Wednesday, December 30, 2009

OCCUPATIONAL HEALTH ERROR AND PRESIDENT YARADUA’S HEALTH

I wonder deeply and same time troubled within me trying to figure out where we went wrong as a Nation so we can factor ways to correct it so the Nation can move on, a number of errors kept creeping into my subconscious and prominent amongst this is the way an Occupational Health error hurt the nation and almost bringing us to a standstill and how President Musa Yaradua continuously suffer incessant health breakdown because of the pressure of his office which does not fit his health status when compared, this is a square peg in a round hole.


Let us start by taking a look at the provision in Occupational Health Law that makes room for intending employees to go through a pre-employment medical fitness test to ascertain health fitness levels before offering employment letters and conditions. Over the years, this has been able to take care of the problem of misfits in employment processes and has saved organizations from direct and indirect cost emanating from workplace accidents, health claims and man-hour-loss. Expected productivity level is achieved while adopting this OHS employment procedure, you may be academically and technically qualified for a job but Occupational Health and Safety Law is more interested in ensuring you are medically qualified and fit to perform the duties of the office you applied for. By this application, the duties you perform are those which have been measured with your health status bearing in mind the health risks and your expected productivity line. This is a global application of Occupational Health laws as initiated by the International Labour Organisation and signed by so many member Nations including Nigeria.

When I refer to office in the context of this write-up political offices are inclusive and I am worried why Nigerians contesting for political offices in any category would not be made to go through pre-election medical fitness examination which I am very sure if applied in 2007 would have taken care of the problem we have at hand now where the Nation has been without a President for such a length of time. Before President Umaru Yaradua was given a ticket to run on the platform of the People Democratic Party, we all knew he was sick and was even rumored to have died while the campaign was going on. Application of Occupational Health Laws would have been a stopper by merely subjecting him to the required pre-election medical fitness test and compare outcomes with the health risk inherent in the political office he is contesting for using a pre-designed health fitness matrix as a reporting guide. This would have saved our country a whole lot such as the health cost being incurred presently, the huge man-hour-loss and other associated costs.

A number of political office holders have died while in offices due to known lingering health problems which could not withstand the pressure of the offices being occupied. During Etteh’s saga, a Medical Doctor who was also a member of the House of Representative slumped and died and a number of other ugly occurrences. This same set of people initiated the Occupational Health Bill which has been in the national assembly for so long and going through a very slow reading when that bill should have been give the attention it deserves to be signed into laws to handle most of the problems currently facing the country across sectors.

Outside the electoral OHS need, a good number of Nigerians both skilled and artisans are being maimed and killed in their multiplied numbers in different sectors of the economy due to work related accidents, absence of Occupational Health and Safety laws and regulations are responsible. Organisations work below acceptable safety standards which Nigeria has not even been able to set, let’s get the law first and we will come together and help Government to set standards as applicable in many parts of the world. The Ikorodu incident is still very fresh in our memory “a stitch in time saves nine” goes a common saying.



