 1974, Birse
Ltd was charged with failing to ensure the safety of people not in its
employment. Birse had failed to ensure that MB Plastics Ltd had
prepared suitable and sufficient risk assessments in relation to its
telescopic forklift truck operations. The court also found that Birse
had failed to adequately monitor MB Plastics, subsequently failing to
identify the cab's broken window and ensuring it was replaced.

Warren Pennington, HSE Inspector said: "This incident would have been
entirely avoidable if the proper health and safety procedures had been
followed.

"MB Plastics Ltd did not have a system in place for formal regular
inspections of the plant. As a result, the company failed to maintain
the cab window which could have saved this man's life.

"Birse, the principal contractor on the site, also had a duty to
supervise its subcontractors properly. The company had a comprehensive
management system but it was not implemented and, as a result,
something as simple as a missing window was not spotted.

"This incident emphasises how important it is that companies should
not only ensure they have the proper procedures in place - but also
ensure they are followed. We're therefore calling on employers to take
their responsibilities seriously so that future tragedies can be
avoided."

When passing sentence, Judge Lakin said: "MB had primary
responsibility for the welfare of its employees. The harsh reality of
this case is that, in relation to this contract, MB completely failed
to have any proper regard to their health and safety obligations.

This directly led to the development of an unsafe and sloppy system of
work in relation to the use of telehandlers. As a result MB's
workforce was exposed to completely unnecessary and avoidable risk.

"Birse, as principal contractors on site, failed to implement their
own systems and accordingly failed to properly monitor what MB were
doing. This lack of monitoring allowed MB's disregard for health and
safety to continue over a number of weeks. In short, Birse failed in
their supervisory role."

Stakeholder Forum: Reviewing Workplace Temperatures Legislation and Guidance

The HSE has prompted a review of health and safety at work in regards
to workplace temperatures following the request of the Secretary of
State.

The Stakeholder Forum will take place on Thursday 23rd July 2009 and
will examine the reasons for and against a maximum workplace
temperature. The Chief Executive of the HSE Geoffrey Podger will be
opening the event.

The event will be an opportunity to discuss:

* Whether the legislation and guidance is up to date and relevant
with the nature of working patterns and workplaces;
* Whether there is good reason for having a recommended minimum
working temperature, but not a maximum working temperature;
* If more can be done for those who work outside in regards to the
effects of seasonal variations;
* What there is to be learnt from good practice, e.g. access to
drinking water and other facilities in the working environment.

Further information concerning workplace temperature legislation and
guidance can be found on the HSE temperature website.

Plant Fined £30,000 After Worker Loses Three Fingers

An employee at a meat processing plant in Prestwick lost three fingers
when a machine he was attempting to repair started up. The owners of
the company have been convicted of failing to have a safe isolation
procedure in place for the machinery.

The incident happened in June 2008 when employee Steven Glass was
working on an Endoline tape packaging machine which had been under
repair. When the machine wouldn't work he tried to fix it. As the
machine could not be properly isolated to prevent accidental
operation, it started and subsequently trapped three of his fingers,
which were amputated. One of his fingers was successfully reattached.

Since Mr Glass' accident, the company has been taken over hand has
seen significant improvements in regards to health and safety.

On 2nd July 2009 at Ayr Sherriff Court, Belcher Food products Ltd of
Prestwick, pleaded guilty to breaching Sections 2(1); 2 (2) and 33 (1)
(a) of the Health and Safety at Work Act 1974 and was fined £30,000.

The Health and Safety Executive (HSE) has stressed the importance of
ensuring machinery is capable of being isolated to prevent operation
and to ensure employees are given sufficient training, instruction and
supervision.

Helen Diamond, HSE Investigating Inspector is now warning companies of
the importance of maintaining machinery and ensure that it is properly
guarded: "This serious accident was entirely foreseeable and
preventable. The company themselves had identified a large number of
serious faults with their machinery well before this accident, yet
little was done to rectify these faults. The company also failed to
follow the advice of our inspectors.

"It is vital for the safety of all employees that companies ensure
machinery is properly maintained and that systems are in place to
ensure it cannot accidentally be operated when under repair. Our
investigations showed that it was normal practice for employees to
repair their own machines."

A year previous to the accident, the court heard that an electrical
inspection of their premises identified 866 faults with the electrics
and wiring system, 200 of these regarded as most urgent. Little or no
work had been done to correct these faults by the time of the
accident.

HSE inspectors visited the plant 3 months prior to the accident and
informed the company that they have a procedure in place to ensure
machinery could be properly isolated while being prepared. This had
not been carried out at the time of the accident.

Director Fined for Smoking at Desk

An anonymous complaint to the HSE led to a company director being
fined for smoking in his office after council officers visited the
firm.

Metric Scaffolding of Preston, Lancashire, was reminded of their
responsibilities under the smoke-free legislation back in November
2008, after the council was informed that the firm's staff smoked
frequently in the office and in the company vehicles.

