Ask an Expert

Utilize our experts for any health and safety questions you have!

You’ve got questions – we’ve got answers! Our safety consultants and partners have years of experience and knowledge they want to share. If you can’t find the question or answer in our library, submit a question using the contact form at the bottom of the page. We’ll do our best to answer within 1-3 business days.

First Aid/Emergency Care

Q. Why do I need to certify every two years for CPR?

A renewal course gives you the opportunity to practice the skills, to refresh your memory on the concepts and physical components of CPR so you are prepared to act in an instant. If you don’t practice the skill often, muscle memory is lost. We’ve all heard the term “use it or lose it” and CPR is no different. Plus, the curriculum changes slightly year over year based on research. Knowing those curriculum or technique improvements is an important aspect in being able to potentially save a life. Lastly, every instructor who teaches brings something new to the table, so each one you take makes you even more prepared to be the help when you’re needed.

– John Woutat, Safety Consultant

Q. How can I tell the difference between Heat Exhaustion and Heat Stroke? Why does it matter?

Both Heat Exhaustion and Heat Stroke occur as a result of prolonged heat exposure. Heat Stroke is the most dangerous stage of the two. In both instances, the person may have altered levels of consciousness, leg cramps, headache, dizziness, and may be lethargic and/or confused.

When a person is dehydrated to the point that they stop sweating, the body loses the ability to cool itself, and the patient’s temperature quickly rises. The patient’s skin will be hot to the touch. If this type of patient is not cooled down immediately by immersing them in a cold bath or cold shower, death may occur.

If they are still sweating, they have Heat Exhaustion. Heat exhaustion can be treated by moving the patient to a cool environment, giving them a sports drink or water and actively cooling them down by wetting clothing or spraying with water. In both instances you should monitor the person’s breathing and call 911.

– John Woutat, Safety Consultant

Q. Is it ok to use an AED on a pregnant person?

Yes. However, our goal is to minimize the amount of electricity that comes in contact with the fetus. Pads should be placed in an anterior/posterior fashion, meaning one pad should be placed in the center of the chest and the other on the person’s back, between their shoulder blades.

– John Woutat, Safety Consultant

Q. If a child experiences anaphylactic shock and another child has an epi-pen. Can I use that child’s medication on the child with the problem?

No, it is not advised to give epinephrine if the victim has not been diagnosed with anaphylaxis and does not have a prescription for epinephrine.  Since epinephrine is a prescription, it should only be administered on the patient it was prescribed for.

– John Woutat, Safety Consultant

Q. How long, on average, does it take an ambulance to get to the scene of an emergency?

In the city, the ambulance will arrive within 10 minutes, 90% of the time. Some city crews will arrive in as little as 5 minutes.  In rural areas, ambulance response times can vary greatly, however they strive to be on scene within 20 minutes. Keep in mind that if you are in a rural environment, with limited access, getting rescuers to a patient can exceed an hour if off-road vehicles are needed.  What does this mean to you?  Knowing how to perform CPR and provide first-aid skills is especially important in a widely rural state like North Dakota.

– John Woutat, Safety Consultant

Emergency Response

Q. What’s the difference between a lock down and a shelter in place?

A lock down occurs when the perpetrator is outside the building and you want to keep people inside the building safe. The perimeter of the building is secure, doors are all locked, no one comes in, and no one goes out. For the most part, it is business as usual until the authorities call the all-clear.

A shelter in place occurs when the perpetrator has gotten in the building and you want to keep people within the building protected. If your business or school has a safe room and you and your people can get there safely, move to that room and barricade the door. If you can’t get to the safe room, you barricade the door where you are, to deny the perpetrator access, and stay out of view of windows. No one is to move or make a sound in order to prevent detection.

– Don Moseman, NDSC Training Director

Q. Does every business need an Emergency Response Plan?

Yes. OSHA requires all places of employment to have a plan for all potential emergencies that may impact that business. Examples include severe weather, fire and active shooter.

– Kathy Zander, NDSC Community Safety Manager

Q. What is the most important component of any Emergency Response Plan?

The employee communication protocol – the means by which an employer notifies the employees that an emergency is occurring. This could include alarms, PA systems, or text alert software.

