www.lawmed.com

Here in the United States, workers’ rights are protected by a federal law called the Fair Labor Standards Act (FLSA). For the average person, the most important things this law does are:

1. guarantee that workers earn a minimum wage;
2. create a premium wage rate (or “overtime”) for working more than 40 hours a week;
3. regulate child labor.

Of course, as with all laws, the FLSA has many “loopholes,” which are called exemptions.  There are dozens of exemptions, and some are so specific that they seem a little ridiculous.  For example, some sugar beet workers are exempt from overtime – this means they just get paid straight time for all of the hours they work, even if they work 70 hours in one week.  Sugar beets! Who would have thought sugar beet workers needed such specific laws.  So yes, the FLSA and its exemptions are that specific at times.  At other times, the exemptions are very, very broad and have been interpreted by the courts in lawsuit after lawsuit. (I will post more on the exemptions later.)

Most employees, though, are NOT exempt and ARE protected by the FLSA.

That means most employees in America should be paid fairly for the hours that they work. This is the idea behind the minimum wage, which is currently $7.25/hour. (If you think this is incredibly low, call your representatives in Congress now!  There is a bill being considered which would increase the federal minimum wage.)

This also means that most employees in America are owed overtime if they work more than 40 hours a week.  Overtime pay should be your straight time rate plus half of that rate again, commonly called “time and a half.”

Usually, for a private company to be subject to the restrictions of a federal law, the company has to engage in certain kinds of business or be of a certain size or fall within specific qualifications laid out in each law. The same is true for the FLSA.  To cover those employers who aren’t covered by the federal law, the North Carolina legislature passed the North Carolina Wage and Hour Act (WHA) in 1937, which protected all employees that the federal FLSA did not.

The WHA largely mirrors the FLSA, and the gist is the same:  minimum wage protection, overtime premiums, and limits on child labor.  The WHA packs every bit as much punch as the FLSA, and ensures what’s important to all of us:  Every employer in this state is covered by these wage and hour laws and must abide by certain requirements of either the FLSA or the WHA.  But if your employer still cheats you out of money despite these laws, that’s when we can step in and help you fight for your wages.

This just in: Owning a dog may reduce your risk of heart disease! This finding was announced by the prestigious American Heart Association (AHA) in a published scientific statement. The precise wording was that owning a dog was “probably associated” with protection from heart disease.

Why? According to an article in The New York Times:

People who own dogs certainly have more reason to get outside and take walks, and studies show that most owners form such close bonds with their pets that being in their presence blunts the owners’ reactions to stress and lowers their heart rate, said Dr. Glenn N. Levine, the head of the committee that wrote the statement.

Studies have shown that dogs decrease the body’s reaction to stress, with a lower heart rate, blood pressure, and levels of adrenaline-like hormones. People who have a dog also tend to report greater amounts of physical activity. They also show slightly lower cholesterol and triglyceride levels. And, most powerful of all, some research showed that people who had pets of any kind were also more likely to survive heart attacks.

Now, it’s possible that people who are healthier to begin with are more likely to bring a dog into their homes, but that doesn’t seem likely. Plenty of sick people have dogs–it could be argued that dog people are dog people to the bitter end.

Dr. Levine and his colleagues don’t recommend going out and getting a pet simply for its heart benefits–you have to want to have a dog… walk a dog… love a dog. Otherwise, chances are that the pet will do no more good for your health than hanging a photo of a dog on your wall.

But for those of us who do share our homes with pets, this information is an additional reason to pat that furry head.

To read the full article in The New York Times, click here:  Owning a Dog

The Honda Fit wasn’t quite fit for sale. This week, Honda announced that it is recalling about 44,000 of its 2012 and 2013 model year Fit Sport cars. The reason has to do with the car’s electronic stability control system, and the fix may be as simple as reprogramming the software.

According to an article in The New York Times:

Electronic stability control systems use sensors and a computer to determine if the vehicle is moving in a direction at odds with what the driver is doing with the steering wheel. The system then applies the brake on single wheels to try and correct the movement.