RECOMMENDATION

1. The Occupational Health Bill should be signed into law as fast as possible

2. INEC should include pre-election medical fitness test for all intending person vowing for political offices

3. INEC should have a few designated health institutions for fitness test in all regions

4. INEC should as a matter of urgency have an advance medical unit for verify medical results and claims

5. Government should set up a National Occupational Safety and Health Administrators (NOSHA) at National Level

6. Government should set up State Occupational Safety and Health Administrators (SOSHA) at State levels





Thursday, November 12, 2009

ERGONOMICS PROGRAMME MANAGEMENT

 SETTING THE STAGE FOR ACTION

Introduction

Fred A. Manuele, author of On the Practice of Safety, considers occupational ergonomics to be "the art and
science of designing the work to fit the worker to achieve optimum productivity and cost efficiency, and
minimum risk of injury." To best fulfill the goal to achieve these benefits through ergonomics, a sound program should be developed. A program that includes a written plan, education, training, and effective procedures to identify, analyze, and evaluate work for ergonomic risk factors.
As with other workplace safety and health issues, managers and employees both play key roles in setting the
stage: developing and carrying out an ergonomics program. It's important that management understand the benefits of an effective ergonomics program.
Ergonomics as part of a company safety and health program
Ergonomics programs should not be regarded as separate from those intended to address other workplace hazards. Aspects of hazard identification, case documentation, assessment of control options, and health care
management techniques that are used to address ergonomic problems use the same approaches directed toward other workplace risks of injury or disease. Although many of the technical approaches described in this course are specific to ergonomic risk factors and MSDs, the core principles are the same as efforts to control other workplace hazards.
Reactive vs. Proactive approaches
Proactive ergonomics activities emphasize efforts at the design stage of work processes to recognize needs
for avoiding risk factors that can lead to musculoskeletal problems. The goal is to design operations that ensure proper selection and use of tools, job methods, workstation layouts, and materials that impose no
undue stress and strain on the worker.
Essential considerations
Ergonomics issues are identified and resolved in the planning process. In addition, general ergonomic
knowledge, learned from an ongoing ergonomics program, can be used to build a more prevention-oriented
approach.
Management commitment and employee involvement in the planning activity are essential. For example,
management can set policies to require ergonomic considerations for any equipment to be purchased and
production employees can offer ideas on the basis of their past experiences for alleviating potential problems.
Planners of new work processes involved in the design of job tasks, equipment, and workplace layout, must
become more aware of ergonomic factors and principles. Designers must have appropriate information and
guidelines about risk factors for MSDs and ways to control them. Studying past designs of jobs in terms of risk factors can offer useful input into their design strategies.
Expressions of management commitment
Management commitment is a key and perhaps the most important controlling factor in determining whether any worksite hazard control effort will be successful. Management commitment is more than mere "support." Support is merely talk, but real commitment is expressed by actually backing up that talk with action that takes time and money.
Remember, support = talk and commitment = action!
Management commitment can be expressed in a variety of ways. Lessons learned from NIOSH case studies of ergonomic hazard control efforts in the meatpacking industry emphasize the following points regarding evidence of effective management commitment:
Policy statements are issued that:
• treat ergonomic efforts as furthering the company's strategic goals
• expect full cooperation of the total workforce in working together toward realizing ergonomic improvements
• assign lead roles to designated persons who are known to "make things happen"
• give ergonomic efforts priority with other cost reduction, productivity, and quality assurance activities
• have the support of the local union or other worker representatives
• allow full discussion of the policy and the plans for implementation
• set concrete goals that address specific operations and give priority to the jobs posing the greatest risk
Resources are committed to:
• train the workforce to be more aware of ergonomic risk factors for MSDs,
• Provide detailed instruction to those expected to assume lead roles or serve on special groups to handle various tasks,
• bring in outside experts for consultations about start-up activities and difficult issues at least until inhouse
expertise can be developed, and
• implement ergonomic improvements as may be indicated.
• provide release time or other compensatory arrangements during the workday for employees expected
to handle assigned tasks dealing with ergonomic concerns.
It's important to furnish information to all those involved in or affected by the ergonomic activities.
Misinformation or misperceptions about such efforts can be damaging: If management is seen as using the
program to gain ideas for cutting costs or improving productivity without equal regard for employee benefits,
the program may not be supported by employees. For example, management should be up-front regarding
possible impacts of the program on job security and job changes. All injury data, production information, and
cost considerations need to be made available to those expected to make feasible recommendations for solving problems.
Employee involvement
Promoting employee involvement in efforts to improve workplace ergonomic conditions has several benefits. They include
• enhanced worker motivation and job satisfaction,
• added problem-solving capabilities,
• greater acceptance of change, and
• greater knowledge of the work and organization.
Worker involvement in safety and health issues means obtaining worker input on several issues.
• The first input is defining real or suspected job hazards.
• Another is suggesting ways to control suspected hazards.
• A third involves working with management in deciding how best to put controls into place.
Employee participation in an organization's efforts to reduce work-related injury or disease and ergonomic
problems may take the form of direct or individual input. A common involvement process is participation
through a joint labor-management safety and health committee, which may be company-wide or departmentwide in nature. Membership on company-wide committees includes union leaders or elected worker representatives, department heads, and key figures from various areas of the organization.
Two factors are critical to the different forms of worker involvement. One is the need for training both in
hazard recognition and control and in group problem solving. The second is that management must share
information and knowledge of results with those involved.
No single form or level of worker involvement fits all situations or meets all needs. Much depends on the
nature of the problems to be addressed, the skills and abilities of those involved, and the company's prevailing practices for participative approaches in resolving workplace issues.
Who should participate?
Ergonomic problems typically require a response that cuts across a number of organizational units. Hazard
identification through job task analyses and review of injury records or symptom surveys, as well as the
development and implementation of control measures, can require input from
• safety and hygiene personnel,
• health care providers,
• human resource personnel,
• engineering personnel,
• maintenance personnel, and
• ergonomics specialists.
In addition, worker and management representatives are considered essential players in any ergonomics
program effort.
In small businesses, two or more of the functions noted on this list may be merged into one unit, or one
person may handle several of the listed duties. Regardless of the size of the organization, persons identified
with these responsibilities are crucial to an ergonomics program. Purchasing personnel in particular should be
included, since the issues raised can dictate new or revised specifications on new equipment orders.
How best to fit these different players into the program could depend on the company's existing occupational
safety and health program practices. Integrating ergonomics into the company's current occupational safety
and health activities while giving it special emphasis may have the most appeal.
Conclusion
Taking a proactive approach to ergonomics is so important to the success of the program. Maximizing
employee involvement is one of the keys to a successful proactive ergonomics program. When employees
identify and help devise solutions, they gain a degree of ownership. We value what we own. Ownership
increases the probability that "EC" (ergonomically correct ;-) behaviors are performed when employees are not being directly supervised.

Tuesday, October 13, 2009

TOTAL QUALITY MANAGEMENT

QUALITY AND SAFETY: PARTNERS IN PRODUCTIVITY

It's important to think of safety as an important aspect of both product and process quality in the workplace. In this course, we'll address those concepts and principles that apply safety specifically to process safety.
Let's take a brief look at how product and process safety differ.
Product quality is elusive. The only way you know you have it is by asking those who define it: The customer.
All the company can do is to try hard to produce a product that fits the customer's definition of quality. When the product is designed to prevent injury or illness, the customer will define the product as safe. As we all know, customer perceptions about product safety are very important these days. Unfortunately, some companies do not take safety into consideration when designing their products. Consequently they may unintentionally design unsafe or unhealthful features into their products.
Process quality and safety are very closely related. Process quality may be considered error-free work, and safety, as one element of process, can be thought of as injury-free work. When an injury occurs, the "event" increases the number of unnecessary and wasted steps in the production process. How does safety fit into the continuous quality improvement philosophy?