– Don Moseman, NDSC Training Director

Q. How do I know if my emergency response plan is adequate?

Conduct a security and safety assessment and a GAP analysis. The NDSC has a GAP analysis resource available. If you need help conducting your assessment, call our Community Protection Program Manager at 701-223-6372.

– Don Moseman, NDSC Training Director

Q. Where do most Active Shooter incidents occur?

Active Shooter incidents often occur in small and medium-sized communities where police departments are limited by budget constraints and small workforces. 46% occur at businesses, 24% occur at schools, 10% occur at government facilities, and 20% other.

– Don Moseman, NDSC Training Director


Q: How can we reduce workers’ compensation and health care costs?

The short answer is to align those efforts as one strategy. In most cases, injury and health care claims data will reveal the value of working on injury prevention and wellness programs together, rather than as separate interventions. Protection of a worker’s health as it relates to occupational injury and exposure remains the primary goal of safety programs. Health and safety together are key drivers of productivity and safety. The company culture can play a central role in advancing prevention, promoting the company’s bottom line and improving the overall health of the community.

To get started:
• Assess both work related and non‐work related data for trends.
• Establish a baseline health report of the workforce.
• Identify top risks or opportunities across all data sets and develop priorities.
• Ensure alignment of safety and benefits programs across the company.

– Stephanie Murdock, MBA, MSN, COHM, Executive Director OccMed & Employee Health

Q. Does a Fit for Duty (FFD) program reduce my costs from injuries? Is it an injury-prevention program?

Fit for Duty is an effective injury-prevention program providing significant cost savings.
FFD is a specific job function test program involving specialized analysis of work site job tasks. Each required task is individually measured and documented by rehabilitation staff. An actual employee then verifies the tasks to confirm the true physical requirements are accurately represented. After confirmation, job function tests (JFTs) are created for the specific job to replicate its physical requirements.

During this process, changes in employee technique may be identified to improve ergonomics at the work site. Education is also provided to help employees safely perform work tasks.

The task-specific JFTs are used pre-hire, assuring the employee is physically capable of safely performing the tasks and preventing injuries early at the work site due to a mismatched job. If an employee is injured, the task-specific JFTs equip the provider with specific, objective evidence of what tasks the injured employee can safely perform. As the employee and safety officer helped create the JFTs, the tasks measured are known.

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q. We want to train our own employees. For which courses do you offer a train-the-trainer course?

Adverse Weather Driving Course, Aerial Lift Trainer Certification, Coach Me Behind the Wheel, CPR/First Aid, Excavator Trainer Upgrade, Express Counterbalanced Forklift Trainer Certification, Lift Truck Operator, Loader Group Trainer Certification, OSHA 500, OSHA 501, IVES Premium Combo Trainer Certification, Professional Truck Driver Instructor Certification, and Responsible Beverage Server.

You can find the train the trainer courses on our training calendar or call one of our program managers to discuss.

– Sarah McKenna, First Aid Manager

Q. Why is it important to keep your injured worker on the job?

In spite of all your safety measures and safety education, your employee has been injured while on the job. Now the goal is to have the worker return to his or her job in a safe manner and as quickly as possible.

It is important to have your injured worker treated by a medical provider who has a strong stay-at-work philosophy. This includes limiting the use of narcotics and avoiding taking the employee off work completely. This will help the injured worker recover more quickly from the injury. If your worker is given any restrictions, make sure you accommodate them. The restrictions given will be more helpful and easier to follow if the medical provider has knowledge of your work site and the demands on your worker. This makes having a designated medical provider all the more important. Together, you and this provider should develop a job function testing plan beforehand so when an injury does occur, you can test the injured worker and be assured he or she is returning to work when it is safest to do so.

The relationship you have established with the designated medical provider prior to the injury will lead to less time lost and fewer restrictive orders. This process will decrease the risk of disability to the injured worker and assure their return to a successful and productive life.

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q. What effect does exposure to heat and dehydration have on workers?

