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Occupational Health

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Occupational Health 16 deaths per day: http://www.youtube.com/watch?v=pssw5bnjnr4 Matewan (union meeting): http://www.youtube.com/watch?v=qwEMIvDEFy4 – PowerPoint PPT presentation

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Title: Occupational Health


1
Occupational Health
  • 16 deaths per day
  • http//www.youtube.com/watch?vpssw5bnjnr4
  • Matewan (union meeting)
  • http//www.youtube.com/watch?vqwEMIvDEFy4
  • Young Worker injury
  • http//www2.worksafebc.com/Publications/Multimedia
    /Videos.asp?ReportID34939
  • Triangle Shirtwaist Fire The Race to the
    Bottom
  • http//www.usw.org/media_center/news_articles?id0
    739

2
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.

3
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 workers environment

4
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 2006.
  • Importance of occupational safety and health to
    the community ? safety and health of surrounding
    community is closely linked to workplace safety
    and health.

5
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

6
Highlights of Federal Occupational Safety and
Health Legislation
Year Legislation
1908 Federal Workmens Compensation Act (limited
coverage) 1916 Federal Highway Aid
Act 1926 Federal Workmens Compensation Act
(included workers) 1927 Federal Longshoremens
Harbor Workers Compensation Act 1936 Walsh-Healey
Public Contracts Act 1952 Coal Mine Safety
Act 1959 Radiation Standards Act 1960 Federal
Hazardous Substances Labeling Act 1966 National
Traffic Motor Vehicle Safety Act Child
Protection Act (banned hazardous household
substances) 1967 National Commission on Product
Safety created 1968 Natural Gas Pipeline Safety
Act 1969 Construction Safety Act Coal Mine
Health Safety Act 1970 Occupational Safety
Health Act 1986 Worker Right to Know Act (part of
SARA, Superfund II)
7
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.

8
Progressive Era (1890-1920)
  • Community/worker health struggles.
  • Started in communities, led by activists linking
    to legal, scientific assistance. Mining, textile
    mills, foundries
  • Alice Hamilton (1869-1970)
  • 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

9
Those who know dont tell (film about worker
health and safety)
  • Why do companies hide the truth? (about cause of
    worker death/injury, information/knowledge about
    chemicals, etc.)
  • Its 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.

10
Those who know dont tell (film about worker
health and safety)
  • In late 19th century/early 20th 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.
  • Hawks Nest/Gauley Bridge disaster (1931-32)
    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.

11
Those who know dont 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.

12
Matewan (film by John Sayles, 1988)
  • Coal mine conflict (Coal Wars), 1920-21, 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 doesnt).
  • Formation of class consciousness that will help
    workers and the union to overcome the companys
    efforts to divide and conquer the workers.

13
Solidarity
  • Both Those who know dont 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.

14
Alice Hamilton, workplace health researcher
15
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

16
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18
Irving Selikoff, MD, workplace health researcher
19
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.

20
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22
Tony Mazzocchi, labor activist,Oil, Chemical
Atomic Workers
23
Tony Mazzocchi
  • Built coalitions with scientists, public health
    advocates, environmentalists in 1950s against
    atmospheric atomic bomb testing.
  • Powered the 1960s movement of labor/environment/pu
    blic 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.

24
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25
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

26
Karen Silkwood, Oil, Chemical and Atomic Workers
27
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.

28
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.

29
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)

30
Recent Trends in Workplace injuries and illnesses
  • Decline in number of injuries and illnesses
    reported in private industry since 1992.
  • Goods-producing industries have higher rate of
    non-fatal injury than service-producing.
  • Highest agriculture, forestry, fishing,
    hunting.
  • Highest service-producing education, health
    care.

31
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.

32
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

33
Manner of Fatal Work Injuries, 2008
34
Nonfatal Workplace Injury and Illness Incidence
Rates by Industry, 2008
35
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

36
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

37
Workplace injuries by age
  • younger workers (lt25) ? higher rates than older
    workers
  • injury death rates highest in oldest workers
    (gt65)
  • 100,000 children (many employed illegally)
    injured each year.

38
Unintentional Injuries in the Workplace
Number and rate of fatal occupational injuries by
age of worker, 2002.

Data from U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.
39
Hours Worked and Fatal Work Injuries by Gender,
2008
40
Most Dangerous Jobs in 2008
41
Workplace injuries by gender
  • Males injured more than females, every age.
  • Men more likely fatally injured than women.
  • Homicides ? half of womens work-related deaths

42
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.

43
Workplace injuries by geography
  • Highest injury death rates in mountain states
    (Wyoming) and Alaska
  • Highest farm machinery injuries in North Central
    states.

44
Workplace injuries by industry, occupation
  • Highest fatality rates mining, fishing,
    agriculture, construction, transportation
  • Most dangerous blue collar jobs timber workers,
    crab fishermen

45
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48
Workplace Unintentional Injuries Prevention and
Control
  • Eliminating or modifying the job
  • Changing the work environment
  • Making machinery safer
  • Improving the selection, training, and education
    of workers

49
Workplace Violence
  • Homicides are 3rd leading cause of death after
    motor vehicle crashes.
  • Homicides are 2nd 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.

50
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53
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.

54
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56
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.

57
Other occupational diseases
  • Neurological disorders
  • Reproductive disorders
  • Cardiovascular disorders
  • Cancer deaths, from workplace exposures
  • Bloodborne pathogens (big concern for health care
    workers)

58
Controlling occupational diseases
  • Vigilance of employer, employee, government is
    essential.
  • Specific controls needed to control disease.
  • Occupational disease control programs require
    trained personnel

59
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

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62
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.

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64
Prevention and Control of Occupational Diseases
and Disorders
  • Agent-host-environment model
  • Identification and evaluation of agents
  • Procedures
  • Engineering controls
  • Protective devices
  • Surveillance

Host
Agent
Environment
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67
MassCOSH volunteer testifying at a hearing
calling for a better teen labor law
68
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.

69
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).

70
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. Hawks
    Nest)

71
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).

72
Failure of Regulation
  • Backlash of industry against OSHA regulation
    since 1970s.
  • OSHAs 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) ?
    cant do an effective job of enforcing
    regulations. OSHA under Pres. Obama raised OSHA
    inspectors to about 2,400.

73
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.

74
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.

75
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.
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