WHAT IS TOTAL QUALITY MANAGEMENT (TQM)?

Total Quality Management is a strategic approach to management that takes advantage of all corporate resources to continually improve performance and processes so that they may ultimately be error free. The result is a product or service that greatly exceeds customer expectations.

The champions of Total Quality Safety Management

Dr. W. Edwards Deming is considered by most to be the father of Total Quality Safety Management. He was probably more responsible than any other person for Japan's meteoric rise in manufacturing. He believed that statistics hold the key to improving processes, and that management must take responsibility for quality in the workplace because management controls the processes. This discussion will take a look at his 14 Points of Total Quality Safety Management as they relate to safety.

Joseph M. Juran was a contemporary of Deming, and a second great contributor to the success of Japan's management revolution of the 40's and 50's. He viewed quality problems as 80% the result of weaknesses in the management system and 20% attributable to workers. He would have, no doubt, the same opinion about the causes of workplace injuries and illness. Like Deming, he admonished managers to avoid campaigns and slogans to motivate the workforce to solve the company's quality problems. He favored the use of quality circles because they improved communications between management and labor, and would have surely improved of the idea of management-labor safety committees which have been established for the same purpose.

Philip B. Crosby, a quality expert, was responsible for quality for the Pershing missile project at Martin Corporation, was director of quality for ITT, and in 1979 formed Philip Crosby Associates. He defines quality as "Conformance to requirements, ...which can only be measured by the cost of nonconformance." He might consider safety as the "conformance to injury- and illness-free work practices, ... which can be measured only by average industry costs." Like Deming, he developed 14 steps to quality improvement.

You'll find more about each of these contributors to continuous quality improvement by reading the texts listed at the beginning of this session.

DEEMING'S 14 POIINTS APPLIED TO TOTAL QUALTY SAFETY

Deming's 14 Points form some of the most important concepts and approaches to continuous quality improvement philosophy. The focus of this module is to better understand and apply each of Deming's 14 points to workplace safety. So, let's examine what he says about quality, and how it can be applied to safety.

Point 1. Create a constant purpose to improve the product and service, with the aim to be competitive, stay in business, and provide jobs.
Deming spoke about the "problems of today and the problems of tomorrow," and that management in America today tends to focus only on today's problems when it should be placing increased, if not most emphasis on tomorrow's threats and opportunities to improve competitive position. Management should be focused constantly on improving the safety of materials, equipment, workplace environment, and work practices today so that it can remain successful tomorrow. The objective of continually working toward a safe and healthful workplace today, so that fewer injuries and illnesses occur in the future fits well with Deming's constancy of purpose. If management successfully communicates the clear, consistent message over the years that workplace safety is a core value (as stated in the mission statement), that there are "no excuses" for accidents, the company can be successful in developing a world-class safety culture. If a company considers safety only a priority that may be changed when convenient, constancy of purpose is not communicated.

Point 2. Adopt a new philosophy. We are in a new economic age. Western management must awaken to the challenge, must learn their responsibilities, and take on leadership for a change.
We continually teach that management must step outside itself to reflect, to take a new look at what its purpose is, long term. Safety can never be understood or properly appreciated if only the short term view is taken by management. Quick fix programs to "impose" change will not work. Only understanding of the long term benefits will give management the vision to properly and consistently send and act on the message of workplace safety.
The old philosophy accepts as fact that a certain level of injury and illness will result from a given process, and that the associated costs should represent one of many costs of doing business.

The new safety philosophy strives to:

􀂃 Prevent injuries and illnesses by continually analyzing and improving upstream factors such as work practices, equipment design, materials, and the workplace physical and cultural environment through education, training and recognition.

􀂃 Improve product safety for the benefit of the customer.

Point 3. Cease dependence on mass inspection to achieve quality. Eliminate the need for inspection on a mass basis by building quality into the product in the first place.
Deming was referring to the practice of inspecting every piece of product at the end of an assembly line to separate out the defects. Instead, he encouraged improving the quality of the process to decrease the defects, thus eliminating the need for mass inspection. When we apply this to safety, Deming might consider relying on the results (defects) as measuring our success solely by counting the number of accidents (also) that occur. No consideration is given to measuring employee and management-level safety activities.
In safety, evaluating only results statistics is like driving a car down the road and trying to stay in your lane by looking through a rear-view mirror. All you can do is react, after the fact. When we only analyze accident rates, we can only react to the number. Accident rates tell us nothing about why the accidents are happening. The old safety philosophy we discussed in above measures primarily injury and illness rates (defects) which represent the end results of the safety component of the process. Incident rates, accident rates, MOD rates, etc. all measure the end point, and since these measures are inherently not predictive, these statistics provide little useful information about the surface and root causes (upstream) for injuries and illnesses.

The new philosophy emphasizes measurement along the entire production process, primarily:

􀂃 Measurement of management/supervisor safety activities;

􀂃 Employee safety education and training;

􀂃 Individual worker behaviors; and

􀂃 Materials and equipment design prior to purchase.