Enforcement Officers re-visited the premises in January 2009 and found
Martin Lenehan, Operations Director, smoking at his desk.

An on the spot penalty of £50 was issued to Mr Lenehan, which he
refused to pay, and subsequently a court date was appointed. On 11th
June 2009, South Ribble Magistrates, found Mr Lenehan guilty in his
absence of smoking in a smoke-free area. He was fined £175 plus costs
of £75.

Councillor Peter Mullineaux commented "This latest conviction will
hopefully serve as a reminder to the small minority of employers who
are not observing the smoke-free legislation that they have a legal
duty to comply and will be prosecuted if they do not."

'Inappropriate' working at height methods lead to big fines

The Health and Safety Executive has reported that a company and its
contractor have been fined following the fall of an employee from a
height of more than 10 metres.

Veolia Environmental Services Birmingham was fined £100,000 with costs
of £22,000, while the contractor Hansen Transmissions of Huddersfield
was fined £70,000 with costs of £22,000.

The incident took place when an employee of the contractor, was
replacing a gear box in a condenser unit at Veolia Environmental
Services' premises. The employee fell causing him to suffer broken
ribs, a hernia and a punctured lung. His fall was broken when he
landed on a pallet of copper pipes.

Paul Smith, HSE investigating inspector said of Hansen Transmissions
system: "was plainly unsafe - men [were] working ten metres and more
up in the air, [they] were manoeuvring bulky plant using inappropriate
methods, [and they were] on and above an inadequate working platform,
with markedly inadequate protection from the drop beneath".

Fatal Glasgow Factory Blast "Avoidable"

An inquiry into an explosion at a plastics factory in Glasgow, which
killed 9 people, concluded it to be "an avoidable tragedy".

The incident which occurred in May 2004 at ICL Plastics Ltd and its
associate company ICL Tech Ltd also injured about 40 workers after the
explosion flattened the factory in the Maryhill area of the city.

The inquiry found that the blast was undoubtedly caused by a leak from
an old underground metallic pipe, which was carrying liquefied
petroleum gas.

The pipe was corroded due to being buried without proper protection
and the report found that the management of the two companies had
shown a lack of understanding concerning LPG and the risk of
explosion.

The report also mentioned that there were deficiencies in the HSE's
oversight of the site with a failure to understand the risk of
underground pipes and to promptly carry out the follow up visits.

Lord Gill, the inquiry chairman wrote: "This was an avoidable
tragedy... Nearly five years after the explosion HSE has not produced
a coherent action plan to deal with underground metallic pipework and
the risk of a recurrence.

While the probability of another explosion may be low, the
consequences of a similar event, should it occur, may be catastrophic.
A sense of urgency would be an appropriate response to the serious
issue of public confidence that this disaster has raised."

In 2007, ICL Plastics and ICL Tech pleaded guilty to four health and
safety breaches and were fined £200,000 at the Glasgow High Court and
were both fined £200,000.

The firms commented: "The ICL companies wish to express profound
sadness and apologise for their omissions and the shortcomings of
those who were responsible for the health and safety of the
employees".

They continued: "The inquiry's analysis of the essential facts and
crucial expert knowledge provides much needed answers and
recommendations which will have an important bearing on the future."

Jim Murphy, Scottish Secretary said that the government will be
providing a full response to the report in January: "What is clear
from the report published today is that this disaster could and should
have been avoided," he said. "It lays out a litany of failings and it
is imperative that we take on board Lord Gill's recommendations for a
better and more effective safety regime surrounding LPG installations
to ensure an unnecessary and preventable fatal incident such as this
never happens again."

Asbestos Disease has been Underestimated say Researchers

A warning comes from medical researchers saying that the health risks
connected with asbestos have been underestimated. The International
Agency for Research on Cancer (IARC) has conducted a report and found
that asbestos may be likely to cause more cancers that formerly
anticipated.

Asbestosis, COPD, lung cancer and mesothelioma have all been
recognised as diseases that can be attributed from asbestos exposure.

A study of the report, discussed in the Lancet Oncology magazine,
stated that the report has found that "Sufficient evidence is now
available to show that asbestos also causes cancer of the larynx
(throat) and of the ovary."

The study by the IARC estimates that 125 million people all over the
world are working in offices and factories which contain asbestos.

The professions which face a higher risk of developing
asbestos-related conditions include mechanics, ship yard workers,
electricians, plumbers, garage mechanics, teachers and hairdressers.
The Health and Safety Executive has approximated that 5,000 people
will die from malignant mesothelioma every year by the next decade in
the UK.

A study by a group in London has found that over 50% of work-related
deaths from six major types of cancer in the UK are because of
asbestos. The report by researchers at Imperial College said:
"Estimates for all six cancers [in terms of the number of
occupation-related deaths] but leukemia, are greater than those
currently used in UK health and safety strategy planning". Dr Lesley
Rushton who worked on this report commented: "You spend a third of
your life at work. You need to take the risks very seriously."

