Evidence has been accumulating about the toll of prolonged sitting, and a new systematic review and meta-analysis published in the Archives of Internal Medicine shows just how harmful sedentary habits can be. University of Toronto researcher Aviroop Biswas and colleagues performed a quantitative meta-analyses on 41 studies that measured adults’ sedentary time and reported health outcomes directly associated with death, disease, or use of healthcare services.
Their findings won’t come as a surprise to anyone who’s been following this research. “Greater sedentary time was found to be positively associated with an increased risk for all-cause mortality, cardiovascular disease mortality, cancer mortality, cardiovascular disease incidence, cancer incidence, and type 2 diabetes incidence, “ Biswas and his co-authors write.
The meta-analysis also confirms something that researchers have been warning us about: Meeting the recommended guidelines for weekly physical activity isn’t enough to offset the damage from sitting still for several hours each day. We can’t just spend an hour at the gym and then go sit in front of a desk for 10 hours and think we’re leading a healthy life. The good news is that Biswar and colleagues found that adults with higher physical activity levels were able to reduce their risks of disease and death to some degree – but not entirely. They write:
Our study demonstrated that after statistical adjustment for physical activity, sedentary time (assessed as either daily overall sedentary time, sitting time, television or screen time, or leisure time spent sitting) was independently associated with a greater risk for all-cause mortality, cardiovascular disease incidence or mortality, cancer incidence or mortality (breast, colon, colorectal, endometrial, and epithelial ovarian), and type 2 diabetes in adults. However, the deleterious outcome effects associated with sedentary time generally decreased in magnitude among persons who participated in higher levels of physical activity compared with lower levels.
I’ve written before (here and here) about research that suggests breaking up stretches of sedentary time with relatively small amounts of activity may reduce the negative effects of sitting still. This suggests we need multiple forms of physical activity – both sustained aerobic activity that keeps our heart rates up, and frequent, less-intense activity so we’re not just sitting like lumps at our desks or in front of the television. For many of us, it’s not all that hard to get up and walk around periodically, but it will be challenging for anyone who drives vehicles for a living or is expected to be at a desk for hours at a stretch. Long commutes can also take a toll. The message from the research is clear, though: We need to be sitting less and moving more.
Study cited: Biswas A; Oh PI; Faulkner GE; Bajaj RR; Silver MA; Mitchell MS; Alter DA, Annals Of Internal Medicine, ISSN: 1539-3704, 2015 Jan 20; Vol. 162 (2), pp. 123-32.
Jason Strycharz, 40 suffered fatal traumatic injuries on Monday, January 23, 2015 while working at Primary Steel, LLC in Middletown, CT. AP reports:
- The incident occurred around 9 am.
- The fire marshal Albert Santostefano says the worker was struck by a piece of steel as it was swinging on a crane inside the warehouse.
NBC Connecticut quotes the fire marshal:
- “They were in the process of moving some steel around inside the warehouse part of the building, and somehow the steel got swinging. It was on a crane inside the warehouse and it struck one of the employees.”
Some news accounts report the incident occurred at Primary Steel which is located at the same address as Kloeckner Metals. Mr. Strycharz’s family indicated his employer was Primary Steel. Bloomberg Business Week indicates that Primary Steel was acquired by Houston-based Kloeckner Metals Corporation in 2010.
The company’s Code of Conduct reads:
“We endeavor at all times a healthy and hazard-free working environment for our employees. We therefore comply with laws and rules on health and safety in the workplace and actively examine and improve safety standards.”
But their safety record is not something to brag about when it comes to OSHA inspections. In just the last two years, 10 inspections have been conducted at Kloeckner Metals’ plants in CA, GA, NC, OH, PA and TN. (There are no records in OSHA’s on-line database to indicate inspections at the Middletown, CT facility, at least not since 1998.) Seven of the 10 inspections were instigated because of complaints or serious injury incidents. An inspection in 2014 at their plant in Cincinnati, OH, for example, resulted in three serious and one repeat violations related to failures in machine guarding and lockout/tagout procedures.OSHA proposed a $56,000 penalty. That inspection occurred after a worker suffered what OSHA described as a “catastrophic injury.” In a news release announcing the citations and proposed penalty, OSHA noted:
“The company knew how dangerous these machines could be, and they did not put their employees first. It’s a culture too common in the manufacturing industry, and it needs to change.”
