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Occupational Safety & Health Enforcement:

Views on the near futureby the Work Environment Department

University of Massachusetts Lowellto the US Government Accountability Office

March 31, 2009

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Occupational Safety & Health Administration (OSHA)

I. Current strengths & weaknesses

II. Recommendations1. Support comprehensive health & safety

programs at all workplaces

2. Strengthen and update enforcement initiatives

3. Prevent musculoskeletal disorders through efficient design and work organization

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Occupational Safety & Health Administration (OSHA)

The Occupational Safety and Health Act of 1970 authorizes OSHA to set occupational safety and health standards, rules, and regulations and to enforce their compliance.

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OSHA Functions

• Enforcement primarily by compliance officers to inspecting employer work sites

• Compliance assistance: encourage employers to work with OSHA to reduce hazards, foster safer and healthier working conditions

- incentives: free consultations, recognition for exemplary safety and health systems, exemption from routine inspections

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OSHA Strengths

• Key rules since 1972: asbestos, cotton dust, inorganic lead, bloodborne pathogens ⇒ reduced exposures and illnesses

• Inspections and enforcement ⇒ reduced injury rates in industries studied

Baggs J, Silverstein B, Foley M. Am J Ind Med 2003 May; 43(5):483-94.

Silverstein M. Am J Public Health 2008 Mar; 98(3):416-23.

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OSHA Weaknesses

• Rates of severe cases steady since early 1970s

• Number of fatalities increased from – falls

– highway incidents– struck by objects

Silverstein M 2008

7US Bureau of Labor Statistics, US Dept of Labor 2008. Census of Fatal Occupational Injuries & Illnesses.

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Barriers to OSHA Enforcement• Few inspectors

– nearly decrease 30% since 2007 – 1% of workplaces inspected yearly

• Small penalties – ($100s for serious violations)

• Many trivial rules• Few new substantial rules• No standards for causes of most common

fatalities, serious injuries– workplace violence– ergonomics Madland D, Walter K. Enforcing Change: Five Strategies for the Obama Administration to

Enforce Workers’ Rights at the Department of Labor. December 2008, Center for American Progress Action Fund.

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Madland and Walter 2008

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Case Studies

11 www.thebravest.com/FDNYNewsArchive/1008/23f.htm, accessed March 26, 2009.

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Failures Post 9/11

• Asbestos, glass, concrete hazardous chemicals pulverized then cooked

• Emergency medical technician died • EPA downplayed the hazards

• OSHA did not require respirators ⇒ preventable lung disease

• Worker lawsuits on failure to provide safety equipment

Barab J. World trade center workers still suffering three years later. Confined Space 2004.spewingforth.blogspot.com/2004/09/world-trade-center-workers-still.html, accessed March 26, 2009.

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Preventable Post 9/11 Problems

• Wheezing, shortness of breath, sinusitis, asthma

• New syndrome: “WTC cough,” persistent cough accompanied by severe respiratory symptoms.

• Almost all firefighters experienced respiratory effects

• Hundreds had to end their firefighting careers

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Hurricane Katrina Reconstruction

www.thedailygreen.com/cm/thedailygreen/images accessed March 26, 2009.

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Hurricane Katrina Reconstruction

Miguel, Guatemala:“He considered himself one of the lucky ones. ‘I’m

not worried about my health. I’ve been fine so far. I’m fortunate to have this face mask from a previous job [about 5 weeks earlier]. I wound up keeping the mask.’ He used it because there was a lot of mold in the walls of the houses he was cleaning and gutting. ‘Sometimes,’ he said, ‘we are issued suits, you know, the white suits.’ When I asked Miguel if he knew why it was important to have the proper safety equipment, he wasn’t too sure.”

Aguilar T, Podolsky L. Risk Amid Recovery. 2006 Labor Occupational Safety and Health Program.

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Failure Post Katrina

• Mold, toxic exposures, safety hazards• 19% interviewed said not given protective equipment for dangerous work• Skin rashes, “Katrina cough”• Workers and residents continued to be exposed

to high levels of heavy metals (arsenic, zinc, barium, cadmium), diesel range organics, polycyclic aromatic hydrocarbons (benzo[a]pyrene and benzo[b]fluoranthene).