COSHH Breach of Regulations leads to £35,000 Fine

A manufacturer of wind turbines has been fined £35,000 after breaching
offences under the Control of Substances Hazardous to Health
Regulations (COSHH). Thirteen workers were exposed to epoxy resins and
subsequently developed dermatitis.

Staff complained of symptoms such as severe itching, swelling and
rashes on their arms, hands and faces at Vestas Blades factoru in
Newport, Isle of Wight.

Expoxy resins, well known to cause allergic reaction and skin
sensitisation, were used as part of the manufacturing process of wind
turbines, however Vestas Blades, had done little to minimise the risk
of contamination. Due to this, employees' skin was regularly exposed
to the wet resin.

Following a number of reports of workers contracting contact allergic
dermatitis, the HSE launched an investigation whereby inspectors found
that the firm had not taken adequate procedures to reduce the risk of
employee exposure and that the correct PPE had not been issued.

The company risk assessment was found to be insufficient as it did not
consider the high-risk nature of the work and the likelihood of
spillage, splashing and transferral to exposed skin by cross
contamination of the hazardous substance.

HSE inspector Roger Upfold said "Epoxy resins are hazardous substances
with well-known ill-health effects. Skin contact with this type of
substance can result in long term consequences. People who become
sensitised to this type of substance may not ever be able to work
again with the substance without experiencing serious ill-health
effects."

He continued to comment that when using hazardous substances,
employers must assess the risks, and decide upon measures to control
the exposure and manage the risk, which can be done through training,
supervision and by regularly reviewing the practice and taking
necessary action.

Firm to Pay £733,000 After Deaths

An international firm has been fined more than £700,000 after two of
its employees died after an argon gas leak.

Stuart Jordan, 50 and Richard Clarkson, 29, who worked for Bodycote
HIP Ltd at a Hereford metal refining plant died 5 years ago after
argon gas leaked from a large vessel in a pit.

After admitting to breaching the Health and Safety at work Act 1974,
Bodycote HIP Ltd of Macclesfield, Cheshire, were fined £533,000 plus
costs of £200,000.

The Health and Safety Executive (HSE), who brought the case against
the firm, informed Worcester Crown Court that the two men were found
collapsed on the stairs that lead to the pit at the College Road site
on 14th June 2004. The HSE continued to tell the court that on the day
of the incident, the pit's oxygen alarm system was switched off, and
the ventilation system, which could have saved the men's lives, was
not running.

The HSE also said that there was no evidence that Mr Jordan had
received any appropriate safety training.

In it s defence, Bodycote HIP Ltd said that complacency had developed,
however there was not a general disregard for health and safety at the
company and that since the incident, the health and safety
deficiencies have been remedied.

Speaking after the case, HSE inspector Luke Messenger said: "Both
these tragic deaths were not only regrettable but also entirely
preventable".

He added: "Confined spaces can be found in a wide range of workplaces
and these deaths should serve as a reminder to all industries of the
dangers of this type of work."

Safety Certification Problems Lose Nearly 40% of Subcontractors' Work

The National House-Building Council (NHBC) is to launch their own
health and safety support service as figures have shown that
self-certification administration is a problem for subcontractors.

The NHBC has advised that almost 40% of subcontractors are losing work
over health and safety issues. These findings have encouraged the NHBC
to initiate their own health and safety support service.

In accordance with the CDM regulations, subcontractors and contractors
must demonstrate how they will effectively and competently manage
health and safety issues on every new tender and a health and safety
policy is to be included.

However, self-certification is a huge demand on time and money claims
the NHBC, and even competent subcontractors are left hesitant
regarding the issue, which is resulting in them losing bids.

Subsequently, NHBC has established SafeMark, a third party
pre-qualification assessment scheme to help those in the house
building industry. Its purpose is to save time, involving an initial
assessment which is valid for one year.

Simon Mantle, health and safety manager at the NHBC said of the new
scheme: "It is vital that subcontractors are fully prepared for all
health and safety issues and the Health and Safety Executive (HSE) is
having a real push on competence to reflect this."

"We know from our research that many subcontractors across the
industry are competent - it's just a question of proving it. For some,
and particularly smaller firms, the administration involved with this
is simply not practical."

SafeMark is accredited to the Safety Schemes in Procurement (SSIP)
standard. For more information view the NHBC's Health and Safety
Competence Assessment Scheme Leaflet

Wakefield firm fined for Legionnaire's outbreak

A butchery processing company has been fined after two of their
employees contracted Legionnaire's disease.

Boguslaw Plociennik and Zbigniew Rauk contracted the disease at the
company's Bamber Bridge premises near Preston in September and October
2006 respectively.

Kepak UK pleaded guilty to breaching health and safety regulation at
Preston Crown Court and were subsequently fined £25,000 and ordered to
pay £20,000 costs.

