Increased Rate of Dermatological Prescriptions in Workers’ Compensation Due to a Variety of Factors

Older Workers Retiring Later

Workers’ compensation costs are statistically higher for older workers than younger workers. One dataset provides numbers about workers’ comp payments averaging $8,000 for the youngest workers and over $20,000 for workers above age 65 when they concern seven or more days of lost time.[1] More people are continuing to work past the retirement age. This presents challenges for workers’ compensation carriers and the industry itself. Older workers tend to suffer more serious injuries than younger workers, including occupational deaths, as well as more slip-and-fall-related injuries.[2] They also tend to suffer injuries to their “knees, shoulders, back, and trunk”, which typically have longer recovery times for these specific injuries.[3] In addition, being older means your body may not heal as fast, further prolonging recovery times for older workers.

Aging Skin Associated with More Cutaneous Complications

As more older workers are staying in the workforce, prescriptions for opioids have declined in workers’ compensation, yet prescriptions for dermatologicals, filled out by physicians, have risen.[4][5] Some dermatologicals work against HIV. Over half of people diagnosed with HIV are 50 and older.[6] People with HIV are at higher risk of cutaneous reactions, or skin reactions, in antiretroviral drugs.

As we age, so does our skin, the largest organ in the body. We can help protect our skin by:

Using sunscreen
Seeking shade
Wearing protective clothing
Not smoking
Treating skin gently such as limiting bath times, shaving carefully, and avoiding strong soaps
Eating a healthy diet
Managing stress[7]

Following these important dermatology steps can limit how quickly your skin ages. Aging skin is associated with a “reduction in functional capacity that itself increases the susceptibility to cutaneous problems and the subsequent development of dermatoses and skin cancers.”[8] It is a normal part in the aging process and can explain a little bit about the increased rates of prescription dermatologicals in workers’ compensation due to more older workers.

Prevalence of Skin Problems in the Healthcare Sector: Dermatology

The healthcare sector is the fastest-growing industry. Healthcare workers have reported a high rate of skin problems and conditions to the point that it is widespread. Much of it is due to prevention measures required to take during the COVID-19 pandemic. Many healthcare workers frequently suffer skin damage to the “nasal bridge, hands, cheek, and forehead”, with the nasal bridge being most affected.[9] In particular, skin lesions to the nasal bridge are caused more commonly by goggles than N95 masks. (Hand) eczema, in addition, is a common consequence facing frontline workers. Common symptoms include dryness, tightness, and skin peeling.[10] Among the reasons for cutaneous complications among healthcare workers are:

Atopy
Winter season
Low humidity
Frequency of hand washing and sanitizing
Wet work
Glove use, including double layers of gloves[11]
Duration of employment[12]

The fact that dermatologicals have risen to be a cost-driver above opioid prescriptions in workers’ compensation may have much to do with more older workers staying in the workforce, the growing healthcare sector, and COVID-19. At the very least, these reasons all contribute towards this rise. Examples of commonly prescribed dermatologicals are diclofenac sodium gel and lidocaine, with the former being used to treat soft tissue injuries of joints.[13]

If you are a healthcare worker and have encountered occupationally related injuries/conditions, you may want to speak with an experienced workers’ compensation attorney. Call us for a free consultation at (973) 718-5173.

Sources

[1] Childers, Angela. “Comp Costs Continue to Rise with Age: WCRI.” Business Insurance, Business Insurance Holdings, 5 Mar. 2020, www.businessinsurance.com/article/00010101/NEWS08/912333405/Comp-costs-continue-to-rise-with-age-WCRI.

[2] Gonzalo Bravo, Carlos Viviani, Martin Lavallière, Pedro Arezes, Marta Martínez, Iman Dianat, Sara Bragança & Héctor Castellucci (2020) Do older workers suffer more workplace injuries? A systematic review, International Journal of Occupational Safety and Ergonomics, DOI: 10.1080/10803548.2020.1763609

[3] Anonymous. “How an Aging Workforce Can Lead to More on the Job Injuries.” Law Offices of Larry H. Parker, The Law Offices of Larry H. Parker, 23 July 2017, www.larryhparker.com/how-an-aging-workforce-can-lead-to-more-on-the-job-injuries/.

[4] Childers, Angela. “Dermatological Drug Payments Rise in Most States, Opioids Drop.” Business Insurance, Business Insurance Holdings, 30 June 2020, www.businessinsurance.com/article/20200630/NEWS08/912335367/Dermatological-drug-payments-rise-in-most-states,-opioids-drop.

[5] Anonymous. “Anticoagulants.” Heart and Stroke, Heart and Stroke Foundation of Canada, www.heartandstroke.ca/heart-disease/treatments/medications/anticoagulants.

[6] Anonymous. “HIV and Older Americans.” Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 14 Sept. 2020, www.cdc.gov/hiv/group/age/olderamericans/index.html.

[7] Anonymous. “Skin Care: 5 Tips for Healthy Skin.” Mayo Clinic, Mayo Foundation for Medical Education and Research (MFMER), 15 Oct. 2019, www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/skin-care/art-20048237.

[8] Ulrike Blume-Peytavi, MD, Jan Kottner, PhD, Wolfram Sterry, MD, Michael W. Hodin, PhD, Tamara W. Griffiths, MD, Rachel E. B. Watson, PhD, Roderick J. Hay, MD, Christopher E. M. Griffiths, MD, Age-Associated Skin Conditions and Diseases: Current Perspectives and Future Options, The Gerontologist, Volume 56, Issue Suppl_2, April 2016, Pages S230–S242, https://doi.org/10.1093/geront/gnw003

[9] Elston, Dirk M. “Occupational skin disease among health care workers during the coronavirus (COVID-19) epidemic.” Journal of the American Academy of Dermatology vol. 82,5 (2020): 1085-1086. doi:10.1016/j.jaad.2020.03.012

[10] Lan, Jiajia et al. “Skin damage among health care workers managing coronavirus disease-2019.” Journal of the American Academy of Dermatology vol. 82,5 (2020): 1215-1216. doi:10.1016/j.jaad.2020.03.014

[11] Ibid.

[12] Elston, Dirk M. “Occupational skin disease among health care workers during the coronavirus (COVID-19) epidemic.” Journal of the American Academy of Dermatology vol. 82,5 (2020): 1085-1086. doi:10.1016/j.jaad.2020.03.012

[13] Childers, Angela. “Dermatologicals Continue to Be Comp Cost Driver: WCRI.” Business Insurance, Business Insurance Holdings, 24 Mar. 2021, www.businessinsurance.com/article/20210324/NEWS08/912340683/Dermatologicals-continue-to-be-comp-cost-driver-Workers-Compensation-Research-I.