Credited to my friend and mentor:
Steve Geigle

Thursday, October 8, 2009

THE ROLE OF RESILIENCE IN RISK MANAGEMENT

As consultants to diverse organizations we encounter dedicated leaders and the nonprofits they serve at various stages of their respective risk management journeys. On one day we may consult with the board of a nonprofit considering the risks and rewards of a significant change in governance or structure (e.g., a merger with another group). Later in the week we may find ourselves advising the leadership team of a nonprofit that is trying to protect its reputation and staff morale in the aftermath of allegations of misconduct by a long-time volunteer. Wherever we find a particular organization, we always remind our clients that sound risk management requires more than the ability to imagine a wide range of future scenarios; it requires planning to survive the circumstances that no one (including an experienced risk management consultant!) is able to predict with absolute precision.
The October 3, 2009 edition of The Economist features a provocative look at world economic conditions in a special report titled “The Long Climb.” The report, authored by Simon Cox, offers several lessons about risk taking that can be applied to the world of nonprofit risk management. I’ve selected two concepts from the article and a third from the work of author David Apgar and offer my interpretations below.
STRING THEORY!
Cox reminds the reader of the work of Milton Friedman, whose theories included the idea that “in America deep recessions are generally followed by strong recoveries.” This economic theory likens market behavior to a piece of stretched string… the greater the force in plucking the string the more it snaps back. Cox reminds us however, that the snap back may well be less than Friedman led us to suspect. There may be no return to normal, as normal has changed! And any change may well be an opportunity to rebound to well beyond “normal.”
The discussion of the string theory and the world economy got me thinking about nonprofits that have and will be again in the future tested to the limit. Although an effective governance structure and strong financial management framework are widely viewed as important goals in a nonprofit, weaknesses in these elements of your operations may not be visible to every stakeholder group. And the willingness to spend financial and other resources to shore up the foundation of your nonprofit may wane when resources for service delivery are under pressure.
I recently experienced this first hand when a client nonprofit elected to delay board training due to the press of programmatic priorities. Within weeks after the decision was made a member of the board took action that suggests a violation of the duty of loyalty. Upon hearing of the crisis caused by the board member’s action it occurred to me that the board training that was regarded as a luxury was actually an unrecognized necessity. The programmatic success of this particular nonprofit will continue to be hampered by the lack of a clear understanding of the board’s basic legal duties.
Enlightened leaders recognize that fortifying the foundation of the organization—its governance, financial management, risk management, and personnel practices—injects strength and elasticity into the nonprofit that it will no doubt require in a crisis. Not every organization will survive or thrive after being tested by a financial, reputation or other crisis. It is the Center’s view that organizations that recognize the importance of a solid foundation and commit to improving governance and management processes are in the best possible position to make effective mid-course corrections when circumstances force the organization off the road and onto the rumble strips.
RUBBER COATING MAY BE PREFERABLE TO A CRYSTAL BALL
In the final section of the special report in The Economist, Cox reminds the reader of the work of author Aaron Wildavesky, who wrote that resilience was sometimes a greater virtue than prescience. Cox writes, “Not every danger can be foreseen, and even if it can be predicted it cannot always be averted." This is, of course, a vital truism in the world of nonprofit risk management, and as my colleague Felix Kloman contends, the “very soul of the risk management discipline”—the ability to bounce back from the unexpected without breaking. Or in the world of nonprofit service delivery, to rebound from the unexpected without letting client needs slip through the cracks or the mission and reputation of the nonprofit go unattended.
THE MYTH OF ABSOLUTE RISKS
Leaders of nonprofit organizations will never be in position to imagine every danger that lies in the immediate or distant paths of their organizations. This concept is explored by author David Apgar who cautions us against obsession with identifying each and every risk we face in his writing on “the myth of absolute risks.” Apgar reminds us that there is no fixed set of discoverable risks. No amount of brainstorming or help from an experienced consultant will unearth a complete set of risks facing a community-serving nonprofit. Why? The risks facing an organization are like a constantly adapting organism; while attention is paid to one issue the measure of the likelihood, consequences and timing of some future event or situation may be changing. Risk changes as our knowledge changes, others react to their own measures and as new information surfaces.
In some cases the very effort to predict the future sets the dangerous illusory process in motion, arguably diminishing our ability to recover (bounce) from the risks that will materialize. "Too much faith in foresight," argues Simon Cox, leads us to "neglect the simpler quality of resilience."
I concur with my colleague Felix Kloman who argues that “the proper goal of risk management is to build and maintain the confidence of stakeholders.” As Felix aptly points out, “that combined confidence and trust is often translated into much-needed support, financial and otherwise, when surprise inevitably hits. It is the essence of resilience.”

Culled from:
Melanie Lockwood Herman's webminar articles
(Non-profit Risk Management Centre)

Tuesday, October 6, 2009

LET'S STOP RACISM, IT DOES NO GOOD



I'm sure many of you watched the recent taping of the Oprah Winfrey
Show where her guest was Tommy Hilfiger. On the show, she asked him if
the statements about race he was accused of saying were true.
Statements like'...'If I'd known African-Americans, Hispanics, Jewish and Asians would buy my clothes, I WOULD NOT have made them so nice. I wish these people would *NOT* buy my clothes, as they are made for upper class white people'
His answer to Oprah was a simple 'YES'.
Where after she immediately asked him to leave her show.
My suggestion? Don't buy your next shirt or perfume from Tommy Hilfiger.
Let's give him what he asked for. Let's not buy his clothes, let's put
Him in a financial state where he himself will not be able to afford the
ridiculous prices he puts on his clothes. BOYCOTT.
PLEASE SEND THIS MESSAGE TO ANYONE YOU KNOW.
Then send it to the whole community that's not white people and see the result. We have to see the result of unity.
Let's find out if Non-whites really play such a small part in the world. Stop buying any range of their (Tommy H etc) product, perfume, cosmetics, clothes, bags, etc.