This type of scenario commonly happens when there is something on the road that affects the tires’ ability to grip, such as when you drive on black ice, or if there is oil or other chemical spillage on the road. But stability control can also kick into gear if you have a tire blow out, or other rare events.

The government has required electronic stability control on most consumer vehicles–all except the true “heavy-duty” trucks. These systems are estimated to reduce the number of single-vehicle accidents by about 34%, and the number of single-vehicle S.U.V. crashes by nearly 60%.

What happened with the Honda Fit Sport is that the car’s stability control system was programmed using one kind of tire–the Bridgestone Turanza. But then some Fit Sports came with Dunlop SP tires, which handle differently. For people who own a Honda Fit with Dunlop tires, a simple software update will recalibrate the stability control system and fix the problem.

One lesson for all of us: If you have a car with an electronic stability control system–and if your car is model year 2011 or later, chances are you do–then make sure you check the specs before purchasing new tires.

We frequently write blogs about concussion, but Dr. Robert Cantu, neurologist and medical director of the Nation Center for Catastrophic Sports and Injury Research in Boston, has a new set of recommendations for parents and sports coaches.

Because a child’s brain isn’t fully developed, any trauma has the potential to be more damaging than trauma to an adult brain.  In addition, Dr. Cantu says children tend to lack the neck strength to reduce the acceleration forces the brain will receive.  As a result, he said, children who play youth sports may be at more risk than adults realize.

According to an article from U-T San Diego, Dr. Cantu’s recommends are:

• No heading in soccer until age 14.

• Require chin straps in baseball; ban the headfirst slide.

• No bodychecking in youth hockey before 14.

• No full-contact football until age 14.

• Eliminate head-to-head hitting in Pop Warner (youth football).

• Reduce the contact allowed in football practice.

• Have children perform exercises to strengthen neck muscles.

• Require helmets in field hockey and girls lacrosse.

These guidelines may change the way youth sports are played, but that’s better than having to watch the outcomes of concussions.

For more information about concussions and other traumatic brain injury, visit our dedicated web page at lawmed.com/braininjury/. If you have questions, HensonFuerst has answers.

It seems like it should be common knowledge, but new research has just shown that when children experience concussion–or mild traumatic brain injury–those with more severe symptoms will need a longer amount of time to recover. Mild concussions may heal within 3 to 4 days, but bigger hits may require a month or longer to heal.

Scientist from the Boston Children’s Hospital and the University of Pittsburgh Medical Center examined medical records from 182 children with concussion. They looked for a group of symptoms and rated them on a scale of 0-6.  Symptoms included headaches, vomiting, balance problems, changes in sleep patterns, sensitivity to light or noise, fatigue, numbness, visual problems, and difficulty with memory or concentration.

According to study author William Meehan, M.D.:  ”Parents, physicians and caregivers of athletes who suffer from a high-degree of symptoms after a sports-related concussion should start preparing for the possibility of a prolonged recovery.”

Most physicians recommend that children who receive a concussion while playing sports shouldn’t return to play until all symptoms resolve. It’s a difficult call to make–coaches may want to put star players back in the game…and the injured child may downplay symptoms so they can return to play more quickly. It’s up to parents, teachers, doctors, and other adults to observe the child and make sure they are confident that the injury has healed entirely before sending the kids back out onto the playing field.

Today starts National Playground Safety Week (runs from April 22-26, 2013). It is a time to focus on the safety of children’s outdoor play environments, and to thank all the adults who work tirelessly to maintain playgrounds.

Tell me what you remember about playgrounds in your childhood, and chances are I can tell your age. Metal “monkeybars,” 10-foot slide, and steel jungle gyms were the norm until the 1970s. (Sometime, those torture devices were actually set up on blacktop or gravel–yikes!) From the 1970s to the 1990s, safety became more of a concern. Plastic was used more often than steel, and the playgrounds were built on softer surfaces, such as wood mulch, plastic mulch, or foam blocks. Since the late 1990s, playgrounds incorporate more natural materials–plants, dirt, hills, streams, pathways, and trees.

The evolution of playgrounds has focused on two main goals: 1) helping children to be active and play creatively, and 2) keeping children safe.

