Worker safety

Medical residents working long hours risk harm to both themselves and the patients they treat, a group of consumer and labor advocates charged Thursday.

The coalition is urging the Occupational Safety and Health Administration (OSHA) to assume jurisdiction over the work hours of physician residents — and to put strict limits on what those hours can be.

"Working these extreme hours for years at a time, predictably, has ill effects on personal health and safety," the groups wrote in a petition to David Michaels, head of OSHA.

"For OSHA not to regulate resident physician work hours is to abdicate its responsibility to protect the health of those who care for the nation’s sick and dying."

The groups — which include Public Citizen, SEIU and the American Medical Student Association — say the rules established by the Accreditation Council for Graduate Medical Education (ACGME), which currently monitors the residents' work hours, don't go far enough to ensure the safety of residents and the patients they see.

Newly proposed ACGME standards, for instance, would still allow interns to work 20 consecutive 16-hour shifts, the critics argue.

The stress surrounding the extensive hours has been shown to increase the risk of depression, pregnancy complications and even car crashes as the residents commute to work. The fatigue can also lead to medical errors, including needle sticks.

"Harm to resident physicians and errors that adversely affect patient safety result from fatigue," the groups wrote, "and working 90 or 100 hours in a single week provides inadequate time for recovery sleep."

Among the reforms, the petitioners want OSHA:

• To cap the workweek at 80 hours — "without averaging." (ACGME limits the workweek to 80 hours — averaged over four weeks.)

• To establish a limit on single shifts of 16 consecutive hours. (ACGME set the maximum shift at 24 hours, while also allowing an additional six hours of educational activities. That, the groups write, "has been universally interpreted as a 30-hour shift.")

• To require at least one full day off per week, without averaging. (ACGME allows one day off per week, averaged over four weeks.)

• To limit the frequency of in-hospital on-call duty to once every three nights, without averaging. (ACGME has the same limit, averaged over four weeks.)

"To be absolutely clear," the petitioners write, "we are only asking OSHA to regulate and enforce resident physician work hours, a responsibility that is clearly within the agency’s jurisdiction. We are not asking the administration to assume oversight of resident physician education and supervision functions."

That responsibility, they say, should remain with the ACGME.

The announcement is as much a nudge to federal inspectors to enforce the law as it is a warning to operators.

Federal mine-safety officials this weekend launched an experimental program designed to reduce the backlog of contested mine-safety violations — a backlog federal officials say has hampered their efforts to protect the nation's miners.

Yet some mine experts say the focus on the appeals backlog is just a smokescreen being used by officials who, all along, have had the authority to close unsafe mines but didn't want to confront the powerful mining industry.

"It's a red herring," Tony Oppegard, a former attorney with the Mine Safety and Health Administration (MSHA), said earlier this year. "It's a way to make you look like you're doing something when you're really not doing something." 

At issue are tens of thousands of mine-safety violations under appeal by mine companies, who are wary of being hit with a dreaded "pattern of violations" (POV) status. That delineation — at least in theory — allows MSHA inspectors to close entire mines more easily when hazards surface.

But there's a glitch: MSHA officials can't determine a pattern of violations based on citations under appeal. 

The industry is well aware of the loophole, and mining companies have launched a strategy in recent years of protesting more and more violations — a trend that’s created an enormous backlog of cases pending before the Federal Mine Safety and Health Review Commission, a federal panel that reviews appeals. 

In 2005, mine operators contested 7,200 violations, or 6 percent of all citations issued, according to MSHA; last year, the number jumped to 46,526, or 27 percent of violations. As a result, there are about 89,000 contested citations idling before the review panel — up from 82,000 in February.

On Friday, MSHA took steps to reduce the backlog, announcing a pilot program designed to resolve the disagreements between mine companies and MSHA inspectors before appeals are filed. 

"It is clear that the current conferencing structure is not working," Joseph Main, who heads MSHA, said in a statement announcing the program. "By resolving factual disputes before a violation is contested, these citations will not be added to the enormous backlog of cases that have bogged down the judicial system."