Heat exposure, and resulting heat-related illness, is an important occupational health hazard for workers in manual occupations who are engaged in strenuous work outdoors. The symptoms reported from exposure to heat include sudden muscle cramps, nausea or vomiting, hot dry skin, confusion and dizziness. If left untreated, this can lead to seizures, coma and death.

The heat index is an important factor in determining the risk for heat-related illness. The risk begins when temperatures reach 80 to 90 degrees Fahrenheit where symptoms of fatigue are possible with prolonged exposure. Extreme caution is required when the heat index is between 90 and 103 degrees Fahrenheit when heat stroke, heat cramps, or heat exhaustion can occur with prolonged exposure. With temperatures 103 to 124 degrees Fahrenheit, the worker requires active intervention to prevent heat cramps and heat exhaustion. Heat stroke is possible with prolonged exposure. With temperatures above 124 degrees Fahrenheit, heat stroke is highly likely.

Who is at high risk of heat related illness?
The following are at risk:
• Those who work in an environment with the ambient temperature above 90 degrees Fahrenheit
• Those working in wet clothes and shoes, using personal protective equipment, and taking certain prescription medications needed to treat mental health problems
• Those working more than three days in a row in very hot working conditions
• Those who go home and remain in a hot, non-air-conditioned environment after work

What can be done to lower the risk of heat related illness?
The following measures lessen the risk for heat related illness:
• Drink more water
• Take breaks in cooler non air-conditioned areas
• Go to air-conditioned place during breaks or after work
• Change/rotate work hours or work activities so the worker is not exposed to the extreme heat conditions for more than two or three days consecutively

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director


Q. Why is workplace ergonomics important?

Ergonomics is the science of fitting the worker to the job rather than the job to the worker. Utilizing workplace ergonomics is an important factor towards the prevention of musculoskeletal disorders (MSDs). In the United States, MSDs make up approximately 33% of all worker injuries and illness. Examples of MSDs include sprains, strains, Carpal Tunnel Syndrome, tendonitis and disc herniation. Taking measures toward fitting the person to the job utilizing ergonomics can assist in lessening work-related stress and strain, increasing productivity and reducing MSDs. A great first step towards injury reduction is to educate yourself and employees on recognizing the signs of MSDs and encourage early reporting and intervention of injuries.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. How do I identify risk factors for musculoskeletal disorders in the workplace?

Employee interviews can be the most valuable tool since the employee will be able to tell you directly what is difficult about their job and present ideas that could make their job better. A consistent and reliable report of worker injuries can assist you in identifying possible trends as to the location and type of workplace injuries. A workplace walkthrough can also assist employers in recognizing ergonomic risk factors by allowing an employer to visually conceptualize a process or piece of equipment that would help improve performance and decrease risk factors. If you need further assistance in identifying if your workplace has an ergonomic issue, or if you are having difficulty initiating the process, an ergonomics consultation from a facility that specializes in ergonomics can be a positive step towards injury reduction.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. Why is it important to stretch and maintain flexibility on the job?

Jumping straight into work activities when your body is not properly warmed up can lead to muscle strain or injury. When your body is stationary, the tissue around your joints becomes stiff and may also produce discomfort and pain. Stretching is a great way to get your joints moving through their full range of motion, while also loosening your muscle tissue by bringing blood flow to the area. This often will result in reduced adverse effects that come as a result of being stationary for a prolonged period of time.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. What type of stretching is most beneficial?

Stretching can be dynamic (movement) or static (stationary). Research has shown that dynamic stretching–taking a brisk walk, jumping jacks, arm circles, etc.–to be more beneficial in warming up the body prior to an activity. Static stretching—head bends, trunk rotation, hamstring stretches, etc.–is more beneficial post-activity as it provides a nice cool down for your body, maintains/improves flexibility and can reduce post-activity soreness. Following this routine before and after any activity will maintain your joint’s range of motion and muscle flexibility, and may reduce your likelihood of an injury.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. Can daily stretching be performed at work?

Developing a stretching program for employees is an excellent way to promote wellness at work. Developing an appropriate stretching program can also help reduce the negative effects of repetitive work activities, such as prolonged typing and computer work. Consult with your Occupational Medicine Provider for help in developing an at-work stretching program for your employees.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. What is a Repetitive Strain Injury?