“Playing on the playgrounds is one of the simplest, safest and most meaningful ways for kids to improve not only their physical health, but their emotional, social and cognitive skills as well,” said Randy Watermiller, [president of the International Play Equipment Manufacturers Association (IPEMA)]. “This week we recognize the many critical advancements that have been made in making playground equipment and surfacing safer and encourage families to prioritize spending time on the playground together.” [Wall Street Journal Online, April 22, 2013.]

 Top Playground Safety Tips

The child safety organization SafeKids.org has provided tips for keeping children safe on playgrounds:

Supervise Kids Using Playground Equipment

• Actively supervise children on playgrounds. It won’t be hard – they’ll probably be calling for you to watch them climb, jump and swing.
• Check playgrounds where your children play. Look for age-appropriate equipment and hazards, such as rusted or broken equipment and dangerous surfaces. Report any hazards to the school or appropriate local office.
• Teach children that pushing, shoving or crowding while on the playground can be dangerous.
• Dress appropriately for the playground. Remove necklaces, purses, scarves or clothing with drawstrings that can get caught on equipment and pose a strangulation hazard. Even helmets can be dangerous on a playground, so save those for bikes.
• Little kids can play differently than big kids. It is important to have a separate play area for children under 5.

Choose the Right Play Area Based on Your Child’s Age

• Ensure that children use age-appropriate playground equipment. Separate play areas for bigger kids and children under 5 should be available and maintained.
• For babies who are mostly crawling or at best learning to walk, the play area should have a smooth and easy surface to walk on.
• If your baby has fairly good head control and can sit up with support (usually around 9 months old), give the baby (bucket-shaped) swings a try.
• Babies love slides but are too young to go down on their own. But they can slide down with your support. Just hold your baby all the way down and enjoy.

Ensure Safe Surfacing Beneath and Surrounding Playground Equipment

• Avoid playgrounds with non-impact absorbing surfaces, such as asphalt, concrete, grass, dirt or gravel.
• Recommended surface materials include: sand, pea gravel, wood chips, mulch and shredded rubber. Rubber mats, synthetic turf and other artificial materials are also safe surfaces and require less maintenance.
• Surfacing should be at least 12 inches deep and extend at least 6 feet in all directions around stationary equipment. Depending on the height of the equipment, surfacing may need to extend farther than 6 feet.
• For swings, make sure that the surfacing extends, in the back and front, twice the height of the suspending bar. So if the top of the swing set is 10 feet high, the surfacing should extend 20 feet.

Check That Playgrounds Are Inspected and Maintained by Qualified Personnel

• Double check with your school and child care center to make sure they have age-appropriate, well-maintained playground equipment.
• If there are any hazards in a public or backyard playground, report them immediately and do not allow children to use the equipment until it is safe.
• Report any playground safety hazards to the organization responsible for the site (e.g., school, park authority or city council).

Meet me at the swing set?

Resources

For more information about health and safety, please visit our website at lawmed.com. If you have questions, HensonFuerst has answers!

Despite jokes and sitcom story lines, hearing loss is not inevitable. It is common, however, affecting one in three adults over age 65, and about half of people over age 70. While some people are genetically prone to develop problems with hearing, others face increased risk because of loud noises they experience throughout their lives–on the job (such as farming, construction, or factory work) or recreationally (such as exposure to noise from firearms, fireworks, snowmobiling, motorcycle riding, or listening to high-volume music). Plus, some medications–such as the antibiotic gentamicin, some chemotherapy drugs, pain relievers, and antimalaria drugs–can damage the inner ear.

Many times, people with hearing loss are the last to know. Their loved ones and friends usually recognize problems first–they are the ones who continually have to repeat themselves and raise their voices to be heard. You don’t know what you can’t hear if you don’t hear it, so those with hearing loss often think they hear “just fine.”