Scene 2
This one took place on a British Airways flight between Johannesburg and London .
A White woman, about 50 years old, was seated next to a black man.
Obviously disturbed by this, she called the air Hostess..
'Madam, what is the matter,' the hostess asked. '
You obviously do not see it then?' she responded. '
You placed me next to a black man.
I do not agree to sit next to someone from such a repugnant group.
Give me an alternative seat.'
'Be calm please,' the hostess replied.
'Almost all the places on this Flight is taken.
I will go to see if another place is available.' The Hostess went
away and t hen came back a few minutes later. 'Madam, Just as I thought, there are no other available seats in the economy class. I spoke to the captain and he informed me that there is a seat in the business class.
All the same, we still have one place in the first class.' Before the woman  could say anything, the hostess continued: 'It is not Usual for our company to permit someone from the economy class to sit in the first
class. However, given the circumstances, the captain feels that it would be scandalous to make someone sit next to someone so disgusting.' She turned to the black guy, and said, 'Therefore, Sir, if you would like to, please collect your hand luggage, a seat awaits you in first class.'
At that moment, the other passengers who were shocked by what they had just witnessed stood up and applauded.
Both the above are true stories. If you are against racism, please send this message to all your friends. In God there is neither, white nor black, we are all equally boound together in one love which is our Lord and Saviour Jesus Christ.
The world can only be Healed if we all see our selves as brothers irrespective of colour, tribe and creed.















Thursday, September 17, 2009

TOBACCO AND CARDIOVASCULAR IMPACT

WHAT IS TOBACCO?

Tobacco is made from the dried leaves of the tobacco plant. Tobacco smoke is a mixture of almost 4,000 different chemical compounds, including nicotine, tar, carbon monoxide, acetone, ammonia and hydrogen cyanide. Forty three of these chemicals have been proven to be carcinogenic (causing cancer).
Tobacco is ingested through smoking cigarettes, pipes and cigars. In the form of a fine powder, it may also be sniffed as snuff, or it is sometimes sold in blocks to be chewed. It can also be ingested through passive smoking.

Tobacco remains the single most preventable cause of death and disease in the United States today. Tobacco use is a major risk factor for heart disease and stroke. Between 1997 and 2001, smoking resulted in an estimated annual average of 137,979 deaths in the US from cardiovascular disease. In 1998, smoking related health care expenditures in the US were estimated at $75.5 billion.

After a steady decline in adult smokers since 1995, the adult smoking rate in Texas increased between 2006 and 2007 from 17.9 percent to 19.3 percent.3 The Texas high school smoking rate in 2007 (that is smoked cigarettes on one or more days during the past 30 days) was 21.1 percent compared to the Healthy People (HP) 2010 goal of 16 percent.

Epidemiologic studies have demonstrated that exposure to second-hand smoke is causally associated with coronary heart disease. Meta-analyses estimate that involuntary exposure to smoking increases the risk of heart attack by 25-35 percent.21 Many Texas communities are working to adopt or have already passed smoke-free ordinances that reduce exposure to second-hand smoke in public places, including bars and restaurants. Still, 75 percent of Texans are not protected by strong smoke-free ordinances that cover municipal workplaces, private workplaces, restaurants, bars in restaurants, and bars not in restaurants.

Tobacco-related health disparities are reflected in unequal treatment of tobacco use, incidence, morbidity, mortality, burden of illness, and access to resources. Racial/ethnic minorities, people with low socio economic status, and people with lower levels of education are at higher risk for tobacco use and exposure to second hand smoke, and they experience more tobacco related illness and death.22 In Texas, we see the highest rates of smoking among young adults between 18 and 29 (24.3 percent), males (21.9 percent), Whites (20.5 percent) and African Americans (21.4 percent).

The Texas Cancer Council, now the Cancer Prevention and Research Institute of Texas, a state agency charged with implementing the Texas Cancer Plan, published the Texas Tobacco Control Plan 2008, A Statewide Action Plan for Tobacco Prevention and Control in Texas (Tobacco Plan). Partners from across the state, including the Tobacco Prevention and Control Program at the DSHS; the American Cancer Society, High Plains Division; and many community level stakeholders are actively working to reduce tobacco use in Texas.

Investments in state-level, evidence-based prevention programs have produced significant reductions in cigarette consumption, demonstrating the need for fully funded state-wide tobacco prevention programs at levels recommended by the CDC. According to the Tobacco Plan, the most significant barrier to tobacco prevention and control in Texas is the lack of funding to implement these evidence-based programs. Currently, less than 1 percent of the 25 year estimate of $17.5 billion in Texas tobacco settlement funds has been invested in comprehensive community level programs.