Another inspection last year at the company’s Sante Fe Springs, CA location identified serious violations related to unsafely stacked heavy loads which could have collapsed or fallen, and machinery inadequately restrained from moving. Cal/OSHA proposed a $36,750. And there’s this which may foretell the circumstances that led to Jason Strycharz’s death: North Carolina OSHA issued citations in November 2014 to Kloeckner Metals related to three serious violations at its Charlotte, NC plant. The violations included industrial slings being loaded in excess of their rated capacities, loads not balanced to prevent slippage, and failing to keep workers clear of suspended loads. It’s difficult for me to see how violations of fundamental safety regulations jive with the Kloeckner Metals’ Code of Conduct. It also is why I get annoyed when work-related fatalities are reported as “accidents,” as if they couldn’t have been prevented.
Each year, about two dozen workers are killed on the job in Connecticut. The Bureau of Labor Statistics reports 26 work-related fatal injuries in Connecticut during 2013 (preliminary data, most recent available.) Nationwide, at least 4,405 workers suffered fatal traumatic injuries in 2013. The AFL-CIO’s annual Death on the Job report notes:
- Federal OSHA has 24 inspectors in Connecticut to cover more than ,88,000 workplaces.
- The average penalty for a serious violation in Connecticut is $1,735.
Federal OSHA has until the end of July 2015 to issue any citations and penalties related to the incident that stole Jason Strycharz’s life. It’s likely they’ll determine that Strycharz’s death was preventable. It was no “accident.”
by Anthony Robbins, MD, MPA
The final closing of the Vermont Yankee Nuclear Power plant in Vernon got few headlines outside Vermont, but for me it brought back a flood of memories and an important lesson. I am convinced that public involvement with nuclear power in Vermont was a factor preventing an accident over the plant’s life of more than 40 years.
From 1973 to 1976 I was the State Health Commissioner, and, due to a strange set of historical circumstances, Vermont had a special relationship to its nuclear utility. The Health Department took the lead for the State, assigning one full-time civil servant to Vermont Yankee.
It all started in the late ’60s, when the utility wanted to build a nuclear power plant alongside the Connecticut River in Vernon, about as far South as one can go in Vermont. Fearing delays during regulatory oversight of the plans, the utility wrote to then state Attorney General James Jeffords. The company made an unusual promise. It would comply with all state regulations. (At that time there were none dealing specifically with nuclear reactors). It would never invoke the preemption clause of the US Atomic Energy Act to challenge Vermont authority over the plant. Regulatory review went smoothly; in retrospect, perhaps more smoothly than it should have.
The utility bought a boiling water reactor from General Electric. The Vernon plant was similar to other GE boiling water reactors, but, as we learned, unique in several ways. Its one-of-kind design became central to debates about whether it was safe, as there were no identical plants with longer performance histories to look at. Most importantly, the torus was different, raising the question of what might happen in a loss of coolant event.
I knew little about generating electricity with nuclear reactors. I had been strongly opposed to nuclear weaponry–initially America’s use of uranium and plutonium fission weapons on the cities of Hiroshima and Nagasaki in Japan. I knew that President Eisenhower had created the Atoms for Peace Program to put the US nuclear weapons program in a more favorable light. But could nuclear power plants be run safely? Could radioactive wastes be stored safely for their centuries–long half-lives? On these questions, I was agnostic.
When I became Health Commissioner in 1973, there were many hotter health issues in the state, most of them concerning medical care, but not in Vermont’s southeast corner around Brattleboro. Down there, Vermont Yankee divided the community. The Health Department, too, was divided, but we were aware that because of the letter sent to Jim Jeffords, we seemed to share with the Federal Government responsibility for making sure that no Vermonters would be harmed by the new reactor.
There was no chance that Vermont would re-create in Montpelier or Brattleboro the scientific capacity of the Nuclear Regulatory Commission (NRC). (The regulatory agency was split off from the Atomic Energy Commission in January 1974.) So Vermont chose instead to piggyback our efforts on NRC oversight and make the process far more open. We asked that Vermont Yankee share with us all of their communication to and from the NRC. They complied.
We had one BS-level nuclear chemist who had worked for Union Carbide. David Scott was living in Rochester, Vermont and commuting to Barre, to the Health Department’s Occupational Health Office. His wife Pat was Brandon Town Manager. Dave took it upon himself to read all of the communications from the utility to the NRC and from the NRC to the utility. These became the basis for his weekly “inspection” trip to the plant in Vernon. Occasionally the utility was reporting “abnormal occurrences.”
Dave had many questions and didn’t always feel he was getting complete answers. Was the GE design amenable to precise control? Human errors seemed too easy to make in the complex control room. He once described to me the problem of running the Vernon boiling water reactor: “It is like asking someone trained to drive a big truck to take the wheel of a Ferrari on a narrow winding road.” Yet that was not the image that the utility conveyed. Dave felt uncomfortable, caught between Vermont Yankee and the NRC.