There are signs that your hearing may be going. According to an article from the Cleveland Clinic, people with hearing loss may:

• Say that people around them are mumbling
• Often ask people to repeat what they have said
• Avoid noisy rooms, social events, or family gatherings
• Keep the television or radio louder than other people prefer
• Have a hard time understanding people when they cannot see the faces of the people who are talking
• Have trouble hearing at the movies, theater, house of worship, or other public places
• Have a hard time understanding conversations in a group
• Become more impatient, irritable, frustrated, or withdrawn

But even with all the symptoms, older adults often believe that they hear perfectly well, even while others recognize the hearing loss. How can that be? According to the Cleveland Clinic:

It is harder for older adults to hear high-pitched consonant sounds (such as d, t, sh, s, f, th) than low-pitched vowel sounds (such as o, a, ah, i, e). The high-pitched sounds carry the meaning of words, so they help us understand speech. In normal conversation, high-pitched sounds are softer than low-pitched vowel sounds. As a result, speech may sound loud but not clear. For example, “Do you have the time?” may sound like “Do you have a dime?”

The confusion and embarrassment of hearing loss may also lead to denial. Plus, if you admit having a problem, the obvious next step is to get help…and that often means getting a hearing aid.

The Other Effects of Hearing Loss

So what if you can’t hear everything, no one died from a little hearing loss, right?

Wrong!

Hearing loss can be very dangerous. According to an article in The New York Times:

Because the ear plays a role in balance, hearing loss can lead to falls. “Even mild hearing loss can triple the risk of falling,” said Dr. [Frank Lin, assistant professor of otolaryngology and epidemiology at Johns Hopkins University], citing his own research as well as a study of Finnish twins.

And then there is the mysterious link to dementia. Some studies have suggested that mild hearing loss is linked to a doubling of dementia risk, and that moderate hearing loss can triple it. With severe hearing loss, the risk can be five times as high, according to Dr. Lin’s 2011 study in Archives of Neurology and a report last month in The Journal of the American Medical Association.

It is possible that hearing loss leads to social isolation, itself a risk factor for dementia, said Dr. Lin.

In addition, few people realize that delayed treatment may make hearing loss worse. “If you don’t use it, you’ll lose it,” said Dr. Remensnyder. “I have a retired nurse, age 90, who has lived alone with no auditory stimulation for years. She doesn’t understand 50 percent of the words, and I can’t reverse that now.”

Add to all that the specific dangers of hearing loss:  Not being able to respond to a crying child…not hearing a car coming at you as you walk down a street…not hearing the warning sound of a smoke detector…and many other situations. So if you have hearing loss, getting a hearing aid is the most logical decision. Unfortunately, logic isn’t the only factor in play when it comes to hearing aids.

Getting a Hearing Aid…Or Not

According to The New York Times:

Even among the enlightened, hearing aids still carry a stigma. “Men think, ‘It’s a sign of weakness,’ and women think, ‘It’s showing my age,’ ” said Dr. [Eric Hagberg, an audiologist in Youngstown, Ohio, and president of the Academy of Doctors of Audiology].

Vanity also plays a part, so people will avoid getting hearing aids the same way they avoid getting glasses.

And then there is the question of money. There’s no denying that hearing aids are expensive–not just pricey, but “luxury” expensive. In general, hearing aids run from $1,800 to $6,800+ per pair…and the cost is not covered by Medicare or most insurance. The most expensive options don’t necessarily work better than cheaper models (although they may, depending on the models), but they generally will be more aesthetically pleasing.

There are some less expensive options, however. In an article titled “The Hunt for an Affordable Hearing,” The New York Times provides several low-cost, good-quality alternatives… including hearing aids now available at Costco.

Hearing loss can be frustrating, depressing, and dangerous, so it’s worth checking out hearing aids. Start by getting an appointment with a physician to rule out other potential causes of hearing loss. Before your appointment, the Mayo Clinic recommends that you:

• List any symptoms you’re experiencing, and for how long. Ask your loved ones to help you make the list. Friends and family may have noticed changes that aren’t obvious to you, but they may be important for your doctor to know.
• Write down key medical information, especially related to any problems you’ve had with your ears. Your doctor will want to know about chronic infections, injury to your ear or previous ear surgery. Also list any medications, vitamins or supplements you’re taking.
• Summarize your work history, including any jobs, even those in the distant past, that exposed you to high noise levels.
• Take a family member or friend along. Someone who accompanies you can help you absorb all the information from the doctor.
• Write down questions to ask your doctor. Having a list of questions in advance can help you make the most of your time with your doctor.

