Occupational health and safety in the casino industry

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There are unique occupational health issues in the casino industry, many of which are attributed to repetitive tasks and long-term exposures to hazards in the casino environment. Among these issues are cancers resulting from exposure to second-hand tobacco smoke, musculoskeletal injury (MSI) from repetitive motion injuries while running table games over many hours, and health issues associated with shift work. Safety and regulatory agencies in the United States have implemented regulatory measures to address the specific risks associated with workers in the casino industry, and have made efforts to identify additional possible risks to casino workers, including noise-induced hearing loss and heavy metal poisoning from exposure to dust from coins.

Contents

Regulation

In the United States, the Occupational Safety and Health Administration (OSHA) is empowered to educate employers and workers, set workplace standards, and enforce violations. [1] OSHA requires casinos to have a written safety plan specific to their location which commonly addresses risk factors for workers such as ergonomics, blood-born pathogens, personal protective equipment, food service, housekeeping, and slips/trips/falls. [2] Taken from regulations for sporting events, there are additional requirements for casino employees working in entertainment to help workers avoid hazards, injuries, and illness caused by theatrical scenery/rigging/props, wardrobe/hair/makeup, and audio/camera/projection/video/lighting. [3]

As of January 1, 2018, workers in Nevada have a 10-hour training course on these subject they must complete within 15 days of being hired. They must renew this certification every five years. [4] These rules are in place to prevent workplace hazards, injuries, and deaths which have occurred during performances. [5]

The National Institute of Occupational Safety & Health (NIOSH) conducts free workplace Health Hazard Evaluations (HHE) under 29 U.S.C. 669(a)(6) [6] to identify workplace health hazards and make recommendations to reduce hazards. [7] NIOSH has evaluated casinos in the United States regarding employee exposure to second hand smoke, [8] [9] noise, [10] [11] and metal coin dust. [11]

Hazards

Second hand smoke

The primary cancer risk factor for casino workers is thought to be due to second hand smoke which can increase the risk of both lung cancer [7] and breast cancer (42% higher) [12] [13] compared to the general population's risk. [14] [15] Second hand smoke contains 700 chemicals that are known to cause cancer. [16] The Surgeon General of the United States determined in 2006 that exposure to second hand smoke is not safe at any level as smoke cannot be filtered by ventilation systems [16] [17] and separate "no smoking" areas do not keep smoke out. [18] [19] More typically, the heating and cooling systems distribute smoke throughout the building, rather than removing it. [20] Employees working in casinos have historically had higher levels of exposure to nicotine than other employees in the United States who reported exposure to second hand smoke. [21] Second hand smoke among casino workers is estimated to cost $112 per casino worker, per year in direct medical costs. [20] [22]

In 1995, NIOSH evaluated non-smoking casino workers who worked in casinos that allowed smoking. The study found that these workers were exposed to elevated levels of nicotine in the air. [23] The American Conference of Governmental Industrial Hygienists (ACGIH) publishes Threshold Limit Values (TLVs) for chemical and physical agents as well as Biological Exposure Indices (BEIs) each year that establishes a maximum exposure recommendation based on current scientific knowledge. As of 2018, the ACGIH recommends employees not be exposed to an eight-hour time-weighted average (TWA) of more than 0.5 μg/m3 to prevent damage to the gastrointestinal tract, heart, brain or spinal cord. [24] In studying these non-smoking casino workers, NIOSH found they were exposed to nicotine levels in the air of 6-12 μg/m3. The investigators also took urine samples of the workers to estimate the internal dose the workers were absorbing and found they had blood cotinine (a metabolite of nicotine) levels of 1.85 ng/ml after their shift. NIOSH monitored employees working in both "smoking" and "non-smoking" sections of the casino and found elevated levels of exposure in both, as measured in the air (externally) and in the worker's blood (internally). While all areas measured were above the recommended exposure limit, the highest concentrations were found at the poker tables. The national average at the time for non-smokers exposed in their work or home was 0.93 ng/ml. As a result of this study, NIOSH recommended that employees not be involuntarily exposed to smoke in the workplace. [23] However, NIOSH is only a research agency and their recommendations do not have the force of law or ability to force employers to comply. [7] Studies in casinos before and after smoking bans were enacted showed a decrease of 85-95% in cancer causing agents. [25] Based on these studies, NIOSH expanded its recommendation to make casinos in the United States 100% smoke free in 2009. [8] As of January 2023 there were 260 commercial and 148 Tribal Casinos in the United states, which don't permit smoking on the casino floor. [26]