THE BURDEN OF CARDIVASCULAR DISEASE AS REPORTED BY AMERICA HEART ASSOCIATION

WHAT IS CARDIOVASCULAR DISEASE?
Cardiovascular disease (CVD) refers to a group of diseases that target the heart and blood vessels and is the result of complex interactions between multiple inherited traits and environmental issues including diet, body weight, blood pressure, and lifestyle habits. This means that cardiovascular disease is largely preventable and, when diagnosed early, disease symptoms and risk factors can often be mitigated with lifestyle change and medication. Common forms of CVD include high blood pressure, coronary heart disease, stroke, and congestive heart failure.
A major cause of CVD is atherosclerosis, a general term for the thickening and hardening of the arteries. It is characterized by deposits of fatty substances, cholesterol, and cellular debris in the inner lining of an artery. The resulting buildup is called plaque, which can partially or completely occlude a vessel and may lead to heart attack or stroke. The most prevalent forms of heart disease and stroke, in which narrowed or blocked arteries result in decreased blood supply to the heart or brain, are referred to as ischemic heart disease and ischemic stroke.
Progress is being recorded in some countries where capacity has been built and developed to tackle the scourge of CVD, while countries, states and local communities in Africa still wallow in the grip of the menace of CVD. Factors affecting this decline in other parts of the world include more effective medical treatment and more emphasis on reducing controllable risk factors.
While CVD mortality rates have declined most developed countries of the world, the financial burden from CVD continues to rise. Together, heart disease and stroke remain the number one drain on health care resources. According to the American Heart association (AHA), the estimated direct and indirect cost of CVD in the US in 2008 will be $448.5 billion. In 2006, hospitalization charges for CVD and stroke in Texas were over $10 billion. Ischemic heart disease alone accounted for 60 percent of these charges.
Cardiovascular diseases include coronary heart disease (heart attacks), cerebrovascular disease, raised blood pressure (hypertension), peripheral artery disease, rheumatic heart disease, congenital heart disease and heart failure. The major causes of cardiovascular disease are tobacco use, physical inactivity, and an unhealthy diet.
Globally, cardiovascular diseases are the number one cause of death and is projected to remain so. An estimated 17.5 million people died from cardiovascular disease in 2005, representing 30 % of all global deaths. Of these deaths, 7.6 million were due to heart attacks and 5.7 million due to stroke. About 80% of these deaths occurred in low- and middle-income countries. If current trends are allowed to continue, by 2015 an estimated 20 million people will die from cardiovascular disease (mainly from heart attacks and strokes).

PRIMARY CAUSES OF CARDIOVASCULAR DISEASE

High Blood Pressure: The relationship between blood pressure and risk for cardiovascular disease is well established and independent of other risk factors. High blood pressure is a factor in 67% of heart attacks, 77% of strokes, and 74% of heart failures. The higher the blood pressure becomes, the greater the risk for heart attack and heart failure. The presence of pre-hypertension signals the need for increased education and lifestyle modification to prevent or reduce the onset of hypertension. Recommended lifestyle changes include weight reduction, adoption of a good eating plan, sodium reduction, physical activity, and moderation of alcohol consumption. Combinations of lifestyle modifications can achieve optimum results.
High Blood Cholesterol: Reducing risk associated with high blood cholesterol involves reducing lifestyle risk factors such as obesity, physical inactivity, a diet high in saturated fats, excess alcohol consumption, and tobacco use. A diet high in carbohydrates (more than 60% of energy intake), certain diseases, certain drugs, and genetic causes are also associated with abnormal lipoprotein levels.
Diabetes: Diabetes, a major risk factor for cardiovascular disease, is a group of diseases marked by high levels of blood glucose and includes type 1, type 2, gestational, and other types resulting from specific genetic conditions. People with type 1 diabetes must monitor and control their blood glucose level by self administration of insulin. Those with type 2 diabetes can often control their blood glucose through diet, exercise, and oral medication. Diabetes self-management education is integral to effective medical care. According to the American Diabetes Association, it is important for patients and their providers to “make the link” between diabetes, heart disease, and stroke. Diabetes management involves not only control of blood glucose but also of blood pressure and cholesterol levels.
Tobacco use and exposure to second hand smoke: Tobacco remains the single most preventable cause of death and disease in the United States today. Tobacco use is a major risk factor for heart disease and stroke. Between 1997 and 2001, smoking resulted in an estimated annual average of 137,979 deaths in the US from cardiovascular disease. In 1998, smoking-related health care expenditures in the US were estimated at $75.5 billion. Tobacco-related health disparities are reflected in unequal treatment of tobacco use, incidence, morbidity, mortality, burden of illness, and access to resources. Racial/ethnic minorities, people with low socioeconomic status, and people with lower levels of education are at higher risk for tobacco use and exposure to second hand smoke, and they experience more tobacco related illness and death.
Overweight and Obesity: Premature death, heart disease, diabetes, cancer, respiratory problems, arthritis, and reproductive complications are among the health consequences of overweight and obesity. The incidence of heart disease, high blood pressure, and high cholesterol are higher in people who are overweight and obese. Risk factors for heart disease such as high cholesterol and high blood pressure are more prevalent in children and adolescents who are overweight.
Recent studies suggest that obesity, independent of other risk factors such as keeping active and not smoking, increases risk for acute coronary syndrome (symptoms associated with myocardial ischemia). Overweight and obesity classifications are determined by body mass index (BMI), a ratio of body weight (kg) to height (m)2. Overweight is defined, in adults, as a BMI between 25 and 29.9, while obesity in adults is defined as a BMI of 30 or higher.
Unhealthy eating: Nutrition plays an important role in an in¬dividual’s overall health and quality of life. A diet high in calories, saturated fat, and cholesterol and high in sodium or sugar is a major contributor to poor health. For reducing risk of CVD and stroke, the American Heart Association encourages people to know their daily caloric intake to help ensure calories eaten do not exceed calories burned through daily physical activity and consume nutrient rich foods that are high in vitamins, minerals, fiber, and other nutrients but low in calories. A diet high in fruits and vegetables is as¬sociated with better weight management and a reduced risk of chronic disease.
Lack of physical activities: Regular physical activity is associated with reduced risk for chronic disease and a healthier, longer life. Cardiovascular ben¬efits of regular physical activity include lower risk for heart disease, high blood pressure, stroke, abnormal blood choles¬terol and triglycer¬ides, type 2 diabetes, obesity and a second heart attack.