Your doctor is likely to ask you a number of questions, including:

• How would you describe your symptoms?
• Did your symptoms come on suddenly?
• Do you have ringing, roaring or hissing in your ears?
• Do your symptoms include dizziness or balance problems?
• Do you have pain in the affected ear?
• Do you have a history of ear infections, ear trauma or ear surgery?
• Have you ever worked in a job that exposed you to loud noise, flown airplanes or been in combat in the military?
• Do you have any close relatives who have been affected by hearing loss?
• What medications do you take?
• Does your family complain that you turn up the volume of the television or radio too high?
• Do you have trouble understanding someone who is talking to you in a low voice?
• Do you have trouble understanding someone who is speaking to you on the telephone?
• Do you frequently need to ask others to speak up or repeat themselves during conversation?
• Do you have trouble hearing someone in a noisy setting, such as a crowded restaurant?
• Can you follow a conversation in which more than two people are speaking at once?
• Can you hear a coin hitting the floor?
• Can you hear a door closing?
• Can you hear when someone approaches you from behind?
• How are your hearing problems affecting your life, including your close relationships?
• Would you be willing to use a hearing aid if needed?

Then, if you discover you need a hearing aid, do your research. Check out all available options, and make sure you understand the return policies–the contract should be as clear as you want your hearing to be.

RESOURCES

Mayo Clinic article about hearing loss

The New York Times:  Why Won’t They Get Hearing Aids

The New York Times:  The Hunt for an Affordable Hearing Aid

Temporary tattoos seem so fun and innocuous. But as the saying goes: It’s all fun and games until someone gets hurt.

The U.S. Food and Drug Administration (FDA) has issued a warning about temporary tattoos, also known as “henna” tattoos. There have been reports of severe skin reactions, sometimes leading to permanent scarring.

“Just because a tattoo is temporary it doesn’t mean that it is risk free,” says Linda Katz, M.D., M.P.H., director of FDA’s Office of Cosmetics and Colors. Temporary tattoos typically last from three days to several weeks, depending on the product used for coloring and the condition of the skin. Unlike permanent tattoos, which are injected into the skin, temporary tattoos marketed as “henna” are applied to the skin’s surface.

Some consumers report reactions that may be severe and long outlast the temporary tattoos themselves. Reported problems include redness, blisters, raised red weeping lesions, loss of pigmentation, increased sensitivity to sunlight, and even permanent scarring. Some reactions have led people to seek medical care, including visits to hospital emergency rooms. Reactions may occur immediately after a person gets a temporary tattoo, or even up to two or three weeks later.

The worst problems seem to occur after getting a temporary tattoo with the so-called “black henna.” Inks marketed as black henna may be a mix of henna with other ingredients, or may really be hair dye alone. The reason for adding other ingredients is to create a tattoo that is darker and longer lasting, but use of black henna is potentially harmful.

That’s because the extra ingredient used to blacken henna is often a coal-tar hair dye containing p-phenylenediamine (PPD), an ingredient that can cause dangerous skin reactions in some people. Sometimes, the artist may use a PPD-containing hair dye alone. Either way, there’s no telling who will be affected. By law, PPD is not permitted in cosmetics intended to be applied to the skin.

Some examples of problems reported to the FDA include:

• The parents of a 5-year-old girl reported that she developed severe reddening on her forearm about two weeks after receiving a black henna temporary tattoo. “What we thought would be a little harmless fun ended up becoming more like a nightmare for us,” the father says. “My hope is that by telling people about our experience, I can help prevent this from happening to some other unsuspecting kids and parents.”
• The mother of a 17-year-old girl agrees. “At first I was a little upset she got the tattoo without telling me,” she says. “But when it became red and itchy and later began to blister and the blisters filled with fluid, I was beside myself.” She explains that as a nurse, she’s used to seeing all manner of injuries, “but when it’s your own child, it’s pretty scary,” she says.
• And another mother, whose teenager had no reaction to red henna tattoos, describes the skin on her daughter’s back as looking “the way a burn victim looks, all blistered and raw” after a black henna tattoo was applied there. She says that according to her daughter’s doctor, the teenager will have scarring for life.