I asked the Attorney General, the Chairman of the Public Service Board, the Environmental Secretary, and the Civil Defense Director to join me and together constitute the Vermont Nuclear Advisory Committee. Scott staffed the group and I chaired it. We met monthly in an open meeting to review developments at Vermont Yankee. We asked the utility to send a representative and make a report to the advisory committee.
We often asked the same questions that the NRC had asked. How much radioactive waste was released into the river? What would happen were there a fire in the charcoal filters at the top of the stack? How much radiation was emitted as “turbine shine” and reached the elementary school across the street from the generating plant? Was local milk contaminated with strontium 90 (90Sr) from grass consumed by local cows? (90Sr emits beta-radiation, is metabolized like calcium, and concentrates in milk and then in bones.) The NRC usually accepted the responses from Vermont Yankee. The NRC had been part of the Atomic Energy Commission that had suffered from its conflicted roles of promoting nuclear power and keeping the public safe. The new NRC remained ambivalent. No one from the Health Department or the other state agencies felt that our role was to protect the utility.
Scott needed help, so we turned to Henry Kendall at the Union of Concerned Scientists in Cambridge, Massachusetts who was studying problems at an older power plant in Shippingport, Pennsylvania that had opened in 1958. We also worked with a couple of consultants who had managed nuclear reactors for the Navy. We learned that nuclear engineers from the Navy (and that would include President Jimmy Carter) were skeptical and questioning about how the AEC designed and managed reactors.
Scott even invited my boss, Human Services Secretary Tom Davis, down to Vernon where we looked at the reactor and the pools where spent fuel was to be stored until it could be moved out of state. For many weeks we remained amused by an exchange between the Secretary and the Yankee executive who took us on the tour. Tom pointed out that there was no state inspection card in the plant’s giant elevator. This seemed to unglue the folks from Yankee far more than the questions about radiation.
I also asked a medical school classmate, Peter Gibbons, who practiced radiology in Brattleboro to participate in discussions. He was trusted by the citizenry, understood the health effects of radiation, and could reflect local concerns. One member of the State Board of Health, Richard Waitt from Brattleboro, seemed particularly pleased to have the Health Department engaged with their local concerns.
For the most vocal opponent of nuclear power, the New England Coalition on Nuclear Pollution, we provided a public forum for raising further questions about the operations of Vermont Yankee and the safety of nuclear power generation more generally.
One person was particularly unhappy about the public process. That was Stella Hackel, the Democratic candidate for Governor in 1976. Candidate Hackel said she would fire me if she became Governor. She had been a lawyer for the utility.
Vermont surely had a different climate for the debate, but it is hard to say that Vermont had a safer nuclear power plant because of the public attention given to Yankee’s operation. In the last forty years, no utility has considered building a new nuclear plant in Vermont. The sale of Vermont Yankee to Entergy in 2002 was a drawn out process, and after the NRC’s 20-year extension of the plant’s operating license was challenged by the Legislature in 2010, Entergy tried to find a buyer for the plant. The state lost in Federal court in 2013, and Entergy abandoned the idea of selling the plant, choosing in 2014 to close it instead.
One wonders if, had the plants at Chernobyl, Three Mile Island, and Fukushima been subject to the same kind of public scrutiny as Vermont Yankee, whether the world would have been spared their disasters.
Anthony Robbins, MD, MPA is co-Editor of the Journal of Public Health Policy. (Facebook pagehere.) He directed the Vermont Department of Health, the Colorado Department of Health, the U.S. National Institute for Occupational Safety and Health, and the U.S. National Vaccine Program.
Rarely do poverty and optimal health go together. In fact, income is consistently tapped as a major factor underpinning a person’s opportunity to live a long and healthy life. And children don’t fare much better, with low-income children facing increased risks of poor health and development. So, just how many American children face this challenge today? Four out of every 10.
This month, researchers at the National Center for Children in Poverty at Columbia University Mailman School of Public Health released their annual “Basic Facts about Low-Income Children” fact sheet, which reports that 44 percent (31.8 million) of U.S. children younger than 18 lived in low-income families in 2013, and 22 percent (15.8 million) lived in families considered poor. (Low-income is defined as families with incomes less than two times the federal poverty threshold, or about $47,000 for a family of four; while poor families are defined as those with incomes below the threshold, or $24,000 for a family of four.) Those poverty numbers are far higher than they were before the Great Recession — in 2007, 39 percent of children were living in low-income families.
The fact sheet found that while the overall number of U.S. children increased by less than 1 percent between 2007 and 2013, the numbers of children living in low-income and poor families went up by 13 percent and 23 percent, respectively.
“Far too many American children live in economically insecure families, and this serious threat to our nation’s future does not get the attention it deserves,” said Renee Wilson-Simmons, the center’s director, in a news release.