Noise-induced hearing loss

Casinos can protect their employees from high levels of ambient noise by locating their performing entertainment and slot machines in a separate physical location. [27] NIOSH has conducted one noise evaluation of a casino in 2003, but did not find any evidence that noise in that casino was loud enough to put employees at risk of hearing loss. As a preventative measure going forward, NIOSH recommended that noise levels be reevaluated whenever a new piece of equipment is installed or whenever employees express concerns about the noise level. NIOSH generally recommends that such noise assessments be conducted on the busiest nights of the week or whenever the noise is likely to be loudest as that is the time of greatest risk to workers and patrons. [28]

The ACGIH eight hour Threshold Limit Value (TLV) for sound is 85 A-weighted decibel (dBA). Exposure at or below this level of sound is expected to protect most workers from noise induced hearing loss over a 40-year career. [24] ACGIH's exposure limits are recommendations based on the most current science, though OSHA's standard still allows employers to expose workers to a maximum permissible exposure level (PEL) of 90 dBA for eight hours each day under 29 CFR 1910.95. OSHA also a 5 dBA exchange allowing this to increase to 100 dBA for four hours of work or decrease to 85 dBA when working a 16-hour shift. Casino workers were generally found to be exposed to an eight hour TWAs noise level of 76.4-81.8 dBA. Another key takeaway of the noise evaluation of the casino was that the highest noise detected was in the children's arcade with levels reaching 78 – 84 dBA. [28]

Metal dust from coin counting

In 2000, NIOSH was asked to evaluate a casino for metal dust after employees reported eye, nose, and airway irritation that they thought might be related to the process used to count metal coins. NIOSH evaluated the air and employees for nickel, copper, and zinc because these metals make up the vast majority of modern US coins. All levels were below the NIOSH recommended exposure limit (REL), specifically nickel was 7 μg/m3 (REL 15 μg/m3), copper was 24 μg/m3 (REL 1,000 μg/m3), and zinc was below the limit of detection (REL 5,000 μg/m3). [29]

Shift work

Those who work the night shift are known to be at increased risk of insomnia, disease, and death. [20] Studies of casino shift workers have found increased emotional and behavioral problems in their children as well as a six-times higher rate of divorce in men with children who have been married less than 5 years. Women with children were also three times more likely to get divorced while performing shift work at casinos. However, there was no increased rate of divorce in couples without children who performed shift work at casinos. [20] [30] A 2012 study by the Kansas Health Institute recommended that casinos try to minimize this risk by keeping each worker on a consistent shift, rather than rotating them between days and nights. It stated that if shift rotation must occur, it is better to rotate employees forward from day into evening shifts. [20]

An increased frequency of breast cancer of 35% [31] [32] has also been found in women who work night shifts. [33] [34] [35]

Injuries

Efficiently dealing or running table games often require workers to perform the same motion over and over for many hours, potentially causing repetitive strain injuries. [36] The repeated lifting and reaching needed to successfully run table games may lead to musculoskeletal injury (MSI). [37] Musculoskeletal injuries in casino workers are most common in the upper extremity, back, and legs. [27] A table with a softer edge for the dealer to lean against will decrease nerve compression in the upper extremity. [27] Carpal tunnel, a disorder caused by compressing the median nerve as it passes through the wrist into the hand, has been found more frequently in table game dealers. [27] [38]

In casinos, burns most commonly occur in preparation or delivery of foods, beverages, or oils since liquid or steam at only 155°F can burn or scald the skin.

Emotions can run high during gambling and this, combined with alcohol, which is often provided for free while playing, can lead patrons to become aggressive and agitated toward the staff or other players, potentially leading to assault and battery.[ citation needed ] Casinos also frequently have large amounts of money present, increasing the possibility of a robbery that can put an employee in a dangerous situation. [36]

Psychosocial hazards

Casino workers have had panic attacks at work when the casino is understaffed. [39] They are also known to be at higher risk for gambling problems, alcoholism, and depression than the average person. [20]

Related Research Articles

<span class="mw-page-title-main">Noise</span> Unwanted sound

Noise is unwanted sound considered unpleasant, loud, or disruptive to hearing. From a physics standpoint, there is no distinction between noise and desired sound, as both are vibrations through a medium, such as air or water. The difference arises when the brain receives and perceives a sound.