Aguilar 2006, Barab 2004

MSNBC www.msnbc.msn.com

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Vulnerable Workers

• Immigrant and temporary workers without clear employment relations

• Lack of access to medical services• Wage violations, harassment, threats of

deportation, denial of access to shelter facilities

Aguilar 2006, Barab 2004

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Handling asbestos:

“When they did ask their supervisor for personal protective equipment (PPE), they were told that since the company had not gotten paid by FEMA, it couldn’t buy such gear.”

Aguilar 2006

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Katrina contractor preferred to hire day laborers to avoid “providing them safety equipment or handle any administrative costs. He saw it as a ‘win-win’ situation. He said that it ‘was understood’ that the workers, since they were ‘independent contractors,’ would provide their own ‘tools and anything else, including safety gear like goggles, gloves.’ However, given that most workers in Lee Circle that morning did not have any such protective gear, this didn’t appear to be a shared understanding.”

Aguilar 2006

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Post-Disaster Obstacles

OSHA

• Could not collect usable data on injuries & illnesses

• Could not ensure that all workers’ needs for training, protective gear, and mental health services were met

• Was often not invited to assist by other agencies

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Spotlight on Underlying Problems

• Not “special emergency cases”:

• Cleanup work without protection for 9 months after 9/11

• OSHA did not resume regular enforcement south of Interstate 10 in Mississippi until June 28, 2006

Barab 2004

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These Problems Continue

• 877 construction trades fatalities in 2007: 355 from falls, 163 from contact with objects and equipment US Bureau of Labor Statistics 2008, CFOI.

• Contingent employment, “independent contractor” misclassification, intimidation of immigrants, continue to contribute

• DOL’s “investigative procedures are generally not designed for individuals in nonstandard work arrangements such as day laborers.” GAO 2002

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Independent Contractors

• Independent contractors in total employed workforce grew from 6.7% in 1995 to 7.4% percent in 2005: 10.3 million

• DOL detects misclassification of employees as independent contractors by investigating complaints

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Key Question

How can the Department of Labor/OSHA prevent these problems in upcoming planned major construction projects?

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Some Recommendations

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1. Support comprehensive health & safety programs at all

workplaces

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Health & Safety Systems

• Mandatory safety and health committees– Management commitment– Employee participation

• Training – require training for all jobs like the 10-hour OSHA

construction course

• Exposure assessment, Hazard control– ‘Continuous improvement’ approach to improving

conditions through exposure assessment and hazard elimination

• Medical surveillanceSilverstein M 2008

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Health & Safety Committees

• Already mandated by some states• Worker participation can:

– resolve OSH issues– reduce industrial disputes– assist with OSHA compliance– increase employee knowledge of OSH– Improve morale and productivity

• Evidence that good h&s committees lead to reduced injury ratesMorse et al. New Solutions 2008;18(4):441-57. Brosseau LM et al. J Occup Environ Med. 2007; 49:338–45.

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Enforcement is needed, but strict enforcement alone is not enough

• Average workplace inspection every 88 years – school cafeterias have 2 food safety inspections/year– underground coal mines have 4/year

• An increasingly service-based economy means complex, variable workplaces– home healthcare among fastest growing industries

• Outsourcing and contingent workers becoming the norm

Silverstein M 2008image: www.wickedlocal.com/brockton/archive/x8997584

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An Alternative: 3rd Party Inspections

• Require workplaces to obtain annual certification of OSHA compliance– By licensed professionals– Not replacement for enforcement– Analogous to hospital accreditation, aircraft

inspection, etc.

Silverstein M 2008

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Viewing worker safety & health separately from environmental

health limits both

• Avoid “risk shifting” – solving a problem in the workplace by dumping it outside– or the reverse – limiting environmental

pollution but increasing worker exposures

• The best way to control health risks of toxins: eliminate the toxin altogether

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Build Broad, Long-Term Infrastructure

• Revive New Directions

• Partner with groups such as workers centers

• Build academic capacity

• Build network of technical assistance for small businesses

• Build occupational health clinics

Silverstein M 2008

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Count all Occupational Injuries and Illnesses

• Increase funding for Federal and State-based public health tracking programs– Provide the evidence base for demonstrating

effective/ineffective interventions

• Include occupational injuries and illnesses in NHIS, BRFSS, other surveys

• Require occupation and work-relatedness fields in electronic health records systems

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Prevent Exposure to Toxic Chemicals