Tuesday, September 15, 2009

TOBACCO USE IN MOVIE PRODUCTION

The World Health Organisation made a global call in 2003 to the entertainment industry to stop promoting a product that kills every second regular user and a focus on Hollywood to keep tobacco off the screen, on that note it made “Smoking in Movies” the focus of that year’s World No Tobacco Day. Tobacco use kills about 5million people World wide annually and has been identified as a cancer causing product, the Motion Pictures industry has not been accused of causing cancer but they do not have to promote a product that does.
                                    Images Influence Kids

The influence of television images on kids became a factor that pivoted every presentation made on World No Tobacco Day 2003 and how young people especially are vulnerable to the glamorous images of smoking portrayed in many movies and television programmes. Every claim was backed up by several studies conducted by Researchers in Dartmouth Medical School, U.S.A. which says “kids who watch a lot of movies that show smoking are most likely to start smoking themselves, and have more positive attitudes about smoking”. Also the claim on the rise of smoking in movies especially the PG-13 targeted at impressionable adolescents was also an issue.
In 1998, tobacco companies in the U.S reached a major legal settlement with 46 States not to advertise to minors or pay film companies to use their products in movies and after this agreement it was discovered that tobacco use in movies increased by 50%. (Massachusetts Public Interest Research Group, 1998).

                                  Tobacco Deserve an R-Rating

The World Health Organisation is urging film executives to give any film that shows tobacco use an R-rating; which substantially reduces the probability that a kid will see the movie. The movie industry was called upon to take tobacco just as seriously as it takes profanity in movie rating, this does not otherwise mean censorship of movies. It simply means if there are bad things in movies, it should be properly labelled.

Tobacco continues to kill globally and films have a crucial role in promoting its use, say WHO. In India, a high number of deaths have been traced to tobacco use which has been made popular through movies and cinema. This has solely been blamed on Bollywood’s relationship with tobacco companies according to ‘Bollywood: Victim or Ally report’ conducted by the Tobacco Free Initiative of the World health Organisation (WHO) 2003. It was reported that in India, tobacco causes 800,000 deaths every year i.e. 2,200 people die each day, 90 die every hour out of the nearly 1 billion population of India.

It is also on record the damage done to the American society by tobacco marketers and producers who had a close working relationship with Hollywood to glamorise tobacco. This they were able to do using Hollywood, being the largest motion picture industry in the world until the legal settlement that 46 States in the U.S collectively signed with the tobacco companies on advert prohibition to minors. On realising the defeat they had suffered in the U.S court verdict and the effects it has on their sales and overall revenue, the tobacco companies leveraged on the ignorance of Bollywood of India being the second largest movie producers in the world. This resulted to so many deaths in India according to an earlier highlighted statistics before the intervention of anti-tobacco experts and advocates that led to the checkmating and prohibitions the tobacco companies suffered in India.

The Nollywood (the Nigerian movie industry), being the third largest movie market in the world had suddenly become the focus and we all can testify on how tobacco usage in our movies had gained popular acceptance at the peril of the teaming population of our youths who are potential smokers. Our actors and actresses are seen by this growing number of youths as role models and supermen and whatever they do is the seemingly right thing in the mind of these youths and if positive steps are not taken to educate the movie producers on the negative effects tobacco usage in movies has on the viewers, we might just be having a repeat of what happened in India and America.

Nigeria being a signatory to the World Health Organisation’s Framework Convention on Tobacco Control (FCTC), the international treaty signed by Member-States of the United Nations and the European Community requires them to restrict advertising and sponsorship of tobacco products and outlaw smoking in public places, tobacco advertising and sponsorship of sporting events by tobacco companies. We cannot fold our hands to watch tobacco companies and their products work contrary to what we as a Nation are a signatory to. This may on the long run ruin the lives of our youths and our tomorrow leaders who the tobacco companies have made their target to remain in business.

                      Some tobacco effects on the Nation of India

India has a population of 1billion people with 250 million tobacco users. India is a major target by tobacco companies because of the vast population growth and it offers the biggest market to tobacco companies after Brazil.

Out of the 250 million tobacco users recorded in India, as many as 199.2 million people are between the ages 15-24, and this group is projected to grow to 231 million by 2013.

It has been recorded that one of the leading causes of preventable deaths in India today - heart disease, loss of breathing capacity (Emphysema) and cancer – which cost the country $5.5billion in 1999, is smoking. In contrast, the nationwide sales revenue of all tobacco products for that year was $4.88billion. Tobacco related diseases cost the country $2.7billion through the loss of productivity alone.
The tobacco companies only source of replacing smokers is to try and rope in thousands of younger adults and school children who they make sure light cigarette the first few times and thus get them hooked. If it fails to do that, big tobacco companies will start to die. It is like population that does not give birth which gradually dies a natural death.