Repetitive Strain Injuries (RSI) are one of the most common work-related injuries in the United States. A RSI occurs in a muscle, ligament or tendon from overuse or repetitive activity; since the activity occurs repetitively, the tissue never has a chance to heal. Repetitive movement causes microscopic tears in the tissue, and these tears can produce inflammation and pain.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. What are the symptoms of a Repetitive Strain Injury?

Repetitive Strain Injuries typically result in a diagnosis of tendinitis or bursitis (inflammation of a tendon or bursa), which may produce symptoms of tenderness, swelling, redness, and stiffness. If the inflammation occurs near a nerve, nerve compression may occur, causing symptoms of tingling, shooting pain and weakness.

These symptoms may initially improve once the repetitive motion stops or once the worker’s shift is done. This often results in the worker not reporting the injury initially or “putting it off” since the RSI seems to have improved. If overuse continues, the symptoms typically become constant, causing the worker to seek medical attention. This may occur weeks, or even months, after the initial strain occurs and can prolong the recovery process.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. How is a repetitive strain injury treated?

The worker should have their injury evaluated by an Occupational Medicine Provider who will guide their treatment. Treatment may include:

– Work or activity restrictions
– Anti-inflammatory medications
– Physical or Occupational Therapy (stretching, strengthening, body mechanic training, home care instructions, bracing, soft-tissue manual therapy)
– Soft-tissue modalities (ultrasounds, Iontophoresis, massages and electrical stimulation)
– Self-care instructions (ice or heat depending on the stage of recovery)
– Ergonomic assessment (evaluating how the worker interacts with their work and identifying/correcting risk factors that could be contributing to the repetitive strain)

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck


Q. What is a Hearing Conservation Program and who should be tested as part of this program?

Hearing loss is the most preventable work-related injury. OSHA mandates all employees who are exposed to noise of 85dB or greater over an eight hour time-weighted average, be placed in a hearing conservation program.

Under this program, employees undergo hearing testing (audiogram) at the start of employment and annually thereafter. They are also provided with hearing protection. These services are free of charge to employees.

The annual audiogram is compared to the initial or baseline audiogram to see if there is any change in hearing that would indicate the employee’s hearing protection is inadequate. A physician or an audiologist must evaluate this test to determine if there has been a notable change in hearing, called a standard threshold shift (STS).

Only employees who are exposed to noise levels of 85dB or greater should be placed in the hearing conservation program and tested. If an employer is uncertain which workers are exposed to this level of noise, the work environment can be tested with a sound level assessment to determine the need for the program.

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q: What respiratory health issues do farmers face and what can be done to protect them?

Because of the environment farmers work in, there are a variety of factors
that can affect their respiratory health. Farmer’s Lung is an inflammation of the lung tissue that can cause shortness of breath and decreased ability to perform strenuous activity. The disease occurs when farmers are exposed to moldy hay, grain dust and droppings from birds or poultry. A respirator is recommended when an individual is exposed to these agents.

Herbicides have been linked to increased risk of certain cancers, and pesticides have been
linked to acute poisoning leading to death. A respirator is recommended when exposure to
both herbicides and pesticides is present. Manure degradation leads to the production of noxious gases such as methane, which can act as an asphyxiant. These gases take over the space leaving no oxygen being present in a confined space and leads to death by suffocation. Training in confined space work and the use of a self‐contained breathing apparatus (SCBA) is required.

When a respirator or SCBA is suggested, it’s important to ensure proper fit. In general industry, all workers are tested to see if they are medically fit to wear a respirator and if the respirator fits properly.

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q. What is influenza and how can I protect myself?

Influenza is an acute respiratory infection caused by influenza A or B viruses.
It occurs every year, mainly in the winter season. Symptoms include fever,
headache, muscle ache and weakness, and it is spread through coughing and sneezing.

Influenza is usually uncomplicated; however, in high‐risk populations (elderly and infants), influenza may lead to disability and death. Also, certain strains of influenza such as H1N1,
H3N2 and H7N9 cause increased chance of disability and death.