A Health and Safety Executive led committee obtained water samples
from the building and found significant levels of legionella were
present in three locations.

Dorothy Shaw, HSE principal inspector said: "Kepak failed to carry out
simple checks on the hot and cold water system. As a result, many of
its employees working at the site were potentially exposed to the
legionella bacteria, and two individuals were made seriously ill.

"Any system containing water at temperatures between 20 and 45 degrees
Celsius, and which may release an aerosol during operation or
maintenance, is at risk of exposure to legionella bacteria.

"Legionnaires' disease is a potentially fatal illness and, had the
correct procedures been in place, the outbreak at Kepak's premises
would not have occurred.

"Legionella bacteria can build up in purpose-built water systems and,
if conditions are favourable, the bacteria can multiply, increasing
the risk."

Safety Gear Continues to Suffer from Image Problems

A specialist survey commissioned by a diversified technology company
and PPE manufacturer 3M has revealed that just 30% of health and
safety managers think that essential Personal Protective Equipment
(PPE) is always worn on construction sites. Thirty six per cent of
managers on Olympic sites believe that this is because work safety
gear is not macho enough.

Building site workers as well as managers were interviewed by the
researchers to find out how manufacturers could improve the products.
A female structural and civil engineering worker wanted to see
"smaller sizes of shoes and safety boots for ladies".

The report illustrates the battles that health and safety managers
have to face in the construction industry in order to get their
workers to wear protective clothing and equipment, which could put
simply, save their lives.

The marketing manager for 3M Occupational Health and Environmental
Safety Vicky Randles, said "One of the issues the survey has thrown up
is the negative general perception of 'elf and safety'. Many managers
feel that the image overall needs be improved, not just the clothing.
Forty-eight percent in companies of 250 workers and over cited this as
the main item that could be addressed in the war to get 100 percent
commitment."

RHSS-signs.co.uk provides a wide range of protective equipment and
clothing at competitive prices. Visit our website for more
information.

Hampshire Waste Firm Fined £60,000 over Worker's Death

The Health and Safety Executive is warning companies that adequate
risk assessments must be in place after an employee died after being
hit by a vehicle at a waste transfer station.

Frederick Aubrey who worked for John Stacey and Sons died on 1st June
2007 at its Tadley facility in north Hampshire.

Mr Aubrey and two other employees were hand-sorting material in a
process known as totting at the waste management and construction
firm. A fourth employee was instructed to tip over a skip using a
shovel loader and in doing so, reversed over Mr Aubrey, who died from
his injuries 5 days later.

John Stacey and Sons appeared at Winchester Crown Court on July 29th
2009 and pleaded guilty to section 2(1) of the Health and Safety at
Work etc Act 1974 and regulations 3(1) of the Management of Health and
Safety at Work Regulations 1999 at a previous hearing at Basingstoke
Magistrates Court on 29th June. The company was fined £60,000 and
ordered to pay costs of £29,061, plus a victim surcharge of £15.

The HSE explained that the process of totting had only been carried
out at the company for about 2 weeks before the incident occurred, and
the company had not identified that this practice unnecessarily
exposed employees to the risk of vehicles moving around them without
protection to them.

HSE Inspector David Bibby said: "This case highlights the importance
of assessing risks and putting adequate controls in place to protect
pedestrians from vehicles, and the tragic consequences when this is
not properly done."

"This should serve as a message to all companies, and especially those
in the waste industry where unfortunately accidents like this are all
too common, to ensure that risks from workplace transport are
identified and suitable measures put in place to prevent accidents."

Church Pleads Guilty to Fire Safety Offences

A church organisation has pleaded guilty to breaches of fire safety
legislation following a prosecution brought against them by the London
Fire Brigade.

Mountain of Fire and Miracles International have been ordered to pay
£30,000 in costs and fines after pleading guilty to three breaches of
the Regulatory (Fire Safety) Order 2005 at Woolwich Crown Court on
24th July 2009.

A prohibition notice was issued to the church in June 2007 restricting
the number of visitors to 600 on the ground floor of its premises at
Crabtree Manorway South in Erith.

However, the fire brigade undertook an inspection of the premises in
January 2008 and found there to be 1,200 people in the main hall
during a service. One of the fire exits was blocked by a steel bar
with another adjoining fire exit was chained and locked.

The inspection also found that there was an increased risk of an
explosive and fast spreading fire due to the disorganised storage of
18 LPG and butane bottles and the use of naked flame heaters inside
the main hall.

Assistant commissioner for fire safety regulation, Steve Turek, said:
"It is regrettable that we had to bring this action against a
charitable church organisation but there were significant fire safety
failures."

"These offences presented a real risk of injury to the congregation
who are our main concern. Church groups and others which organise
large gatherings need to make sure their premises are fit for purpose
and that they take their responsibility very seriously to ensure the
safety to visitors."

