Occupational Health 16 deaths per day: Matewan (union meeting): Young Worker injury: os.asp?ReportID=34939 Triangle Shirtwaist Fire: The Race to the Bottom:

Introduction Occupational disease: any abnormal condition or disorder, other than one caused by occupational injury, caused by work- related factors. Occupational injury: injury resulting from exposure resulting from a single incident in the work environment.

Scope of the Problem: Global 2.6 billion workers 250 million occupational injuries/year 330,000 fatalities 1.1 million worker deaths each year from work-related illnesses 160 million new cases of diseases resulting from the worker’s environment

Scope of the Problem: U.S. 14 people die of work-related injuries each day in the U.S. About 5000 people/yr. Fatalities have declined significantly over past 100 years: 23,000 (1913); 14,000 (1968); 4,600 (2010). Economic impact of occupational injuries, illnesses, and deaths: $142 billion in Importance of occupational safety and health to the community  safety and health of surrounding community is closely linked to workplace safety and health.

History of Occupational Safety and Health Problems 1561: De Re Metallica (G. Agricola) – mining hazards, need for ventilation) 1700: Discourse on Diseases of Workers (Ramazzini) Industrial Revolution State legislation –Child labor laws –Workers’ compensation laws Federal legislation –Bureau of Labor (1884) –Many related laws from 1908 to 1970 –Occupational Safety and Health Act of 1970

Highlights of Federal Occupational Safety and Health Legislation YearLegislation 1908Federal Workmen’s Compensation Act (limited coverage) 1916Federal Highway Aid Act 1926Federal Workmen’s Compensation Act (included workers) 1927Federal Longshoremen’s & Harbor Workers’ Compensation Act 1936Walsh-Healey Public Contracts Act 1952Coal Mine Safety Act 1959Radiation Standards Act 1960Federal Hazardous Substances Labeling Act 1966National Traffic & Motor Vehicle Safety Act Child Protection Act ( banned hazardous household substances) 1967National Commission on Product Safety created 1968Natural Gas Pipeline Safety Act 1969Construction Safety Act Coal Mine Health & Safety Act 1970Occupational Safety & Health Act 1986Worker Right to Know Act (part of SARA, Superfund II)

Industrial Revolution Serious environmental and workplace health/safety problems. Govt. and industry did little. Earliest unions take on H & S issues –(e.g. Knights of Labor, Industrial Workers of World) take on H & S. Struggles over community and worker health  started first in community, led by activists with access to legal and scientific assistance.

Progressive Era ( ) Community/worker health struggles. –Started in communities, led by activists linking to legal, scientific assistance. Mining, textile mills, foundries Alice Hamilton ( ) –Health researcher, came out of settlement movement (middle/upper class women, promoted better housing, sanitation, public health) Workers Health Bureau (1920s) –Organized by women activists to promote worker health and safety

“Those who know don’t tell” (film about worker health and safety) Why do companies hide the truth? (about cause of worker death/injury, information/knowledge about chemicals, etc.) –It’s cheaper not to tell. Workers are too fearful to protest. It would damage company reputation. Instead, companies push the cost of health onto society  they externalize the cost to the workers and society.

“Those who know don’t tell” (film about worker health and safety) In late 19 th century/early 20 th century, workers were getting sick and dying. Govt. did nothing. Workers protested. Employers take safety short-cuts. e.g. boss turns off air monitor alarm in microchip plant, so that workers will continue working. Not enough safety focus in workplaces. Hawk’s Nest/Gauley Bridge disaster ( ): workers dropped dead of acute silica inhalation. Workers rely on themselves to monitor air and their health. Alice Hamilton was early health and safety crusader.

“Those who know don’t tell” (film about worker health and safety) When a worker died, the company would typically hide the cause of death. Workers join together to change things: unions, workers, community, public health activists. “Mules got treated better than workers.” Established unions (United Mineworkers, Steelworkers, Chemical Workers) gained control of hazards, pushed for better conditions. Accident prevention can happen with a more educated staff, including production workers. Occupational health doctors advanced in 1970s, as some unions (Oil, Chemical and Atomic Workers, United Steelworkers) trained them.

“Matewan” ( film by John Sayles, 1988) Coal mine conflict (Coal Wars), , West Virginia. Companies, together with government, sought to break the unions and their organizing efforts. Joe is a union organizer, trying to unite local whites, African-Americans, Italian immigrant workers. Joe tries to help workers see their class interests (the workers work, management doesn’t). Formation of class consciousness that will help workers and the union to overcome the company’s efforts to divide and conquer the workers.

Solidarity Both “Those who know don’t tell” and “Matewan” demonstrate that “an injury to one is an injury to all.”  the basic message of the labor movement and the worker health and safety movement in the U.S. “An injury to one is an injury to all” = solidarity on part of workers and communities for one another.