If you have a reaction to or concern about a temporary tattoo or any other cosmetic, in addition to recommending that you contact your health care professional, FDA asks you to contact MedWatch, the agency’s problem-reporting program. You can also call 1-800-FDA-1088 to report by telephone.

(photos from the FDA)

Here are some sobering numbers from the Centers for Disease Control and Prevention (CDC):

• Nearly 70% of Americans ages 18 to 64 report chatting on phones while driving in the past 30 days
• About 30% of Americans ages 18 to 64 report sending a text message while driving
• Since the last CDC report, 10 states have banned hand-held cell phones, and 39 states banned texting while driving… and yet, the rates of cell phone use and texting have RISEN

According to an article in The New York Times:

“The problem is unfortunately not improving over time,” said Ileana Arias, the principal deputy director for the Centers for Disease Control and Prevention (CDC). “If anything, it seems to be getting worse.”

Dr. Arias said it was unclear why there appears to be so little progress. One possibility is that people are becoming more reliant on and attached to their cellphones and hand-held devices, making them less likely to shut them off or ignore them when they get behind the wheel. The numbers may also reflect a need to create stricter policies that are implemented more widely and vigilantly enforced, like drunken-driving laws, Dr. Arias said.

The study also looked at cell phone use and texting in 6 other countries. In Great Britain, cell phone use while driving is against the law, and the laws are strict. There, only 21% of people report talking on a phone while driving. In fact, cell phone use was below 50% in all but one other country, Portugal, which reported 60% of drivers using a phone while driving.

It takes a single split-second of inattention to cause a wreck and change a life. For more information, visit www.DistractedDriving.gov.

To read the full article in The New York Times, click here:  The Distracted American Driver

To read the CDC report, click here:  Mobile Device Use While Driving

This is Severe Weather Awareness Week in North Carolina, a week for residents to understand that we’re heading for the season of tornadoes and severe thunderstorms.

According to WRAL.com, more than 24 tornadoes touched down dozens of times in 33 counties on April 16, 2011, killing 24 people and damaging and destroying thousands of homes. Five hit in the early-morning hours on Nov. 15, 2008, killing several people in Wilson and Johnston counties. An F-4 tornado struck Raleigh in 1988, killing four people.

Last year, the National Weather Service issued 60 tornado warnings for North Carolina and recorded 21 tornadoes that injured 22 people. Combined, the tornadoes caused more than $19 million in damages.

In addition, the National Weather Service issued more than 1,050 severe thunderstorm warnings, and recorded more than 1,200 incidents of severe thunderstorms with either damaging winds or large hail or both. The severe storms killed six people and injured 46 others.

This means that everyone needs to be aware of these dangers, and take preparedness action.

North Carolina Emergency Management recommends the following safety tips.

• During severe weather, listen to local radio, television, a weather channel or a National Oceanic and Atmospheric Administration radio for information.
• Know the terms. A tornado watch means a tornado is possible. A tornado warning means a tornado has been spotted and that shelter should be taken immediately.
• At home, take shelter in a basement or the lowest floor of the house in an interior room, such as a hallway, pantry or closet. Stay away from windows.In school, go to inner hallways, but stay out of rooms where there is a large roof span, such as gymnasiums, auditoriums or cafeterias.
• In the office, take shelter under something sturdy, such as a desk or a table to protect from flying debris or a collapsed roof.
• Mobile homes are especially vulnerable to high winds. Residents should go to a prearranged shelter when severe weather is predicted.
• In the car, drivers who see a tornado forming or approaching should leave the car immediately and take shelter in a low-lying area. Tornadoes can easily blow vehicles off a road and many people have been killed while trying to outrun a tornado.
• On foot or bicycle, go to a safe place immediately to avoid falling trees, downed power lines or lightning. Inside a sturdy building is best. Lying flat in a ditch or low area may also offer protection, but beware of possible flash flooding and flying debris.
• Preparation for any type of severe weather also means having a family disaster plan and an emergency supply kit assembled and in a location that is easy to access during an emergency. More information is available at www.ReadyNC.org.