Company Fined for Legionnaire's Test Failings

A company has been ordered to pay £41,276 after admitting that they
didn't carry out the correct water treatment surveys in two care homes
in South Wales.

DEBA UK Ltd appeared at Abertillery Magistrates Court on 6th August
after failing to carry out legionella surveys on water systems at
nursing homes in Tredegar and Llangattock.

This led to vulnerable residents at the homes being put at a
considerably higher risk of contracting the potentially fatal
legionnaire's disease.

The court was told that DEBA UK Ltd was commissioned to carry out the
risk assessments for legionnaire's disease at the nursing homes and
found the risk to be low. A following routine check at the nursing
homes revealed there to be insufficient controls for legionella, and
focus moved onto the work carried out by the company.

The company was fined £24,000 plus ordered to pay costs of £17,276
after pleading guilty to three charges under Section 3(1) of the
Health and Safety at Work etc Act 1974.

Speaking after the case, Matthew Hamar, HSE inspector, said: "The
nursing home operators commissioned DEBA UK Ltd to carry out the
surveys in good faith and to help them comply with their
responsibilities to manage the risk posed by legionella on their
premises. They were badly let down in this case.

"Elderly nursing home residents are at greater risk from the bacteria
that give rise to conditions such as legionnaires disease, so it is
imperative that safety critical surveys like those carried out by DEBA
UK Ltd are adequate.

"Fortunately, there was no evidence of any outbreak of the disease as
a result of these incidents, but there is a clear responsibility to
those companies carrying out specialist work that they need to carry
out adequate surveys and provide accurate information.

"The health and safety of all those who use our services, as well as
our members of staff, is always our top priority. We take matters such
as this very seriously and have been working very closely with the
Health and Safety Executive throughout this case. We hope that
everyone acts upon the valuable lessons from this case."

Ladder Exchange Initiative

As part of the Health and Safety Executive's Shattered Lives Campaign,
they will be running this year's annual Ladder Exchange Initiative
from 1st September until 31st December 2009.

If you have a ladder which is bent, broken or battered, you can take
it to any of the HSE's partner outlets and part exchange it for a new
one. Duty holders are also provided with the opportunity to review
pre-use checks, training, supervision and other arrangements for
ladder work.

The Ladder Exchange Initiative will now be an annual occurrence due to
the last previous two year's success. The HSE's collaborative work
with Local Authorities and partner outlets has removed over 5,000
dodgy ladders from the work place.

Working at height is a high risk activity and in 2007/2008, 58 workers
died and 3,623 suffered serious injuries from falling from height. Of
all reported falls from height incidents, the use of ladders is
accountable for a third of these.

Asbestos Warning After Company Prosecuted

A company has been fined for potentially exposing employees and
contractors to carcinogenic fibres at their plant in Swansea.

Vale Inco Europe Ltd appeared at Cardiff Magistrates' Court on 6th
August 2009 and were fined £12,000 and ordered to pay costs of £28,000
after pleading guilty to four charges under the Control of Asbestos
Regulations 2006 in regards to refurbishment work being carried out by
a contractor, A-Weld at the company's premises in Clydach.

The company had carried out asbestos surveys on the buildings, but not
on the interior of plant and equipment. Subsequently, asbestos
insulation material within the reformer furnace was disturbed and
broken, giving rise to powder and fibres, posing a greater risk.

Even after workers discovered a white material they suspected was
asbestos, the site was not isolated and work continued as normal,
while they waited for the results of the sample's analysis confirmed
that the material was asbestos.

Andrew Knowles, HSE Principal Inspector said: "There are numerous
failures in this case, including the failure to assume that asbestos
would be present in the reformer furnace unless it could be proved
that it was not. Knowledge that asbestos insulation was present would
have resulted in a licensed contractor being used to remove the
material and prevented these workers coming into contact with asbestos
at all".

"Another important aspect was the failure to provide asbestos
awareness training for employees, which is a specific requirement
where asbestos may be present in a workplace".

"Asbestos is the greatest single cause of work-related deaths in the
UK. Every week, 20 tradesmen die from asbestos related diseases,
including mesothelioma - a cancer of the lining of the lung caused by
asbestos".

"The failures in this case were entirely preventable and the defendant
fell far short of the high standards required. This should serve as a
warning to others about the dangers of asbestos and the legal
requirement to manage it properly."

Driver CPC for Lorry Drivers Takes Effect from 10th September 2009

The Driver Certificate of Professional Competence for lorry drivers
comes into effect from 10th September.

Driver CPC is a qualification, which lorry drivers will need to have
with aims to:

improve road safety
recognise and accredit skills for professional lorry drivers
to encourage drivers to continually update their skills and knowledge
raise the status of bus, coach and lorry drivers and promote driving
as a career.

Bus and coach drivers are also required to have this qualification;
however their requirement came into force in September last year.