Alice Hamilton, workplace health researcher

Resurgence of Health and Safety Reform/Activism (1950s-60s) Irving Selikoff – medical research on asbestos hazards. Mining hazards, accidents, illnesses. Haphazard state regulations. 14,000 deaths/year. 1960s social movement era (civil rights, environmentalism) – pushed along H & S reforms. Union leadership on H & S reform  –Oil, Chemical & Atomic Workers, United Auto Workers

Irving Selikoff, MD, workplace health researcher

Irving Selikoff Addressed the cover-up by the asbestos industry of the long-known hazards of asbestos for workers. Worked closely with labor unions. Helped to develop occupation health clinics.

Tony Mazzocchi, labor activist, Oil, Chemical & Atomic Workers

Tony Mazzocchi Built coalitions with scientists, public health advocates, environmentalists in 1950s against atmospheric atomic bomb testing. Powered the 1960s movement of labor/environment/public health for passage of the OSH Act (1970) and creation of OSHA. Created training program for doctors to become occupational health physicians, bringing together medical doctors and labor. Forged labor/environmental coalitions throughout the 1970s, 80s, 90s.

Occupational Safety & Health Act of 1970 Purpose: to ensure that employers in the private sector provide employees with a working environment free of recognized hazards that can cause death or serious harm. Creates the “General Duty Clause”: –The employer must provide a work environment free of recognized hazards  that is, the employer must provide a safe workplace. The employer is ultimately responsible for providing a safe workplace. –Employees must work safely. Formed Occupational Safety & Health Administration (OSHA): to create & enforce occupational standards Formed National Institute for Occupational Safety & Health (NIOSH): research body now in CDC; recommends standards

Karen Silkwood, Oil, Chemical and Atomic Workers

Karen Silkwood Whistleblower about sloppy conditions at a Kerr- McGee nuclear facility in Oklahoma. Killed before she could reveal information about corporate deception and health and safety shoddiness to a New York Times reporter (1974). Her struggle and death demonstrates power of corporations to silence whistleblowers and avoid accountability. An unsung hero for standing up for health and safety.

Key Worker Health and Safety Rights 1.Right to work in a workplace free of recognized hazards. The OSHA General Duty Clause: employer must provide a workplace free of recognized hazards. 2.Right to refuse hazardous work. 3.Right to not be discriminated against for exercising health and safety rights (e.g. filing a complaint). 4.Right to know about health and safety hazards you are working with. 5.Right to health and safety training.

Hierarchy of Controls, Workplace health and safety 1.Eliminate/reduce the hazard (e.g. substitute a safer chemical) 2.Engineering controls (e.g. use ventilation to remove the hazard) 3.Administrative controls (e.g. work practices such shifts or rotations to reduce exposures to hazards) 4.Personal Protective Equipment (e.g. respirators, suits and gloves)

Recent Trends in Workplace injuries and illnesses Decline in number of injuries and illnesses reported in private industry since Goods-producing industries have higher rate of non-fatal injury than service-producing. –Highest: agriculture, forestry, fishing, hunting. –Highest service-producing: education, health care.

Injuries/fatalities in workplace Fatalities: 5,214 fatalities (2008) –#1 cause: transportation –#2 cause: struck-by object, caught-in/between –#3 cause: assaults, violent attacks –#4 cause: falls –Most homicides  robbery motivated Types of injuries: –Motor vehicle crashes, machinery injuries, assaults, falls, electrical injuries –Leading anatomical site: hands and fingers.

Fatal Work-Related Injuries Highway incidents leading cause –Falls, being struck by object, homicide Industries with highest rates of fatal occupational injuries Agriculture Forestry Fishing and hunting Mining Transportation and warehousing

Manner of Fatal Work Injuries, 2008

Nonfatal Workplace Injury and Illness Incidence Rates by Industry, 2008

Nonfatal Work-Related Injuries Males account for majority of treatment Younger workers highest nonfatal workplace injury/illness rate Disabling injuries and illnesses –Repeat trauma disorders

Characteristics of Workers Involved in Work-Related Injuries Age Gender Poverty and race Geographic differences in workplace injuries Temporal variations in workplace injuries Workplace injuries by industry and occupation

Workplace injuries by age younger workers (<25)  higher rates than older workers injury death rates highest in oldest workers (>65) 100,000 children (many employed illegally) injured each year.

Unintentional Injuries in the Workplace Number and rate of fatal occupational injuries by age of worker, © Data from U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.

Hours Worked and Fatal Work Injuries by Gender, 2008

Most Dangerous Jobs in 2008

Workplace injuries by gender Males injured more than females, every age. Men more likely fatally injured than women. Homicides  half of women’s work-related deaths

Workplace injuries by income and race Lower socioeconomic groups  higher death rates Injury death rates 12% higher for non- whites than whites. Highest death rates: Native Americans. Asian Americans: low injury death rates.

Workplace injuries by geography Highest injury death rates in mountain states (Wyoming) and Alaska Highest farm machinery injuries in North Central states.

