Exam Flashcards
Full Service EAP
Internal or external EAP covering a variety of services
Most likely to provide:
Crisis management and critical incident debriefing
Employee counseling in response to worksite changes (i.e. downsizing)
Innovators in developing new services such as HIV, legal, and financial counseling
Disability management
Elder and child care assistance
Risk management and prevention
Expensive to operate
The Integrated Program (EAP)
Utilizes combination of in-program services and referrals
Focuses on behavioral health benefit management by merging managed behavioral health care and employee assistance services
Attempt to unify assessment, service, and benefit management
Reduce administrative overhead (cost) and improve efficiency
Most common with larger, self-insured companies and large internal union groups
Wrap-Around EAP
Developed by smaller employers
Response to restrictions imposed by managed care on the use of mental health services
Smaller employers contract with EAP’s to provide access to outpatient behavioral health benefits
Compliance EAP
Monitor and comply with conditions of Drug-free Workplace Act, DoT and various State regulations, etc.
Relatively few of these programs
Often used as the least expensive mechanism to comply with regulations (instead of offering substance abuse programs, etc.)
Central elements: Alcohol and drug testing, counseling services for detected abusers, medical review officer services.
Peer-assistance programs
Operated by labor and professional groups to support their membership
Typically adopted to serve workers who are not provided with EAP coverage by their employers due to:
Small size of company or contract worker status
Mobility or geographical dispersion of employee group
Worker-employer relationship (i.e. contracted labor)
May also be implemented by workers who have a concern about confidentiality of EAP services
Typically rely on trained peer counselors and referral agents often with referral to self-help groups
Which types of workplace violence are most common?
Types II and III are most common
Type I Workplace Violence
no association with the workplace
Type II Workplace Violence
customer or patient (customer/client)
Type III Workplace Violence
current or former employee (worker-on-worker)
Type IV Workplace Violence
personal relationship with employee only (not organization)
mercury poisoning
used in production of felt when making hats led to the poisoning of some hat makers
At low-level exposures, nonspecific symptoms: weakness, fatigue, anorexia, weight loss, and gastrointestinal disturbance have been described
Higher exposure levels: mercurial tremor: fine muscle fasciculations punctuated every few minutes by coarse shaking
Erethism may also be observed: severe behavior and personality changes, emotional excitability, loss of memory, insomnia, depression, fatigue, and in severe cases delirium and hallucination
“Phossy” jaw
Osteonecrosis secondary to phosphorous exposure often in match factories
described by dr. alice hamilton
THE OCCUPATIONAL SAFETY AND HEALTH ACT
Established NIOSH and OSHA to carry out its mandate to ensure a workplaces free of recognized hazards.
1970
Principles of Control of Workplace Hazards*
Identify Evaluate Control: Eliminate Substitute Enclose/separate PPE/vaccinate
most common problem among food service and construction workers
Drug Abuse
The National Labor Relations Act
federal statute governing collective bargaining, among other things, and applies to companies with union employees
Americans With Disability Act
enacted to protect the rights of disabled individuals and their ability to perform a job despite a disability, includes language on drug testing
opiates v opioids
opiates are natural: poppy seed, Codeine, Morphine, and Heroin
opioids: Hydromorphone/Oxycodone, Methadone, Propoxyphene
Employee Assistance Programs (EAPs)
“EAPs are workplace-based programs designed to address substance use and other problems that negatively affect employees’ well-being or job performance”
Have evolved significantly over time in response to workplace and societal issue
Goal: to advance workplace environment and maximize employee performance through improved employee & family health
PEP for HIV
Must be taken within 72hrs of exposure
2-3 anti-viral medications, taken for 28 days
Preferred HIV PEP Regimen*
Raltegravir (Isentress; RAL) 400 mg PO twice daily Plus Truvada, 1 PO once daily (Tenofovir DF [Viread; TDF] 300 mg, emtricitabine [Emtriva; FTC] 200 mg)
PrEP Pre-Exposure Prophylaxis*
Daily oral PrEP with the fixed-dose combination of tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg has been shown to be safe and effective in reducing the risk of sexual HIV acquisition in adults
amphibole asbestos can remain
can remain in the lungs for decades
particularly bio-persistent
Burton line
blue line along the gums, with bluish black edging to the teeth
indication of chronic lead poisoning
Lead poisoning
Brain – most sensitive – target organ
Children – decreased IQ, cognitive deficits, reading disabilities, decreased motor skills
Adults – neurobehavioral changes
From time of exposure, lead stays in RBCs for 20 – 40 days
Long term - 90% stored in the bones for 20 – 30 years**
“Mad Hatter’s Disease”
mercury poisoning: nephrotoxic, neurotoxic
paresthesias, vision, and hearing impairment, slurred speech, anxiety, hallucinations, irritability, depression, lack of coordination, tremors