Researchers, who based their findings on the latest data from the U.S. Census, also found that younger children are more likely to live in low-income and poor families than older children. For example, 5.8 million children ages 3 to 5 — or nearly half of the 3- to 5-year-old population — live in low-income families, compared to 41 percent of children ages 12 to 17. Black, Hispanic and American Indian children disproportionately live in low-income and poor households: 65 percent of black children live in low-income families, 63 percent of Hispanic children do, and 63 percent of American Indian children do. Comparatively, 31 percent, or 11.7 million, white children live in low-income families.
Noting that children who have parents with full-time, year-round employment are less likely to be low-income, the fact sheet reports that in 2013, 15.9 million children with at least one parent working full-time lived in low-income families. Nine percent, or 4.5 million, children with the same parental employment conditions lived in poor families. Among children with at least one parent who worked part-time or part of the year, 74 percent lived in low-income families and 48 percent lived in poor families. Also, living in a low-income family wasn’t confined to children whose parents had lower educational attainment: Forty-one percent of poor children in 2013 had at least one parent with some college education.
When it comes to health insurance coverage, low-income and poor older children are more likely to go uninsured than younger children. Researchers reported that in 2013, 10 percent of children in low-income families had no insurance, 27 percent of kids in low-income families had private health coverage and 68 percent of such children had public insurance. Geographically, the American South was home to the largest percentage of low-income children, followed by the West, Midwest and Northeast.
To download the entire fact sheet, visit the National Center for Children in Poverty.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
The AP headline read: “Regulators: Coal dust samples compliant with new rule.” The accompanying story was based on a news release issued by the Mine Safety and Health Administration on January 15. News outlets throughout US coal mining regions picked up the AP story. It said this:
Federal regulators say samples collected from U.S. mines last year found the lowest levels of breathable coal dust since stepped-up efforts aimed at reducing miners’ exposure. The U.S. Mine Safety and Health Administration says nearly 99 percent of samples taken from August through December at underground and surface mines were compliant with a new federal rule.
The “new federal rule” was issued by MSHA in April 2014 to address miners’ exposure to respirable coal dust and lung disease associated with it. It becomes fully effective in August 2016. The new rule includes reducing the permissible exposure limit (PEL) for respirable coal dust from 2.0 mg/m3 to 1.5 mg/m3, requiring continuous monitoring of coal dust levels, and eliminating the practice of using an average of five dust samples to determine whether a citation will be issued for violating the PEL.
The AP story headline “Coal dust samples compliant with new rule” caught my attention. I had to read MSHA’s announcement for myself. MSHA chief Joe Main wrote:
“The [annual] average dust level in samples collected by MSHA inspectors in 2014 dropped to an average of 0.70 mg/m3.That compares to 0.83 m/m3 in 2009.”
I thought it was a little funny seeing MSHA announce these findings by reporting “average dust level” to characterize workers’ exposure to coal dust. It’s been a contentious, two decades-long fight by MSHA to get away from a requirement to rely on the average of sample results to take enforcement action.
A key provision in its new regulations is being able to determine a mine operator’s compliance with dust limits based on the results of a single full-shift sample. The trouble with the old MSHA system was that workers doing certain jobs were overexposed to coal mine dust, but the average of samples from workers doing different tasks was not over the PEL. If the average result wasn’t over the PEL, the mine operator did not receive a citation to force correction of the dusty conditions.
This reporting by MSHA of the annual average coal dust level just seems strange. It’s like reporting the average speed limit on an interstate highway. The annual average speed may be 50 miles per hour. But what I’d like to know is how many times and the circumstances when vehicles are caught going 10, 20 or more MPH over the speed limit. MSHA telling us that in 2014 the annual average dust levels in coal mines was 0.7 mg/m3 seems meaningless.
The other thing that struck me in MSHA’s announcement was this:
For the period August 1 through December 31, 2014, “the dust samples collected by MSHA and mine operators… show extremely high compliance with the new standards, with 99% of the 23,600 valid samples meeting compliance levels.”
The trouble is, there is no new compliance level. The current exposure limit—2.0 mg/m3—remains in place. A more protective exposure limit of 1.5 mg/m3 will not take effect until August 2016. All the “99%” tells me is that US mine operators have no trouble whatsoever complying with a PEL that’s been in place for more than 30 years.
What would have been informative is the percentage of samples with dust concentrations at or below the pending 1.5 mg/m3 exposure limit. The mining industry has been moaning and groaning that adopting this more protective level is infeasible. But as MSHA noted in its final rule, for some key mining tasks more than 50 percent of samples collected by MSHA were not only below the 1.5 mg/m3 level, but already at levels at or below 1.0 mg/m3.