If you already hold a lorry driving licence on the start dates, you
will have 'acquired rights' for the next 5 years and will not need to
hold a CPC during that time.

If you wish to carry on driving after those 5 years, you will have to
undertake 'periodic training', which consist of 35 hours training
every 5 years in order to retain your Driver CPC.

However, new drivers who do not already hold a lorry driving licence
on the start date will be required to undertake an initial Driver CPC
test before being able to drive professionally. The initial Driver CPC
test will consist of a theory test and a practical test.

Again, in order to retain the Driver CPC, drivers will need to
complete 35 hours of 'periodic training'. If you fail to complete the
training and continue to drive professionally beyond the end date of
your CPC, you could face legal charges.

For more information view the DSA's Driver Certificate of Professional
Competence Booklet.

Seeing the Doctor: Getting the Best out of Every Visit

Getting top-notch health care in an ever-changing economy requires
becoming a savvy patient. Visit The Washington Post for a great
article on savvy healthcare consumerism and then hop over to the Johns
Hopkins Health Alert site for more tips and tools. Be sure to share
this information with a friend or loved one!

Can An Attitude of Gratitude Keep You Healthy?

Research Project on Gratitude and Thanksgiving? Conducted by Dr.
Michael McCollough, of Southern Methodist University in Dallas, Texas,
and Dr. Robert Emmons, of the University of California at Davis, this
study showed that gratitude plays a significant role in a person's
sense of well-being. The study revealed that people who express
gratefulness on a regular basis benefit from the following:

* Higher levels of alertness, enthusiasm, determination
* More optimism and energy
* Less depression and stress
* More likely to help others
* More motivated to exercise regularly
* Made more progress toward personal goals
* More likely to feel loved

The study also showed that gratefulness begets gratefulness
encouraging a positive cycle of reciprocal kindness.

Here are a few quick tips for developing an attitude of gratitude:

* Make a note of three things that go well everyday and why. This
exercise was devised by Martin Seligman, the guru of the positive
psychology movement.
* Identify your strengths and use them in new and creative ways.
Studies show that the average person uses their strengths 37 percent
of the time. Try going to strengthfinders to find yours.
* Show gratitude in unexpected ways. Write someone a thank you
letter. Show kindness toward a stranger. Send someone flowers.
* Commit to small acts of kindness. Put the toilet seat down
instead of complaining about it. Do the dishes when it's not your
turn. Fill the gas tank up just because (speaking from personal
experience here...it really works!)
* Light a candle. Visit gratefulness.org and light a candle to
express your gratefulness. You can visit as much as you wish. Look
for my candle initialed "tlh".

Deflating Your Excuses Not to Exercise

Have you ever wondered why the moon looks bigger on the horizon than
it does overhead? It's actually an optical illusion called the Ponzo
illusion. The Ponzo illusion suggests that our minds judge the size
of objects based on it's background. In our minds, we see the sky as
a flattened dome so objects over our heads appear farther than near
the horizon. This image is reinforced by objects such as clouds,
birds and airplanes which move across the sky at a uniform height and
are indeed closer when they are over our heads and farther away when
at the horizon. All of this means that when we see the moon near the
horizon, we will think it closer thus, it appears to be bigger.

When it comes to exercising regularly, it is easy to give in to one of
these favorite excuses:

I am too busy at work.

I do not have enough time.

I am too tired.

It is too cold.

I do not have the right clothes.

I am too old.

I am too fat.

I hate going to the gym.

I don't like exercising.

I am too busy with the kids.

The list goes on and on. But how many of our excuses not to exercise
are inflated by the Ponzo illusion? Just as the moon appears to look
bigger on the horizon, our excuses might seem to hold more truth by
the angle from which we perceive them.

Take, for example, the most famous excuse not to exercise, "I don't
have enough time." What if you were to separate this statement from
your perception of "enough time" and your belief about how long you
need to workout. Now reexamine this excuse. How much truth does this
excuse hold now?

Many times, our perception gives power to excuses that maintain the
status quo. It's a brilliant strategy!

By the way, to see that the moon is not actually any larger at the
horizon than overhead, look at the moon through an empty paper towel
roll when it is near the horizon. Without the dome-like space to
refer to, it will appear smaller as it does overhead.

Thoughtful reflection: How does your perception about age, weight or
physical ability influence your excuses not to exercise?

Music--Not Just for Drive Time!

Everyone loves music. We all have our favorite bands or singers,
sometimes even going as far as labeling ourselves "fans" and devoting
a serious amount of time and money to following the careers of certain
musicians.

But music can do more than just entertain. It can move, inspire,
uplift, and even heal our spirit. Spirit Music is made for the
specific purpose of nourishing our minds, bodies, and souls. It can
soothe us when we are anxious or frustrated; or energize us when we
are in need of inspiration.

I encourage you to take the opportunity to try some new music this
week. Here are some of my suggestions for spirit music from various
traditions. If you have any recommendations for music that has made a
difference in your life, leave a comment and share them with me and
your fellow readers!