<span class="mw-page-title-main">Isocyanate</span> Chemical group (–N=C=O)

In organic chemistry, isocyanate is the functional group with the formula R−N=C=O. Organic compounds that contain an isocyanate group are referred to as isocyanates. An organic compound with two isocyanate groups is known as a diisocyanate. Diisocyanates are manufactured for the production of polyurethanes, a class of polymers.

<span class="mw-page-title-main">Personal protective equipment</span> Equipment designed to help protect an individual from hazards

Personal protective equipment (PPE) is protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or infection. The hazards addressed by protective equipment include physical, electrical, heat, chemicals, biohazards, and airborne particulate matter. Protective equipment may be worn for job-related occupational safety and health purposes, as well as for sports and other recreational activities. Protective clothing is applied to traditional categories of clothing, and protective gear applies to items such as pads, guards, shields, or masks, and others. PPE suits can be similar in appearance to a cleanroom suit.

Occupational noise is the amount of acoustic energy received by an employee's auditory system when they are working in the industry. Occupational noise, or industrial noise, is often a term used in occupational safety and health, as sustained exposure can cause permanent hearing damage. Occupational noise is considered an occupational hazard traditionally linked to loud industries such as ship-building, mining, railroad work, welding, and construction, but can be present in any workplace where hazardous noise is present.

<span class="mw-page-title-main">Occupational hygiene</span> Management of workplace health hazards

Occupational hygiene is the anticipation, recognition, evaluation, control, and confirmation (ARECC) of protection from risks associated with exposures to hazards in, or arising from, the workplace that may result in injury, illness, impairment, or affect the well-being of workers and members of the community. These hazards or stressors are typically divided into the categories biological, chemical, physical, ergonomic and psychosocial. The risk of a health effect from a given stressor is a function of the hazard multiplied by the exposure to the individual or group. For chemicals, the hazard can be understood by the dose response profile most often based on toxicological studies or models. Occupational hygienists work closely with toxicologists for understanding chemical hazards, physicists for physical hazards, and physicians and microbiologists for biological hazards. Environmental and occupational hygienists are considered experts in exposure science and exposure risk management. Depending on an individual's type of job, a hygienist will apply their exposure science expertise for the protection of workers, consumers and/or communities.

The permissible exposure limit is a legal limit in the United States for exposure of an employee to a chemical substance or physical agent such as high level noise. Permissible exposure limits are established by the Occupational Safety and Health Administration (OSHA). Most of OSHA's PELs were issued shortly after adoption of the Occupational Safety and Health (OSH) Act in 1970.

<span class="mw-page-title-main">Chemical hazard</span> Non-biological hazards of hazardous materials

Chemical hazards are typical of hazardous chemicals and hazardous materials in general. Exposure to certain chemicals can cause acute or long-term adverse health effects. Chemical hazards are usually classified separately from biological hazards (biohazards). Main classifications of chemical hazards include asphyxiants, corrosives, irritants, sensitizers, carcinogens, mutagens, teratogens, reactants, and flammables. In the workplace, exposure to chemical hazards is a type of occupational hazard. The use of protective personal equipment (PPE) may substantially reduce the risk of damage from contact with hazardous materials.

<span class="mw-page-title-main">Occupational hazard</span> Hazard experienced in the workplace

An occupational hazard is a hazard experienced in the workplace. This encompasses many types of hazards, including chemical hazards, biological hazards (biohazards), psychosocial hazards, and physical hazards. In the United States, the National Institute for Occupational Safety and Health (NIOSH) conduct workplace investigations and research addressing workplace health and safety hazards resulting in guidelines. The Occupational Safety and Health Administration (OSHA) establishes enforceable standards to prevent workplace injuries and illnesses. In the EU, a similar role is taken by EU-OSHA.

<span class="mw-page-title-main">Health Hazard Evaluation Program</span>

The Health Hazard Evaluation (HHE) program is a workplace health program administered by the National Institute for Occupational Safety and Health (NIOSH). NIOSH developed the HHE program to comply with a mandate in the Occupational Safety and Health Act of 1970 to investigate workplace health hazards reported by employers and employees. According to Section 20(a)(6) of the Act, the Secretary of Health and Human Services is authorized "following a written request by any employer or authorized representative of employees, to determine whether any substance normally found in the place of employment has potentially toxic effects in such concentrations as used or found."