Often influenza viruses change their genetic information, which can lead to pandemics
such as the H1N1 pandemic of 2009. That is why each year the influenza vaccine must be
changed to provide protection from the current strain.

The best way to prevent getting sick from influenza is to get the flu vaccine every year.
Although, the vaccine does not provide total protection, it gives you the best line of defense.

Early prevention is essential as flu season can begin as soon as October, and runs all the
way through May. The only vaccine recommended is the flu shot. The nasal spray (Flumist)
is no longer recommended as it has been shown to provide significantly less protection
compared to the flu shot.

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director


Q. Do you have a driver course that helps me remove points from my license?

Yes, we offer the Defensive Driving Course – 4 hour (DDC4) in person or online. We also offer the Alive at 25 driver safety course for inexperienced drivers. These fast-paced, driver improvement programs, offer practical strategies to reduce collision-related injuries, fatalities, and costs.  After taking DDC-4, DDC Online, or Alive at 25, you will be eligible for a three-point reduction on your North Dakota driving record which could help you avoid a license suspension. It will not cancel a mandatory suspension or violation, nor will it cancel any action which is already being taken against your driving record. Contact the North Dakota Department of Transportation (NDDOT) for more information at 701-328-2600. If your license is not issued by the NDDOT, contact your state DOT to see if one of these courses qualifies in your state.

– Terry Weaver, NDSC Traffic Safety Manager

Q. Do you have a driver course that will reduce my insurance premium?

Yes, we offer the Defensive Driving Course – 4 hour (DDC4) in person or online. We also offer the Alive at 25 driver safety course for inexperienced drivers. Complete an approved NDSC Defensive Driving Course and become eligible for motor vehicle insurance premium discounts from your insurance carrier. Your discount may apply to all vehicles for which you are listed on the policy as a principal operator, including autos, trucks, recreation vehicles and motorcycles. Contact your insurance company for details.

– Terry Weaver, NDSC Traffic Safety Manager

Q. If I have an out of state license but received a ticket in North Dakota, will a DDC course help reduce points?

If your license is not issued by the NDDOT, contact your state DOT to see if one of our Defensive Driving courses qualifies in your state.

– Terry Weaver, NDSC Traffic Safety Manager

Q. How does CSA (Compliance, Safety and Accountability) impact my business if I have CDL drivers?

EVERY company that employs CDL drivers is in the CSA system. Every error that a driver makes, even if he or she is only given a warning by a police officer, will result in points assessed to the company in the CSA system. If your company accumulates too many points, you will be audited by USDOT with vehicles, drivers, and all records being inspected and reviewed.

– Don Moseman, NDSC Training Director

Q. How do I know that my vehicle is classified as a commercial vehicle by USDOT?

In North Dakota, a commercial vehicle is any vehicle, or vehicle plus trailer, with a Gross Vehicle Weight Rating (GVWR) of 26,001 lbs. or more. Anything 26,000 lbs. and under is not considered a commercial vehicle, as long as you are ONLY traveling in the state of North Dakota (intrastate travel). However, if you travel across state lines (interstate travel), the threshold is 10,001 lbs. Basically, a Commercial Motor Vehicle (CMV) is one that weighs 10,001 lbs combined (pickup and trailer) and is used for commerce or business in surrounding states. This is intrastate to interstate travel which means you must have a 1) Medical Card 2) a Log Book 3) a DOT number 4) Comply with Hours of Service and 5) Comply with all FMCSA Rules.

– Don Moseman, NDSC Training Director

Q: How will the FMCSA-Mandated changes to the DOT exam affect my company and employees?

The FMSCA has proposed the following changes to the existing DOT form as of Dec. 15, 2015. Medical examiners (ME) will be required to use the new medical examiner’s report (MER) form MCSA-5875, medical examination certificate (MEC) form MCSA-5876, and CMV driver medical examination results form MCSA-5850.