Innersong.com
http://www.innersong.com/

The Spirituals Project
http://www.spiritualsproject.org/

Oliver Rajamani - Forty Days and Forty Nights
http://www.oliverrajamani.com/

Nusrat Fateh Ali Khan - Night Song
http://www.amazon.com/Night-Song-Nusrat-Fateh-Khan/dp/B000000HPH/ref=m_art_li_3

Native American Winds
http://www.nativeamericanwinds.com/index.html

Not Just for Valentine's Day Anymore!

Fairtrade chocolate pieces, originally uploaded by net_efekt.

Just because something tastes good, doesn't mean it has to be bad for
you. Recent research in to the properties of chocolate show that it
contains potassium, magnesium, vitamins B1, B2, D, E, and
antioxidants.

Cocoa, the main ingredient of chocolate, contains phenols which are
known antioxidants and which contribute to fighting free-radicals,
heart disease, and boosting the immune system. Some ancient cultures
used chocolate as a medicine and as a tranquilizer; it contains
Trypophan and when eaten releases seratonin in the brain.

Like anything else, of course, over-indulgence can be bad for you. The
sugar and cream used to make "milk chocolate" are not part of the
health benefits; in fact, milk is thought to block the absorption of
chocolate's antioxidants, so choose dark chocolate for the most
benefit to your body.

Additional reading: http://scicom.ucsc.edu/scinotes/0001/chocolate.htm

Fresh Fruit: Just Eat It

In nature, fruit is like precious gems that are collected by man and
beast--colorful spots of fragrant sweetness that bring both benefit
and pleasure. Studies show, however, that Americans are eating less
and less fresh fruit. People used to live by the motto, "An Apple a
Day Keeps the Doctor Away." But in 2005, it was reported by the U.S.
Center for Disease Control that only 32.6% of the U.S. adult
population consumed fruit two or more times per day.

For years doctors have been telling us to add more fresh produce in
our diets. Maybe we should start taking that advice. The antioxidants
in fresh fruit are known cancer fighters. They provide us with fiber,
energy, and essential vitamins.

They also provide us with a link to the natural world. In a daily
grind full of plastic wrappers, paper cups and microwave meals, taking
a few minutes to savor a fine piece of organic fresh fruit reminds us
that there's a big beautiful world out there that we're naturally a
part of. Drink in the scent of the fruit, enjoy the color, and savor
the unique flavor. It is such a joy!

Try going to a local farmer's market and picking out some choice
pieces for you to take to work throughout the week. Or visit an
organic grocer and pick up some new variety of pear or berry that you
can experience with your breakfast. Forget dessert! Buy a mango and
take time after eating to carefully peel and cut it into thick slices
that you can enjoy with your tea as much as any cake or cookie.

http://mhlcoaching.typepad.com/the_health_and_life_mixin/2008/05/supplements.html

Vitamin, mineral and herbal supplements play an important role in our
health and well-being. However, because there is not FDA regulation
for supplements, it is important that you take a couple things in to
consideration when you're buying them:

1. Does it give you what you need?
Find out what the recommended daily allowances are for different
vitamins and minerals and make sure the supplements you are buying
meet those. If your supplement requires that you take three or four
just to get 100% of your daily requirements, you might be better off
buying a more expensive vitamin that you only have to take once.

2. Is the brand reputable?
Read some product reviews and make sure there are not major complaints
from other consumers. Look for brands that have been around for many
years and are known for quality.

3. Has your supplement been tested?
The company that makes it should be testing it in a laboratory setting
to make sure it is not only doing what it says, but also, so that it
doesn't cause damage. You can find out if your supplements are tested
by joining ConsumerLab.com

Java Sugar Rush?

I just read an article about java causing a significant increase in
blood sugar if consumed before breakfast. Apparently having a cup of
joe in the morning can spike blood sugar levels if eaten before a
low-sugar breakfast. Who would have known?

Go Natural

More and more companies are claiming that their products are
"natural", which sounds great, except when you realize that the term
"natural" can be interpreted in a lot of ways.

The Natural Ingredient Resource Center online has a wonderful
compilation of products and common ingredients to assist you during
your shopping adventures. Make sure that the items you buy for
yourself and your family are everything they claim to be!

Its Future is in our Hands

You are part of the world, so take care of it and you're taking care
of yourself! Sounds simple right? Well, it is!

Check out this excellent list of 50 Ways to Help the Planet. Start
small, and incorporate these things one by one. With each step you
take toward a greener life, you'll feel a growing sense of optimism
and joy, knowing that your efforts are making a better world for
yourself and everyone else.

The Sting of Defeat

"...But it's better to lose some of the battles in the struggles for
your dreams than to be defeated without ever knowing what you're
fighting for."