For 20 years, coal mine operators been allowed to run their operations with dust levels that NIOSH concluded would cause thousands of case of lung disease.I still can’t help but think that Labor Secretary Tom Perez and MSHA chief Joe Main missed an opportunity to require an even more protective 1.0 mg/m3 PEL.
As more research is emerging on the potential health effects of fracking, a new study — perhaps the largest to date of its kind — has found that people living near natural gas wells may be at increased risk for adverse health impacts, including skin and respiratory conditions.
Published in the January issue of Environmental Health Perspectives, the study is based on the self-reported health symptoms of nearly 500 people in 180 households in Washington County, Pennsylvania, a community home to some of the most long-standing and intense natural gas drilling activities. Researchers found that even when accounting for confounding variables, such as age, cigarette smoking, education level and occupation, residents who lived less than a kilometer away from a gas well reported more health symptoms than those living more than two kilometers away from a gas well. Peter Rabinowitz, a co-author of the study and an associate professor in the Environmental and Occupational Health Sciences Department at the University of Washington, said that to his knowledge, the study is the largest to examine general health conditions among people living near fracking sites.
“This doesn’t prove association,” Rabinowitz told me. “But we feel that it really adds significant evidence to questions of whether to keep looking at and taking seriously the potential for health effects (associated with fracking).”
To conduct the study, researchers used mapping technology to randomly select households that depend on naturally occurring water supplies — known in the study as ground-fed wells — which are vulnerable to fracking-related contamination. They literally went door to door, asking residents to participate in a general health study on residents’ health status. In fact, Rabinowitz said researchers purposefully did not describe it as a fracking study to help reduce any bias in participants’ responses. Rabinowitz added that compared to similar studies, this study went to great lengths to systematically eliminate selection bias — “we were open to seeing whatever the results may be,” he said. After gathering residents’ responses, researchers then mapped the distance of participating households to the nearest natural gas well. Here’s what they found.
The average number of reported health symptoms was greater among households located less than a kilometer from a gas well than in households more than two kilometers from a well. Residents living less than a kilometer from a gas well were also more likely to report skin conditions during the past year as well as upper respiratory symptoms. Even after adjusting for other health risk factors, such as smoking, household proximity to natural gas wells was still associated with increased health symptoms. The study did not find an association between proximity to a natural gas well and increased cardiac, neurological or gastrointestinal symptoms.
While the study did not undercover the exact causes of residents’ health symptoms, researchers hypothesized a number of possible contributors, such as exposure to certain chemicals via contaminated ground water, fracking-related air pollutants, and increased stress and anxiety associated with living closer to a gas well. Study authors Rabinowitz, Ilya Slizovskiy, Vanessa Lamers, Sally Trufan, Theodore Holford, James Dziura, Peter Peduzzi, Michael Kane, John Reif, Theresa Weiss and Meredith Stowe write:
Since most of the gas wells in the study area had been drilled in the past 5–6 years, one would not yet expect to see associations with diseases with long latency, such as cancer. Furthermore, if some of the impact of natural gas extraction on ground water happens over a number of years, this initial survey could have failed to detect health consequences of delayed contamination. However, if the finding of skin and respiratory conditions near gas wells indicates significant exposure to either fracking fluids and chemicals or airborne contaminants from natural gas wells, studies looking at such long-term health effects in chronically exposed populations would be indicated.
Rabinowitz told me that he was prepared to find no association between gas well proximity and health symptoms and was “somewhat surprised” at the results.
“It was very hard with previous studies to know how much was reporting bias versus a real effect,” he said. “We were prepared to see that as we controlled for bias, the effects would lessen.”
But that didn’t happen, and Rabinowitz said this most recent study underscores the need for ongoing health monitoring of those living near natural gas extraction activities to better understand potential health risks. In particular, he noted that greater study and surveillance of natural gas extraction workers would likely provide the most telling insights.
Overall, Rabinowitz told me that fracking-related health research is still very much in its infancy, though enough is known to justify precautionary steps. He noted that New York’s recent decision to move forward with a fracking ban, in which potential health risks were cited as a main justification, could help drive additional research efforts and highlight the importance of including public health experts in related policy discussions.
“We’re at a stage in which we know enough to recommend prudent precaution and exposure reduction,” he said. “We have a long way to go in terms of definitive studies and effective surveillance. We still don’t know what exposures are of greatest interest and how to best control and monitor those exposures.”
Rabinowitz noted that researchers followed the study’s participating households for two years — from 2012 to 2014 — and are in the midst of conducting a longitudinal assessment of potential health impacts. In addition, researchers are now analyzing data on agricultural and domestic animals living near fracking sites, as animals often serve as sentinels for environmental health hazards.