The program will launch in three MSHA districts: one in Pennsylvania; another in Kentucky; and a third in Alabama. Funding for the program comes courtesy of the late Sen. Robert Byrd (D-W.Va.), whose final legislative victory was a $22 million provision to help MSHA prosecute mine-safety appeals, including $3.8 million for the review panel to hear them.  

The pilot is a direct response to April's explosion at the Upper Big Branch mine in southern West Virginia, which killed 29 miners. In the months leading up to the blast, MSHA issued the mine operator hundreds of safety citations, yet the project was never shuttered to allow inspectors to examine why the numbers were so high. MSHA officials have said the appeals backlog was at least partially the reason the agency didn't take more aggressive steps to close the operation. 

Some mine safety experts, however, don't buy that argument.

Oppegard, now a Kentucky-based attorney representing victims of mining accidents, was quick to point out that the POV delineation originated in a 1977 mine-safety law — long before the backlog — but MSHA has been reluctant to use it.

"There was never one single pattern of violations issued before the backlog occurred," Oppegard said in June. "How can you blame the backlog now?"

That same law, Oppegard noted, gave MSHA temporary injunction authority to close unsafe mines, even for projects not officially on POV status. 

"It's never been used in 33 years," Oppegard said, "because they're too timid to do it."

Massey Energy failed to report more than 20 accidents at the Upper Big Branch (UBB) mine over several years prior to April's deadly explosion there, the Associated Press reported Tuesday, citing documents from the Mine Safety and Health Administration (MSHA).

MSHA, which has cited Massey over the accidents, discovered the omissions while investigating April's blast, the AP reported.

The episodes span from January 2008 right up to the UBB explosion, the AP said. "Among other things, they involve unreported roof collapses, assorted injuries and two instances of miners exercising their right to move out of dusty areas of the mine because they've contracted black lung disease," the news wire wrote. "All were supposed to be reported."

The news comes as a number of Massey miners — both former and current — have come forward with claims that the company manipulates its safety record by discouraging injured miners from filing accident reports.

Former Massey miner Chuck Nelson, for instance, said injured miners were often offered simple tasks in the mine office following accidents. The idea was to keep those workers on the payroll and preclude the need for workman's compensation payments, Nelson said. 

"I’ve hauled people out of the mines on a stretcher — at Massey mines," Nelson said in April. "And the very next day you’ll see 'em walking up the hill, coming back to the mine office on crutches and [in] neck braces — just to keep from having a lost-time accident, to keep 'em from filling out an accident report."

More recently, Jeff Harris, another former Massey miner, made similar allegations about the company's policy on "lost-time accidents."

"Reports about Massey’s lost time accidents are also misleading," Harris told lawmakers in late April. "If you got hurt, you were told not to fill out the lost time accident paperwork. The company would just pay guys to sit in the bathhouse or to stay home if they got hurt — anything but fill out the paperwork."

Massey says it's still taking a look at MSHA's newly alleged violations, the AP reported. 

The Obama administration this week said it will step up its enforcement of safety violations related to ventilation systems in the nation's coal mines.

"These standards are not voluntary," Joseph A. Main, who heads the Mine Safety and Health Administration (MSHA), said in a statement, "and every mine operator in the country is on notice that MSHA will not tolerate violations of ventilation standards."

The move comes in direct response to recent testimony surrounding April's Upper Big Branch (UBB) disaster in southern West Virginia, which killed 29 miners and all but killed a 30th. The mine owner — Virginia-based Massey Energy — has been under fire over allegations that the company systematically put coal production above worker safety.

Among the most damning charges, a number of Massey miners — both current and former — have said that company managers habitually encouraged workers to tear down line curtains, sheets of plastic designed to direct fresh air from vents into underground work chambers.

“The ventilation system they had didn’t work,” Stanley “Goose” Stewart, a 15-year veteran of the UBB mine, said during a May field hearing of the House Education and Labor Committee in Beckley, W.Va. “With no air moving, it gave me the feeling that area was a ticking time bomb.”

Stewart, who was 300 feet underground when the blast occurred, was one of the few to get out alive.