Prof. Stanton Glantz, an America Smoke Free Movies Campaigner and Anti Tobacco Activist describes how over 40 years the tobacco industry knew nicotine was an addictive substance and it causes cancer, and yet withheld this information from the public.
The World Health Organisation has always preached the harmful effect of tobacco on young people and Nigeria being a signatory to the WHO Framework Convention on Tobacco Control (FCTC), advertising tobacco product is illegal. The WHO study has shown that smoking in films is an insidious form of advertisement as people, especially the youth, tend to emulate their film idols and take up to smoking.

                              Statements credited to Philip Morrison

The article quotes excerpts from several documents, among them a 1989 Philip Morris marketing plan which said: "We believe that most of the strong, positive images for cigarettes and smoking are created by cinema and television. We have seen the heroes smoking in Wall Street, Crocodile Dundee and Roger Rabbit. Mickey Rourkey, Mel Gibson and Goldie Hawn are forever seen, both on and off the screen, with a lit cigarette. It is reasonable to assume that films and personalities have more influence on consumers than a static poster of the letters from a B&H (Benson and Hedges) pack hung on a washing line under a dark and stormy sky. If branded cigarette advertising is to take full advantage of these images, it has to do more than simply achieve package recognition - it has to feed off and exploit the image source."

Another document, a draft speech prepared for the president of Philip Morris International to be read at a company international meeting, says: "Recently, anti-smoking groups have also had some early successes at eroding the social acceptability of smoking. Smoking is being positioned as an unfashionable, as well as unhealthy, custom. We must use every creative means at our disposal to reverse this destructive trend. I do feel heartened at the increasing number of occasions when I go to a movie and see a pack of cigarette in the hands of the leading character. This is in sharp contrast to the state of affairs just a few years ago when cigarettes rarely showed up in cinema. We must continue to exploit new opportunities to get cigarettes on screen and into the hands of smokers."

A 1981 memo from a researcher from the same company (quoted elsewhere) says: "Today's teenager is tomorrow's potential regular customer, and the overwhelming majority of smokers first begin to smoke while still in their teens.... The smoking patterns of teenagers are particularly important to Philip Morris."

THE ABSENCE OF OCCUPATIONAL HEALTH AND SAFETY LAWS IN NIGERIA

We strongly believe Nigeria has come of age to operate within the confines of globally accepted standards. Occupational Health and Safety has been made so crucial in functional systems in virtually every parts of the world with enabling laws guiding processes and policy formulations. These are in the true sense of it not necessarily local laws but careful implementation of numerous contents of several ILo conventions being domesticated into the local laws for safety of lives and properties in a given Nation. This is a global standard as obtainable in most countries of the world.
In our Nigeria context, we are groping in the dark, maiming and incapacitating the present and future active workforce of the country. Work places have become death traps, loss of loved ones to Occupational accidents are increasingly high without simple accident reporting of detection mechanism. Employers of labour are cashing on the lack of interest from our legislators to set up companies without a single safety policy or principles. The Asians investors who are known for owning and running production factories in Nigeria have so taken advantage of this at the expense of the Nigerian work populace. The saddening part of it all is that there is no law in place to prosecute these set of murderers of even press for claims, it is a common saying that "where there is no law there is no offence. This is a clear situation of the Nigerian system. Multinational Oil and Gas companies introduced Health and Safety into Nigeria and in our ignorance we thought it was an idea borne out of the magnanimity of these companies little did we know a "safe work place is a human right". The presence of these oil and gas companies is strong in the Niger Delta region so safety has a better representation in this region even though skeletal.
We were so elated when the modern-day thinking Governor of Lagos State, Mr. Babatunde Raji Fashola took the initiative of calling all stakeholders in the state to come for a forum on the discuss the setting up of Lagos State Safety Commission we were all happy but it has been quite a while now and nothing has been heard on that. We are also of the opinion that the whole idea must have met a strong brick wall because there are no enabling Federal Laws to support his initiatives.
We have a continuously sick President who i personally feel cannot withstand the pressure of his office based on his State of Health and this has become issues of national concern but if we have through Occupational Health and Safety model requested pre-qualification medical fitness test for all politicians before registering to get the ticket to run in an election, this present problem would not have caught up with the Nation Nigeria. During Etteh's saga we lost a member of the House of Representative to Cardiac arrest and unfortunately the late legislator was a qualified medical Doctor, a number of such cases abounds. We are itching for a National Safety Commission which will house and regulate other safety agencies under its operations such as Nigeria Occupational Safety and Health Administrators (NOSHA), National Hygiene Administrators, Hazardous Material Handling and Control Board etc. The Nation has a lot of revenue that can be derived from this but we have a set of slumbering leaders.
Time will not fail me to talk about the embarrassment we receive when we are writing international exams in health and safety and you are given a task to accomplish and you are told to liken it to the existing Occupational Health and Safety Laws of your country and you have no choice than to tell the institute you country does not have such laws. You do not know the shame.
In conclusion, I suggest the legislative arm of government takes a closer look into the ILO conventions and the Occupational Health and Safety Laws initiated and agreed upon by member nations including Nigeria. The law is supposed to protect the right of every Nigerian worker but they are all dying in droves.
A stitch in time saves nine goes a common saying.