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One-by-One Regulation Doesn’t Work• Thousands of chemicals have little or no safety

information

• New hazards are introduced faster than

epidemiologists can study them

• Government agencies and citizens are very

weak, new regulations are rare

• Corporations aggressively block regulation

• - Including through manipulation of the

scienceKriebel D. Cancer Prevention through a Precautionary Approach to Environmental Chemicals.Lowell Center for Sustainable Production Presentation, March 6, 2009

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Example: Benzene1897: recognized as hazard 1910: start of epidemic of aplastic anemia 1928: published case of leukemia1948: no safe level of exposure1970s: excess leukemia documented with low

levels of exposure1987: standard set based on “economic feasibility”delay in setting standard ⇒ extra 198 deaths from

leukaemia, 77 from multiple myeloma

Infante PF. Benzene: an historical perspective on the American and European occupational setting. 38-51 in Harremöes et al eds., Late lessons from early warnings: the precautionary principle 1896–2000, 2001, European Environment Agency.

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Uncontrolled Risk Affecting Public

Benzene in gasoline → health effects in

• gasoline vendors

• mechanics• public using lawn equipment

Lesson:

Dangers of waiting for precise quantitative dose-response association before acting

Infante 2001

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Workplace Toxins Affect Everyone

• We live and play near industrial facilities and hazardous waste sites

• Vulnerable populations especially exposed at work and in neighborhood

• In 2006 released or disposed of 820 million pounds of known or suspected carcinogens.

• Products in daily life: pressed wood (formaldehyde), paint strippers (methylene chloride)

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Alternative: Precautionary Principle

• Taking preventive action in the face of uncertainty

• Shifting burden of proof to proponents of an activity

• Exploring wide range of alternatives to possibly harmful actions

• Increasing public participation in decision making

(from Wingspread Conference, 1998)

Kriebel 2009

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Precautionary PrincipleCase Studies

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Massachusetts Toxics Use Reduction Act (TURA)

• First comprehensive pollution prevention bill in U.S. (1989)

• Requires firms who use more than a certain amount of listed toxic chemicals to:– Certify a Toxics Use Reduction Planner– Prepare a Toxics Use Reduction Plan: how and why toxic

chemicals are used, evaluate options – Report the quantities of toxic chemicals used, generated as

byproducts, shipped in, or as product

• No mandated bans or limits on any chemicalswww.TURI.org

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Massachusetts Toxics Use Reduction Act (TURA)

• Companies voluntarily reduced toxics while maintaining competitive advantage

• Office of Technical Assistance and Technology (OTA) provides confidential technical assistance

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TUR Approaches

• Input substitution: changing to nontoxic or less toxic alternatives

• Product reformulation: reformulating end products to be less toxic upon use, release, or disposal

• Production unit modernization

• Recycling, reuse, or extended use of toxics

www.TURI.org

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TURA Results

• Since 1990 Massachusetts industries subject to reporting have reduced– toxic chemical use by 40%– byproducts by 71%– Releases on site by 91%

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TURA Successes

Acushnet Rubber, New Bedford MA

• cut air emissions of methylene chloride, trichloroethylene, and Freon by > 50 tons/year, saving over $100,000 in chemical costs alone.

• saved $1.75 million/year in water and sewer costs, $160,000 by reducing energy consumption

Texas Instruments Inc, Attleboro MA• reduced trichloroethylene from 850 tons/year to < 2 tons• eliminated > 2 million pounds of anhydrous ammonia• cut use of cyanide compounds from 35,000 lbs per year

to 5,000

www.TURI.org

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Sustainable Hospitals Project (SHP) at UMass Lowell

Pollution Prevention – Occupational Safety and Health (P2OSH)

SHP worked with hospitals to • replace mercury-containing equipment and

products with non-mercury alternatives• prevent down-the-drain disposal of mercury...But what motivated the hospitals?Large fines and costs (up to $360,000)

This brings us to…Quinn MM et al. J Occup Environ Hygiene 2006; 3:182-93.

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2. Strengthen and update enforcement initiatives

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Visible Top-Level Support

Increase

• number of inspectors

• funding for compliance • fines and penalties

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Increase Fines and Penalties

• Adjust fines with inflation

• Stop automatic reductions for small companies, etc.