“When a significant new technology comes to an area, the public health impact needs to be considered,” he said. “In general, there’s always some trade-off between health impact and the introduction of a new technology and it’s important to know what that trade-off is going to be and how to manage it appropriately.”
To read a full copy of the new fracking study, visit Environmental Health Perspectives.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
In the week before his 2015 State of the Union address, President Obama took modest but important steps toward expanding US workers’ access to paid sick and family leave. Valerie Jarrett, Senior Advisor to President Obama and Chair of the White House Council on Women and Girls, broke the news with a blog post on LinkedIn, where she explained the importance of paid leave:
Anyone who has ever faced the challenge of raising or supporting a family, while holding down a job, has faced tough choices along the way, and likely felt stretched between the financial and personal needs of their family.
How many working parents know that sinking feeling from sending their child off to school with a fever? How many Americans have to show up to work when battling an illness even when they know they won’t be at their best, it will lengthen their recovery time, and they may likely spread their sickness to others? And how many moms and dads have been denied the ability to bond with their newborn, or to care for an aging parent, all because they could not afford to miss work? These are real, significant moments in life that nearly everyone faces at some point. The last thing we should do is add guilt, fear, and financial hardship on working parents as they try to do what’s right – while keeping their job.
On Thursday, President Obama did three things:
- Urged Congress to pass the Healthy Families Act – and encouraged cities and states to pass their own laws requiring employers to offer paid sick leave. The Healthy Families Act would require employers with 15 or more workers to allow employees to earn one hour of paid sick time for every 30 hours worked, up to seven days per year. The Act was first introduced in Congress by Representative Rosa DeLauro and Senator Edward Kennedy in 2004; Representative DeLauro and Senator Tom Harkin introduced it in the 113th Congress, but it has not yet been introduced in the 114th Congress.
- Announced a President’s Budget item of $2.2 billion to fund state efforts to create paid medical and family leave programs. California, New Jersey, and Rhode Island have all established social-insurance programs that use payroll-tax funding to cover a portion of missed pay for workers who need to take time off to care for a new child or another family member with serious health needs. President Obama’s budget will propose funding to help other states follow their examples. (The Department of Labor has already awarded some grants toward this purpose.) I’m surprised that President Obama did not take this opportunity to suggest that Congress pass the FAMILY Act, which would create such a social-insurance system at the federal level. The Washington Post’s Zachary Goldfarb suggested last year that Obama’s silence on this proposal might be due to his reluctance to support anything that qualifies as a middle-class tax increase. If that’s the case, the final two years of a president’s second term seems like an appropriate time for him to start supporting the best policy ideas, even if it leaves him open to criticism about breaking a promise on taxes.
- Supported paid parental leave for federal employees. In a Presidential Memorandum, President Obama directed federal agencies to ensure that employees can be advanced up to six weeks of sick leave for the birth or adoption of a child or for other sick leave eligible uses. This isn’t giving federal employees any more leave than they had before, but essentially allowing them to borrow against future accrued leave, which they will “re-pay” over time. Managers have had the discretion to do this in the past, but I imagine that cultures and practices in some agencies have made some workers fearful of requesting so much advanced leave, and some manager reluctant to grant the requests. The Memorandum directs the Office of Personnel Management to issue guidance on implementation within 90 days, and federal agencies to make any necessary changes to their policies 60 days after that. Only Congress can provide a new benefit of paid parental leave that employees can access in addition to the paid sick days they already earn. President Obama announced that he is proposing legislation, similar to the Federal Employees Paid Parental Leave Act introduced by Representative Carolyn Maloney in the 106th – 113th Congresses, that would allow federal employees six weeks of paid administrative leave for the birth, adoption, or foster placement of a child.
It’s important for the President to voice his support for state and federal legislation that would advance paid sick, medical, and family leave for the US workforce. The Presidential Memorandum doesn’t give federal employees any new benefits, but I expect that it will result in employees requesting and receiving more paid leave to care for the newest additions to their families. This latest announcement builds on President Obama’s past expressions of support for paid leave, including statements in his 2014 State of the Union address and at the June 2014 White House Summit on Working Families.
Paid sick leave enjoys widespread support, so it’s hardly surprising that a flood of positive reactions greeted President Obama’s latest announcement. The Center for Law and Social Policy commended the White House and noted that paid leave doesn’t only help families, but helps create a more effective workforce – something many employers already recognize:
“The Administration’s support for earned sick days and paid family and medical leave demonstrates a keen awareness of working families’ needs. Millions of Americans are currently losing wages and jobs in order to care for their families and their health,” said Liz Ben-Ishai, senior policy analyst at CLASP. “It is encouraging to see broad support for the president’s actions from all corners of our society, including both workers and employers. In fact, more than 340 employers have signed on in support of local and state earned sick days legislation and a growing number of business leaders are speaking in support of a federal proposal for paid family and medical leave.”