What this means for your employees:
1. The ME would be required to give qualified drivers a copy of the MCSA-5876 form to provide to their employers and government enforcement officials.
2. A new status will be added to the exam: Determination pending. This status allows the ME up to 45 days to determine qualification. Drivers with this status may continue to operate a CMV if they have a valid MEC.
3. The ME or staff will have to record what type of government-issued photo ID was used to verify the driver’s identity (e.g., CDL, driver’s license, passport)
4. Drivers will be required to have a new examination when their MEC expires, regardless of its length.

What this means for your company:
1. A full DOT examination and change will be required once your driver’s MEC expires, even for short term certificates.

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q. How does heart disease and high blood pressure affect commercial driver guidelines?

Heart disease and strokes are two of the most serious medical conditions that can lead to sudden incapacity of a commercial motor vehicle driver and potentially a crash on our highways.

If a driver has heart disease, it’s important that it’s treated so the driver is no longer at risk for sudden incapacity. When a driver is diagnosed with a heart attack or angina (chest pain from the heart), certain extra tests are required.

Immediately after a heart attack, there is a two-month waiting period before your employee can drive again. The driver needs an echocardiogram to make sure there is no heart failure and a stress test to make sure the heart disease is under control.

Then every two years the driver needs a stress test to make sure they aren’t at risk for another heart attack. If the stress test shows signs of blockage to the heart, your employee can’t drive until this has been treated and stabilized.

If a driver has undergone a heart bypass, he is disqualified from driving for three months. The driver is not required to have a stress test until 5 years after the bypass. Then the driver is required to have an annual stress test to make sure the blockage has not returned.

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q. How often do people actually get hit by a train?

About every 3 hours a person or vehicle is struck by a train in the United States. In the past five years, 2015-2020, North Dakota has documented 45 highway-rail injuries, and 9 deaths. There have been 14 trespasser injuries and 4 trespasser deaths. South Dakota has documented 18 highway-rail injuries, and 1 death. There have been 2 trespasser injuries and 2 deaths.

– Valerie Fischer, NDSC Business Development Manager

Q. What is the leading cause of unintentional injuries in North Dakota?

Motor vehicle crashes are the leading cause of injury-related death in North Dakota. There are more than 15,000 vehicle crashes in North Dakota each year, and more than 100 lives are lost due to these crashes.

– Terry Weaver, NDSC Traffic Safety Manager


I have had 70E (arc flash) training. Do I need to take it ever again?

Yes. In the 2015 NFPA 70E code book there was a major change to the code book regarding the training requirement timeframe. The prior codebook (2012) there was verbiage about what training needed to be done for qualified and non-qualified (electricians and non-electricians) but there was nothing in the code regarding a need to repeat or update your training. In the 2015 codebook it not only tells who needs to update what training but now it also tells you that you need to do this training at least every 3 years.

– Dick Welle, Safety Consultant

Q. Is AR and FR the same rating in my electrical safety PPE?

No. clothing may be Flame Resistant (FR) and not be Arc Rated (AR), however ALL clothing that is AR is in fact FR. Just because a piece of clothing, typically shirts, pants or coveralls are flame resistant does not mean they are made to withstand the testing requirements to be listed as being Arc Rated. Now all of these items that are made and listed as being Arc rated due to their materials, design and construction are by default flame resistant.

– Dick Welle, Safety Consultant

Drugs & Alcohol

Q. What is the leading cause of unintentional injuries in the United States?

Poisoning is the leading cause of unintentional death in the United States. The leading cause of poisoning is drug overdoses. Other causes include inadvertent drug or chemical ingestion and exposure to environmental substances.

– Kathy Zander, NDSC Community Safety Manager

Q. How does the recent Marijuana initiative affect my worksite?

Measure 5 was overwhelmingly approved by North Dakota voters on November 8, 2016. This measure will allow medical cannabis access to North Dakota residents suffering from certain qualifying conditions if their doctor recommends it. Employers are pressured to make changes in their workplace drug policies, while maintaining a safe workplace. Legalized marijuana is similar to the consumption of alcohol in that you would not allow an employee to be intoxicated at work. It is different in that there is no good measure to determine intoxication form marijuana’s active compound, THC as there is for measuring alcohol levels.