The US National Institute for Occupational Safety and Health funds the Adult Blood Lead Epidemiology and Surveillance (ABLES) program, a state-based surveillance program of laboratory-reported adult blood lead levels. In 2009, the ABLES program updated its case definition for an Elevated Blood Lead Level to a blood lead concentration equal or greater than 10 micrograms per deciliter (10 µg/dL). This chart shows CDC/NIOSH/ABLES Elevated blood lead level case definition in perspective.

Workplace health surveillance or occupational health surveillance (U.S.) is the ongoing systematic collection, analysis, and dissemination of exposure and health data on groups of workers. The Joint ILO/WHO Committee on Occupational Health at its 12th Session in 1995 defined an occupational health surveillance system as "a system which includes a functional capacity for data collection, analysis and dissemination linked to occupational health programmes".

<span class="mw-page-title-main">Physical hazard</span> Hazard due to a physical agent

A physical hazard is an agent, factor or circumstance that can cause harm with contact. They can be classified as type of occupational hazard or environmental hazard. Physical hazards include ergonomic hazards, radiation, heat and cold stress, vibration hazards, and noise hazards. Engineering controls are often used to mitigate physical hazards.

<span class="mw-page-title-main">Occupational safety and health</span> Field concerned with the safety, health and welfare of people at work

Occupational safety and health (OSH) or occupational health and safety (OHS), also known simply as occupational health or occupational safety, is a multidisciplinary field concerned with the safety, health, and welfare of people at work. These terms also refer to the goals of this field, so their use in the sense of this article was originally an abbreviation of occupational safety and health program/department etc. OSH is related to the fields of occupational medicine and occupational hygiene.

<span class="mw-page-title-main">Safe-In-Sound award</span>

The Safe-in-Sound Excellence in Hearing Loss Prevention Award is an occupational health and safety award that was established in 2007 through a partnership between the National Institute for Occupational Safety and Health (NIOSH) and the National Hearing Conservation Association (NHCA). In 2018, the partnership was extended to include the Council for Accreditation in Occupational Hearing Conservation (CAOHC).

Occupational cancer is cancer caused by occupational hazards. Several cancers have been directly tied to occupational hazards, including chimney sweeps' carcinoma, mesothelioma, and others.

<span class="mw-page-title-main">Occupational hearing loss</span> Form of hearing loss

Occupational hearing loss (OHL) is hearing loss that occurs as a result of occupational hazards, such as excessive noise and ototoxic chemicals. Noise is a common workplace hazard, and recognized as the risk factor for noise-induced hearing loss and tinnitus but it is not the only risk factor that can result in a work-related hearing loss. Also, noise-induced hearing loss can result from exposures that are not restricted to the occupational setting.

A psychosocial hazard or work stressor is any occupational hazard related to the way work is designed, organized and managed, as well as the economic and social contexts of work. Unlike the other three categories of occupational hazard, they do not arise from a physical substance, object, or hazardous energy.

Engineering controls are strategies designed to protect workers from hazardous conditions by placing a barrier between the worker and the hazard or by removing a hazardous substance through air ventilation. Engineering controls involve a physical change to the workplace itself, rather than relying on workers' behavior or requiring workers to wear protective clothing.

<span class="mw-page-title-main">Occupational dust exposure</span> Occupational hazard in agriculture, construction, forestry, and mining

Occupational dust exposure can occur in various settings, including agriculture, construction, forestry, and mining. Dust hazards include those that arise from handling grain and cotton, as well as from mining coal. Wood dust, commonly referred to as "sawdust", is another occupational dust hazard that can pose a risk to workers' health.

Occupational hazards of fire debris cleanup are the hazards to health and safety of the personnel tasked with clearing the area of debris and combustion products after a conflagration. Once extinguished, fire debris cleanup poses several safety and health risks for workers. Employers responsible for fire debris cleanup and other work in areas damaged or destroyed by fire are generally obliged by occupational safety and health legislation of the relevant national or regional authority to identify and evaluate hazards, correct any unsafe or unhealthy conditions and provide any necessary training and instruction and personal protective equipment to employees to enable them to carry out the task without undue exposure to hazards. Many of the approaches to control risk in occupational settings can be applied to preventing injuries and disease. This type of work can be completed by general construction firms who may not be fully trained specifically for fire safety and on fire hazards.

References

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National Occupational Research Agenda, Service Sector Council, 2018.

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