Jeff Harris, a former Massey miner, told lawmakers a similar tale in April.

"When we got to a section to mine coal, they’d tear down the ventilation curtain," he said. "The air was so thick you could hardly see in front of you. When an MSHA inspector came to the section, we’d hang the curtain, but as soon as the inspector left, the curtain came down again."

MSHA on Monday also issued a reminder to mine operators that they can't alter their vent plans without the agency's approval.

"Any intentional change to the ventilation system that alters the main air current or any split of the main air current in a manner that could materially affect the safety and health of miners must be approved by MSHA before it is implemented," the agency said.

"This announcement serves to remind all mine operators of their obligation to comply with all federal regulations to ensure the health and safety of their employees," Main said.

"Mine inspectors," he added, "are being instructed to beef up enforcement of ventilation standards."

Massey, which has denied all charges that it fostered a culture that prioritized coal production above worker safety, is under a federal investigation surrounding the UBB blast.

BP has agreed to pay a $50.6 million federal fine for ongoing worker-safety violations at the site of a 2005 explosion at its Texas City, Texas, refinery that killed 15 workers, The New York Times reports.

The penalty from the Occupational Safety and Health Administration reflects BP's failure to correct problems at the plant since the explosion. BP paid a $21 million fine in 2005 and agreed to a number of improvements. In the settlement announced Thursday, BP accepted 270 citations for failing to fix problems it had promised to address, the Times reports.

Under the new settlement, BP must also take immediate steps to protect workers at the refinery and spend at least $500 million on safety efforts there.

Massey Energy on Wednesday released pictures of a crack in the Upper Big Branch (UBB) mine, which exploded with tragic results in April.  

The Virginia-based coal giant has suggested a huge crack near a mine-harvesting machine could be the source of the methane gas that fueled the blast.

“The crack, along with other potential sources in the mine, need to be fully examined by company, federal and state investigators as they continue the ongoing probe into the UBB mine accident,” Shane Harvey, Massey's vice president and general counsel, said in a statement.

Release of the pictures came just a few hours after federal mine-safety officials told reporters they've seen no evidence of a massive crack in the UBB to back Massey's claims.

Massey is under federal investigation following April's UBB disaster.

It's still too early to say methane monitors weren't tampered with prior to April's deadly mine blast at the Upper Big Branch (UBB), federal mine-safety officials said Wednesday. 

"We believe there are still units missing," Joe Main, the head of the Mine Safety and Health Administration (MSHA), told reporters during a phone call. "No conclusions have been reached at this time." 

The statement flies directly in the face of claims made earlier in the week by Massey Energy, the Virginia-based coal giant that owns the UBB. The company said Monday that a "thorough examination of the methane monitors from the UBB mine longwall face area conclusively confirms that the equipment was not tampered with or disabled."

"Additionally," Massey attorney Shane Harvey said in a statement, "the tests verified that on the day of the UBB mine accident, these sensors were in working condition and capable of automatically shutting down the longwall in the event that methane readings exceeded safety thresholds."

Not so, MSHA officials said Wednesday. 

The nation's largest mental health organization is pressing claims administrator Kenneth Feinberg to cover mental health needs through the $20 billion BP relief fund.

The National Alliance on Mental Illness (NAMI) is taking issue with Feinberg's July 21 testimony before the House Judiciary Committee during which he said the fund is not likely to pay damages for mental illness and distress caused by the Gulf of Mexico oil spill unless a "physical injury" is also present.

That statement is "incompatible with modern scientific knowledge of mental illness and the impact of traumatic events," NAMI Executive Director Michael Fitzpatrick wrote in a letter sent Tuesday to Feinberg. "Denial of a class of individuals with medical disorders affecting the brain from compensation that is available to those with medical disorders affecting other organs of the body would be neither fair nor equitable."

Alabama, Florida, Mississippi and Louisiana have all called on BP to fund mental health care. And Louisiana advised the Department of Health and Human Services last month that it was encountering "increases in anxiety, depression, stress, grief, excessive and earlier drinking and suicide ideation."