• Allow “per instance” citations

• Allow criminal penalties for serious willful violations

• OSHA fines are often so low that they are seen as a minor cost of doing businessMadland and Walter 2008

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New Standards for Priority Hazards

• Construction-related confined spaces

• Excessive noise

• Combustible dust • Respirable crystalline silica

• Aerosol infectious agents

Harrison R et al. Protecting workers on the job. American Public Health Association 2009.

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Protect Employee Rights

Enforce existing legal rights to

• file complaints, accompany inspectors

• be informed about hazards• and be protected from discrimination

Promote stronger rights for workers to

• refuse unsafe work

• initiate legal action for workplace hazardsSilverstein M 2008

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Reprisal = Key Hazard

Fear of job loss, blacklisting, retaliation common barrier to reporting hazards and injuries, especially for vulnerable workers

“They say if I get sick, they will take it out of my pay. One time I did take a day off because of feeling sick due to the [floor stripping] chemicals. Sometimes these chemicals make me get nose bleeds and sick to my stomach and my vision gets blurry. I try to work anyway but one day I was too sick and I couldn’t come into work. My supervisor threatened to fire me if I stayed home again.” Janitor

Lashuay N and Harrison R. Barriers to Occupational Health Services for Low-Wage Workers

in California. University of California 2006.

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When retaliation is reported...1205 whistleblower cases filed for OSHA

issues in 2007

• Only 19% of cases were ruled in favor of whistleblower

• resolution 41-182 days (selected cases)

• inaccurate, incomplete data

• investigators lack equipment, training, legal assistance

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Leverage Resources

• Strategically target high-violation sectors

• Partner systematically with organizations that know workplaces (community groups, labor unions)

• Revive rapid response teams

• Inspect multiple locations of employer with violations

Madland and Walter 2008

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Protect Vulnerable Populations

Hire and train to obtain investigators

• with multi-lingual skills

• with firsthand work experience• from diverse cultural backgrounds

• with knowledge of issues facing elderly, young, disabled, and immigrant workers

Madland and Walter 2008

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Abuse of Immigrants Harms All Workers

• Poor conditions for immigrant workers results in hazardous conditions for all

• Need a firewall between health & safety enforcement and immigration enforcement

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3. Prevent musculoskeletal disorders through efficient

design and work organization

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Musculoskeletal disorders

• MSDs = largest cause of disability, leaving workforce

• Frequent causes:– heavy work– work in awkward positions– long hours, noise,

– repetitive muscle strain

Albertsen K et al. Scand J Public Health 2007; 35:78-85.

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Musculoskeletal disorders

• 38% of 1.16 million illnesses/injuries reported for private industries due to overexertion or repetitive motion US BLS, www.bls.gov/news.release/osh2.t06.htm

• Highly underreported Punnett L. J Occup Environ Med. 2000;42(10):470-81.

• MSDs costly: medical care, wage loss, productivity, disability, diminished quality of life

• Reduce productivity among clerical workers

• Musculoskeletal conditions among roofers strongly associated with work limitation, missed work, reduced physical functioning → leaving workforce

Welch L. Scand J Work Environ Health 2009 Feb; 5(1):56-64.

Welch 2009

Hagberg M et al. Ergonomics 2007;50(11):1820-34.

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• >50,000 claims per year• 32% of all accepted industrial insurance claims

(state fund + self insured)• More than 50% of lost work day claimsCosts• Annual Direct Costs (medical care & partial

wage replacement) = $410 Million• Plus Indirect Costs (reduced productivity &

product quality, increased training)• Annual Total: > $1 Billion Silverstein M. Ergonomics and Regulatory Politics: The Washington State Rule. 2005.

MSDs In Washington State

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Ergonomics means fitting the job to the worker

Silverstein M 2005

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Ergonomics is not new...A centuries-old safety and

efficiency problem.

Silverstein M 2005

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A 19th-century ergonomic solution -

safer and more efficient

Silverstein M 2005

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Musculoskeletal disorders are preventable!

• Ergonomics interventions can reduce disability by several months Anema JR et al. Occup Environ Med 2004;61:289–94.

• Estimated at least 50% of work-related MSDs could be prevented by appropriate ergonomic job designPunnett 2000

• To regulate, Congress would needto repeal ban on anErgonomics StandardKotelchuk D, in NYCOSH 2009

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Looking to the Future

• Protect all workers at all upcoming stimulus projects

• Return occupational safety & health to central place in public health

• Look towards prevention and precaution

• Act aggressively against the most common disabling hazards