Yesterday, both Small Business Majority and the American Sustainable Business Council released statements in support of the president’s announcement. Business support for paid leave has been building for some time. Speaking about the benefits of earned sick days, Jennifer Piallat, owner of a bistro called Zazie, said: “Paid sick days have helped my workforce be healthy and productive and have helped my bottom line.” Her restaurant is located in San Francisco, which became the first city to pass an earned sick days law in 2007.
The American Public Health Association commended the administration’s proposal and highlighted the importance of paid leave for public health:
“Ensuring access to paid sick and family leave is vital to strengthening the well-being of our workers and their families, especially low-income workers who can least afford to get sick,” said APHA Executive Director Georges Benjamin, MD. “Not only will it give workers more flexibility in caring for their families, but allowing sick workers to stay home will also help prevent the spread of disease and allow working families time to access preventive care.”
The United States falls behind many other developed countries when it comes to providing paid family and medical leave, and is the only developed country that does not require employers to provide paid sick leave. According to a 2013 U.S. Department of Labor survey, only 12 percent of workers in the U.S. have access to paid family leave through their employers, and less than 40 percent have access to personal medical leave through an employer-provided temporary disability program.
APHA supports the Healthy Families Act and adopted a position calling on Congress to pass legislation that would expand paid medical and family leave for U.S. workers. In August 2014, APHA signed on to a letter urging members of Congress to co-sponsor the Family and Medical Insurance Leave Act of 2013, or FAMILY Act, which would create a national family and medical leave insurance program.
Of course, one of the most concrete demonstrations of support for paid sick, medical, and family leave is the fact that so many state and local legislatures have been passing their own laws to assure that workers don’t have to choose between their families’ health and their paychecks. Rhode Island’s temporary caregiver insurance system first took effect last year, after legislation passed in 2013. California and Massachusetts recently passed laws requiring employers (with some exceptions) to let workers earn and use paid sick days; both will take effect in July 2015. The growing list of cities with laws requiring paid sick days includes San Francisco, CA; Washington, DC; Seattle, WA; Portland, OR; New York City; Jersey City, NJ; Newark, NJ; Eugene, OR; San Diego, CA; and Passiac, NJ. I hope that one day we’ll be able to say that all US employees, regardless of where they live, can take time off work to care for their own health or that of a family member without worrying about missing pay or losing their jobs.
If you’re in the market for a paint remover and head to your local hardware store, most of the products you’re likely to find will contain methylene chloride. These products’ containers promise “professional results” – that they remove paint “in 10 minutes” – and that they are “specially formulated for antiques and fine furniture.” One called “Dad’s Easy Spray,” suggests it can be used to remove paint from fabrics and rugs. Also available are adhesive removers and “prepaint” products that contain methylene chloride. Some of these come in aerosol dispensers.
These products all carry hazard warnings that say “Danger!” and “Poison” along with cautionary statements about the chemical’s nervous system effects and the possibility that exposure can cause blindness, birth defects, cancer and respiratory harm. But there’s little – if anything – to suggest such products are so hazardous that they were responsible for at least 14 deaths in the United States between 2000 and 2011. Among those who died using these products was a man in Houston who was removing the finish from the walls of his bathroom; a worker removing paint from a church’s baptismal font; a worker hired to refinish an apartment bathtub; a worker cleaning a paint-mixing tank and the co-worker who tried to rescue him. Yet another such fatality occurred on December 16, 2014 when a worker in New York died while refinishing a bathtub.
Also called dichloromethane (DCM), methylene chloride is a potentially deadly neuro- and respiratory toxicant that may also cause cancer. Its acute effects can include skin, eye and respiratory irritation, headache, dizziness, nausea, depression of the central nervous system, lack of coordination, unconsciousness and death. Chronic effects include kidney, liver and central nervous system damage. The U.S. National Toxicology Program classifies methylene chloride as reasonably anticipated to be a human carcinogen while the International Agency for Research on Cancer (IARC) classifies it as possibly carcinogenic to humans. The U.S. Occupational Safety and Health Administration (OSHA) considers methylene chloride a potential occupational carcinogen. The U.S. Environmental Protection Agency (EPA) estimates that more than 230,000 U.S. workers are directly exposed to DCM from paint-strippers.
The Toxic Use Reduction Institute (TURI) at the University of Massachusetts Lowell also notes that “high, short-term exposures” to methylene chloride “can be lethal.” In addition, says TURI, methylene chloride’s “extreme volatility makes it especially dangerous since it is very easy to create unsafe airborne concentrations through evaporation.” Once in the body methylene chloride can be converted to carbon dioxide, which is toxic to the brain and nervous system. It can damage blood cells and has been linked to brain, liver and biliary system cancers. Animal studies have linked the substance to lung cancer and to breast and salivary gland tumors.