Workplace injuries by industry, occupation Highest fatality rates: mining, fishing, agriculture, construction, transportation Most dangerous blue collar jobs: timber workers, crab fishermen

Workplace Unintentional Injuries: Prevention and Control 1.Eliminating or modifying the job 2.Changing the work environment 3.Making machinery safer 4.Improving the selection, training, and education of workers

Workplace Violence Homicides are 3 rd leading cause of death after motor vehicle crashes. Homicides are 2 nd leading cause of death among women workers. Most workplace homicides (85%) are robbery- related. Hospitals, nursing homes, social service agencies are prone to non-fatal assaults. Risk factors: working near money/valuables, working alone, working late at night. Prevention: change environmental design, work policy, worker behavior.

Occupational Diseases 430,000 cases reported each year. #1: Chronic musculoskeletal diseases (trauma to muscles, joints, tendons). Leading cause of workplace disability. Most costly. #2: Dermatological conditions. Contact dermatitis, skin cancer, infections. #3: Occupational lung diseases. Inhalation of toxic substances.

Occupational lung diseases Long latency period Pneumoconiosis: fibriotic lung disease caused by inhalation of dusts: –Asbestosis: 1,265 die each year. –Black lung (coal dust) disease (54%) –Silicosis (crystalline silica), 15%. –Byssinosis (brown lung disease), cotton dust, 20 deaths.

Other occupational diseases Neurological disorders Reproductive disorders Cardiovascular disorders Cancer deaths, from workplace exposures Bloodborne pathogens (big concern for health care workers)

Controlling occupational diseases Vigilance of employer, employee, government is essential. Specific controls needed to control disease. Occupational disease control programs require trained personnel

Resources for Prevention of workplace injuries and diseases Safety and health professionals –Safety engineers and safety professionals  education, correct and remove hazards –Health physicists  monitor radiation –Industrial hygienists  examine workplace environmental factors –Occupational physicians  preventive medicine. –Occupational health nurses

Resources for Prevention of workplace injuries and diseases Safety and health programs: hire and maintain healthy workers. Pre-placement exams. Disease prevention programs: control diseases. Safety programs: reduce injuries. Health promotion programs: boost morale and productivity, reduce medical costs. Employee Assistance Programs: assist employees in overcoming personal problems.

Prevention and Control of Occupational Diseases and Disorders Agent-host- environment model –Identification and evaluation of agents –Procedures –Engineering controls –Protective devices –Surveillance AgentEnvironment Host

MassCOSH volunteer testifying at a hearing calling for a better teen labor law

Social Movements Create Change Labor movement and urban reform movements  raised awareness and built pressure for better health and safety conditions at work, Progressive Era and later too. 1960s social movements created a dynamic to push through changes in health and safety laws: federal OSH Act, Mining Safety Act (MSH Act). Social movements respond to disasters (mines, plant explosions, fires)  push through new laws.

Social Movements Create Change Health and safety heroes: Alice Hamilton, Tony Mazzocchi, Irving Selikoff. Coalition builders between unions and public health. Environmental/workplace health and safety coalitions are important for change, forcing new regulations, enforcement. e.g. Workers Health Bureau (1920s), OSH Act coalition (late 1960s), right-to-know movement (1980s).

Social Movements Create Change Worker and Community Right-to-Know Acts (part of SARA (Superfund part 2, 1986)  resulted from broad activism by labor and environmental activists. Social movements pushed Congress to act  they force regulations into being. Tragedies/disasters help spur action, e.g. Bhopal chemical release (1984); Farmington, WV mine disaster (1968); Sago mine disaster (2006), Triangle Shirtwaist Co. fire (1911). But some tragedies are quickly forgotten (e.g. Hawk’s Nest)

Weakness of Social Movements Labor union membership has been in decline since 1960: 32% (1960) to 12% (2010), percent of workforce in unions. While Labor is vocal, it has lost overall political clout. The environmental movement is weak and fragmented, much weaker than when it successfully pushed through SARA and Community Right-to-Know (1986).

Failure of Regulation Backlash of industry against OSHA regulation since 1970s. OSHA’s power and effectiveness undermined by a small budget (smaller than U.S. Fish and Wildlife Service). Up to 2008, only 1500 OSHA inspectors nationwide (Spain has 1500, but 1/6 of the population)  can’t do an effective job of enforcing regulations. OSHA under Pres. Obama raised OSHA inspectors to about 2,400.

Failure of Regulation Industry and Republican administrations, since 1980, have forced OSHA to move away from enforcement of regulations toward voluntary compliance with regulations. Industry is powerful and will fight back: e.g. ergonomics standard; asbestos research by Dr. Irving Selikoff. A long, hard effort (10 years) to establish an OSHA ergonomics standard (to combat repetitive stress injuries) finally succeeded in 2000 (under Clinton), only to be thrown out in early 2001 by President Bush.

Summary Overall improvement in workplace health and safety in U.S. since 1960s, since OSHA Act was passed. But passage of new regulations and enforcement of many current regulations are thwarted, undermined by powerful industry elites and their allies in federal government. The real cost of health and safety (illness, injury, fatalities) has been shifted (“externalized”) onto workers, their families and communities.

Summary Backlash on workplace health and safety, and environmental activism. Worker and Community Right-to-Know Acts (1986), part of SARA law, were the last substantial health and safety and environmental legislation in U.S.  the power of capital (owners of means of production) has held labor and environmentalism in check.