Paulo Coelho

It has taken me three days to pull myself out of a deep depressive
state to write this post. I am a Redskins fan (no hate mail please)
and this past Sunday stung bad.

Long story short: Forth quarter. Redskins 17, Giants 24. Fifty seconds
left in the game. Redskin's ball. Forth and goal (3 yards from a
touchdown). They play their hearts out. They lose.

Defeat and loss are a part of life. How will the Redskins respond?
Our response is what matters the most.

Player of the Week: Jason Campbell for his fearless, risky, and bold
performance. You played your heart out, Jason! You make a life coach
proud. Keep fighting for what you stand for.

Awakening the Giant Within: Losing Weight with a Life Coach

Last year, Forbes Magazine ran a great story on how people are
beginning to hire life coaches to lose weight. Hurray!! This life
coach gives "two thumbs up" to trying something different! As I often
say, we are inundated with information on weight loss, nutrition and
exercise. In my opinion, the shift to life coaching for weight loss
means that most of us know what to do, but we just need a little
support and accountability to successfully reach our goal. And life
coaches don't stop there! There is so much more we offer.

Life coaching offers a wake-up call for the sleeping giant within, the
part of us that is stronger than willpower, discipline and
self-control. Our giant's primary desire is to intentionally create a
life we really want. Our giant is grounded in principles, committed
to what is most important and resilient in the midst of adversity.
Our giant always plays a big game, much like a stealth quarterback
playing in the Super Bowl. It's determination is unwavering, it's
focus is winning and it's goal is to live a rich full life. In terms
of losing weight permanently, I say, "bring on the giant!!" Why would
you not want to bring your most powerful self to one of life's biggest
challenges?

How would a life coach approach the issue of weight loss?

Read the following excerpt from Rethinking Thin by Gina Kolata that
chronicles the journey of a chronic dieter:

He tried repeatedly to lose weight and keep it off, starting with
fad diets — the grapefruit diet, the hard-boiled egg diet, "everything
that came down the pike." He called them "water-cooler diets." They
are, he says, the thing you talk about at the water cooler, and that
is how they spread from person to person. But they were of little
help. Each time, he would lose 10 or 15 pounds, then gain them back.
Carmen still has those old diets — he keeps the sheets of instructions
for them in a folder in his basement the same way another person might
keep old yearbooks or diaries. Each one brings back memories, like
hearing an old song or smelling an aroma from your past. If he looked
at an old diet, the sensations came flooding back — that wonderful
feeling of iron discipline, of self-control. The giddy thrill of
watching the numbers on the scale plunge. And the period of regaining
that weight? It was never part of the fond memories evoked by the diet
sheets. The weight gain was separate from the diet, a sign of weakness
or a lack of resolve, not a problem with the diet.

Over the years, as his weight inched up, Carmen began to worry
about the health consequences of being fat. His father was a diabetic
and had died of heart disease, and his uncle, his father's younger
brother, had died of heart disease. "I just thought, Let me diet so I
don't become diabetic," Carmen says. And, of course, he is concerned
about his appearance. "I'm an American. We live in a society where
people have to be beautiful."

There's a lot of great coaching opportunities here, so let me lovingly
roll up my sleeves and flush out a few things:

He called them "water-cooler diets." They are, he says, the thing you
talk about at the water cooler, and that is how they spread from
person to person. But they were of little help.

Coach Terri: What is Carmen's intuition about what would work for him?

Carmen still has those old diets — he keeps the sheets of instructions
for them in a folder in his basement the same way another person might
keep old yearbooks or diaries. Each one brings back memories, like
hearing an old song or smelling an aroma from your past.

Coach Terri: What's behind cherishing things that no longer serve him?

The weight gain was separate from the diet, a sign of weakness or a
lack of resolve, not a problem with the diet.

Coach Terri: Whose disempowering voice do I hear?

If he looked at an old diet, the sensations came flooding back — that
wonderful feeling of iron discipline, of self-control. (yikes)

Coach Terri: What could make this journey more about passion than pain?

"I'm an American. We live in a society where people have to be beautiful."

Coach Terri: Who is calling the shots here?

There is so much more to coach here.

I sense that Carmen is overwhelmed with feelings of defeat, but I also
detect that he is hungry for more. There's a part of Carmen that is
angry--hurt, fed up, tired of tolerating whatever is holding him
back-- but there's another side of him that is empowered, stronger,
and wiser. This is the part of Carmen I would love to see in the
driver's seat. What would it take for Carmen to bring forth his
magnificence? Boy, would I love to coach Carmen for a while!

Life is short, and unfortunately, so many dieters like Carmen will
look back at their lives and realize that there was never any
resolution around weight loss but only a series of struggles.

It doesn't have to be this way.

"When we die and go to Heaven, our Maker is not going to ask: "Why
didn't you discover the cure for such and such?" The only thing we're
going to be asked at that precious moment is "Why didn't you become
you?"

- Elie Weisel

It's time to awaken the giant within.