With this in mind, as you determine your workplace drug policy you should address the following:

• Who may or may not be permitted to have THC present in their system based on a particular job description?
• Is an individual at risk to themselves or to others if they are under the influence?
• Is there liability for you as an employer for allowing the employee to work with THC in their system?
Once you establish that there is a subset of employees that you feel can risk impairment while at work, you would like to determine what is considered an appropriate amount of THC to be allowed in their system while working. Unfortunately, the science is not there to answer that question.

This leaves you with two options:
• Zero tolerance: Marijuana is still a federal schedule 1 substance. If your organization receives federal dollars, you may have to remain as a zero-tolerance workplace. Safety sensitive positions should remain as zero-tolerance positions.
• Safety focused: New applicants who test positive for THC on the post-offer drug screen, can be asked to retest in 30 days before receiving a start date, and then placed in a quarterly random testing program as part of the hiring process. Current employees who test positive may be suspended for 30 days and may be allowed to return to work once a clean urine drug screen is provided.

Testing options:
• Oral fluid testing detects recent marijuana use. This eliminates the problem with positive urine drug test in long term users who are no longer actively using and may not be impaired.
• Urine drug screen measure long term use of marijuana and a negative result indicates that marijuana use has stopped.

The impact on the workplace is unknown. Common sense logic and an approach that puts workplace health and safety as the first priority, raises the question; just because they can use should they?

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q. How does the opioid epidemic affect my company? What measures can I take to protect my company and employees?

Opioid use has skyrocketed in the United States in this last decade. Seventy-five percent of drug users are currently employed, which can cause a dangerous work environment. Any individual using opioids is seven times more likely to get injured at work. That individual is also more likely to injure a coworker.

Drug testing all employees during hire and employment helps deter drug use among your
prospective and current employees. Should drug use be discovered, your company can
provide confidential access to help and treatment. This may save the person’s life while
protecting other employees from the increased risk of injury.

Your company’s drug screen may not cover the drugs currently being used in your community.
The commonly used DOT Panel only tests for five drugs and does not include the newer
synthetic opioids that are currently being abused in large numbers. A medical review
officer is your best resource to help determine which drugs should be included in your drug

– Dr. Joel Blanchard, MD, Sanford Enterprise Executive Medical Director

Q. As a server of alcohol, am I liable if an obviously intoxicated individual injures another person after leaving my establishment?

You can be. Under North Dakota’s dram shop statute (law NDCC5-01-06.1), any person injured by an obviously intoxicated person has a claim against any individual who “knowingly disposes, sells, barters, or gives away alcoholic beverages to a person under twenty-one years of age, an incompetent, or an obviously intoxicated person.” Civil and/or Criminal charges may apply to the server AND the establishment, if found guilty.

– Kathy Zander, NDSC Community Safety Manager

Employment Offers

Q. What is Post-Offer Employment Testing?

Post-Offer Employment Testing (POET) is a method used by companies to assure that employees can meet the essential functions of a job as a conditional offer of employment. A post-offer employment test will include all the physical demands of the job that an employee must meet in order to perform the job safely.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. What are the benefits of a Post-Offer Employment Testing program?

Injury prevention can be a major benefit of a Post-Offer Employment Testing program. Fitting the right person to the right job can decrease workers’ compensation claims and lost time at work. A POET program can also assist the employer in determining if reasonable accommodations can be made to workers that are unable to complete all essential functions of the job. If other jobs are available with an employer, they may offer another job where the physical demands are more appropriate.

If an employee does have a workers’ compensation injury, a POET program can accurately assist in identifying which portions of the job an employee can perform safely under restricted conditions to make an earlier return to work possible, thus avoiding lost work days.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

Q. How do I begin a Post-Offer Employment Testing Program?

Consultation with an Occupational Medicine Provider that is able to measure the job through Job Analysis is a good first step. Once a Job Analysis has been completed, your provider will be able to produce an accurate Functional Job Description with corresponding post-offer employment testing for each measured job. Post-offer testing can be performed wherever there are facilities that are able to carry out the testing, however, most Occupational Medicine Providers that provide Job Analysis will also be able to carry out a post-offer testing.

– Grant Judah, Senior Physical Therapist, Sanford OccMed Bismarck

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