1. Barbara Materna, PhD, CIH, Chief Occupational Health Branch CIHC Annual Meeting – December 4, 2006 Update from the Occupational Health Branch, CA Dept. of Health Services

2. Overview Intro to the Occupational Health Branch New California Department of Public Health Activities in 3 key areas How to contact us

3. OHB Programs & Leaders Occupational Health Branch Barbara Materna, PhD, CIH, Chief Hazard Evaluation System and Information Service Julia Quint, PhD, Chief Occupational Health Surveillance and Evaluation Program Robert Harrison, MD, MPH, Chief Occupational Lead Poisoning Prevention Program Michael DiBartolomeis, PhD, Chief HESIS established in 1978 OHSEP - 1985 OLPPP - 1991

5. Role of Public Health Elevated California Department of Health Services California Department of Public Health California Department of Health Care Services Effective 7/1/2007 Division of Env. & Occ. Disease Control Occupational Health Branch

6. OHB Focus Areas & Project Examples New and emerging health & safety issues –Lung disease in food flavoring workers Special needs of low-wage, immigrant, and underserved workers –Fatalities among Latino workers Protecting both workers and the environment from toxic substances –Partnering on asthma –Partnering on pollution prevention

7. Serious Lung Disease Linked to Diacetyl (butter/food flavor chemical) NIOSH investigations in microwave popcorn industry & animal toxicity studies 2004: 1 st case of bronchioloitis obliterans found in CA in flavor manufacture OHB assisted Cal/OSHA Medical Unit, began industry-wide focus April 2006: 2 nd case found

8. Outreach Effort Initiated Diacetyl Hazard Alert in English and Spanish Case summaries, resources, customized letters to employers, health care, worker organizations Outreach hampered by lack of info on diacetyl users Phone survey to locate all CA manufacturers (30)

9. Industry Special Emphasis Program Collaboration between OHB, Cal/OSHA Consultation, NIOSH & industry trade association Companies to have IH assessment, medical monitoring & implement controls – or get inspected OHB to evaluate medical surveillance programs & results, follow up with suspect cases

10. Disease Highlights H&S Gaps Hazard information withheld by manufacturer for years; not listed on many MSDSs Not all employers acted on 2003 NIOSH Hazard Alert & other outreach efforts calling for: –Medical surveillance programs –Local exhaust ventilation –Respirator programs –Hazard communication Health care providers misdiagnose serious breathing problems in young nonsmokers who handle diacetyl & other flavor chemicals

11. Additional Diacetyl Activities NIOSH technical assistance to recommend engineering control solutions Petition & Advisory Committee for diacetyl standard CDHS collected inadequate MSDSs for referral OHB project with UCSF to assess & improve spirometry quality Need for outreach to food manufacturing industries (users of diacetyl-containing flavors)

12. Investigating Latino Fatalities for Prevention NIOSH-funded OHB project based in Los Angeles 187 Latinos killed statewide in 2005 (41% of total) Collecting new information during investigations Focus on identifying causes & ways to prevent incident

13. Case Example: Death of 17-year-old Latino Laborer Worker was guiding forklift driver moving pallets into curing oven. On the job for 1 month; generic safety training only. ID said his age was 21. Flimsy pallets collapsed. Worker crushed by falling material.

14. Recommendations Made Ensure use of pallets that support weight of items stored. Ensure employee training on safe work practices – and verification of skills through testing. Establish work policies that comply with youth employment standards. Employers should:

15. More Outreach to Latino Workers Translating more materials into Spanish Partnering with other organizations for distribution Speaking at industry & professional meetings to reach employers of Latinos

16. Partnering on Asthma Prevention OHB has identified & investigated cases of work-related asthma since 1993 Many agents affect both workers & others in the same environment OHB works with others in CDHS & a broad coalition on statewide asthma prevention efforts

17. Occupations with Highest Asthma Rates & Related Exposures Correctional officers Firefighters Special ed teachers Health technicians Welfare eligibility clerks Respiratory therapists Machine operators Chemical technicians Police supervisors Bus drivers Pepper spray, smoke, dust Smoke Mold, dust, indoor pollution Glutaraldehyde, paint, latex, dander, dust, cleaning chemicals Roofing tar, paint, dust Latex, cleaning chems, glutarald. Solvents, inks, acids, glues Solvents, inks, isocyanates, HCs Pepper spray, mold, smoke Diesel exhaust Work-related Asthma in California, 1993-2004 (N=3,479)

18. Workplace Asthma Integrated into Statewide Prevention Efforts Collaborating with environmental health & others: www.CaliforniaBreathing.org Updating state Strategic Plan for Asthma Evaluating new data sources to ID work-related cases: –hospital discharges –emergency depts. –Workers’ Comp Info System

19. Partnering on Pollution Prevention Pollution prevention consistent with IH goal of eliminating / substituting out hazards, or controlling at the source Environmental & occupational health professionals often work in “silos” -- can result in unintended, conflicting outcomes OHB linking with environmental groups & agencies to support efforts that protect the environment and workers

20. Evaluating Use, Toxicity & Safer Alternatives for New Solvents U.S. EPA-funded collaboration with the Institute for Research & Technical Assistance Studied uses and toxicity of 5 solvents & assessed possible safer alternatives: –N-propyl bromide (NPB or 1-bromopropane) –N-methylpyrollidone (NMP) –Decamethylcyclopentasiloxane (D5) –Parachlorobenzotrifluoride (PCBTF) –1,2-trans-dichloroethylene (DCE)

21. N-Methyl Pyrrolidone in Paint Strippers Marketed as “safer” alternative to methylene chloride in paint strippers NMP is a Prop 65 developmental toxicant, not regulated in workplace Less toxic benzyl alcohol- based strippers shown to be acceptable alternative

22. Occupational Health Internship Program Interns hosted in SF Bay area & Los Angeles: www.aoec.org/OHIP www.aoec.org/OHIP Focus on field experience, learning workers’ perspective on H&S OHB projects on: –Heat illness –Silica in bricklaying –Restaurant hazards –Garment work & ergonomics

23. Seeking new staff in OHB Industrial hygienist for asthma & pesticide illness prevention projects (open now, www.phi.org) www.phi.org Research Scientist III for Safe Cosmetics Program (new civil service position)

24. Contacting OHB Website: www.dhs.ca.gov/ohbwww.dhs.ca.gov/ohb Sign up for email list by sending your info to occhealth@dhs.ca.gov occhealth@dhs.ca.gov 850 Marina Bay Pkwy., Bldg. P, Richmond, CA 94804; (510) 620-5757 Telephone helplines, toll-free for CA callers: –Workplace Hazard Helpline: (866) 282-5516 –Lead in the Workplace Information Line: (866) 627-1587 –Asthma & Pesticide Illness Helpline: (800) 970-6680