While such products continue to be sold in the U.S., the health risks associated with them prompted the European Union to prohibit sale of such methylene chloride-based products beginning in 2012. In 2013, citing “just two of many similar cases,” in which a worker died while refinishing a bathtub using a methylene chloride-based product, OSHA – along with the National Institute of Occupational Health and Safety (NIOSH) – issued a “Hazard Alert” for these products.
In an analysis of three deaths caused by methylene chloride exposure through paint-strippers, researchers with the California Department of Health (CDPH) concluded that “although the cases” they examined “involved occupational exposures, both products were consumer-available formulations, one of which was purchased at a local hardware store. DCM-containing paint strippers are sold in U.S. retail stores, placing consumers at risk for similar injury.” The researchers also note that these cases “illustrate that warnings alone do not ensure safety, and even personal protective equipment (such as respirators) may fail to protect.” The continued occurrence of fatal exposure to such paint-strippers, they write, “argues for a more aggressive regulatory approach to protect both workers and consumers.”
In August 2014 the EPA released its final risk assessment for DCM under the Toxic Substances Control Act. It found “health risks to both workers and consumers who use these products and to bystanders in workplaces and residences where DCM is used.” EPA is now considering what it calls “a range of possible voluntary and regulatory actions to address” these concerns.
In 2014, as part of its Safer Consumer Products Regulations, the California Department of Toxic Substances Control (DTSC) “identified” paint and varnish removers that contain methylene chloride as proposed “priority products.” If approved for listing as a “priority product,” manufacturers of these products would have to perform analyses to find safer alternatives and measures to reduce adverse health and environmental impacts. DTSC can – as part of its “regulatory response” to the outcome of the law’s “priority product” process – require that a hazardous product be taken off the market. California is expected to begin the rulemaking phase for the first proposed “priority products” by the end of March of 2015.
So are there safer alternatives to methylene chloride-based paint removers and if so, why are these exceptionally dangerous products still on U.S. store shelves?
In comments submitted to California DTSC in 2014, Savogran, a Massachusetts-based company that makes paint and varnish removers wrote, “No known substitute chemical removes paint as effectively as methylene chloride. The alternatives on the market are not functionally acceptable.” In its comments to the DTSC, the Halogenated Solvents Industry Association (HSIA) said similarly that no alternatives exist for DCM in these products. HSIA, which also suggested that federal and California occupational safety standards should be sufficiently protective, made similar comments to the EPA in 2013.
Meanwhile, the European trade association Eurochlor noted in an earlier white paper: “Chlorinated solvents have been used extensively for many years. During this time, the fatalities or serious injuries which have occurred have been due to massive over-exposure through a total disregard for good operating practices, or through deliberate misuse. When solvents are stored, used and disposed of correctly, there is no risk to human health.”
When it comes to other types of paint-removers, there are a number – like several found on my neighborhood hardware store shelves – that contain a chemical called N-methyl-2-pyrrolidone (NMP). According to Savogran’s coments to DTSC, these “performed reasonably well” but may not be truly safe because NMP is considered “a chemical of concern.” TURI deputy director Liz Harriman explains that “N-methly-2-pyrrolidone (NMP) is a reproductive toxin.” While products with NMP are for sale in the U.S., they are now being phased out in Europe due to toxicity concerns.
Meanwhile, the EPA is in the process of evaluating NMP and has released a draft risk assessment of the chemical. The assessment is not final but based on findings thus far, EPA says the agency recommends minimizing exposure to NMP-containing paint strippers.
So what’s out there besides paint-removers based on methylene chloride and NMP? To help potential users sort through the confusing array of product CDPH has developed a guide to such products that it shared during a presentation at the 2014 American Public Health Association meeting. It rates these products on a scale that goes from Red – “Not Recommended,” through Orange – “Use with extreme caution,” Yellow – “Use with caution,” to Green – “Preferred.” Among the products on this list include those based on benzyl alcohol, soy-based paint strippers, and others based on hydroxide, formic acid and various esters (dimethyl gluterate and dimethyl adipate).
CDPH found that most paint-removers now on the market fall into the red, “not recommended” category. They also found that most workers are now using “red” category products. Workers interviewed also reported experiencing symptoms that include chemical burns, skin, eye and respiratory irritation, headaches and dizziness while using these products.
CDPH researchers also investigated how well retailers and product users understood the relative safety of these products and precautions required for safe use. They found – not surprisingly – that retailers were hazy on the details, assumed that contractors and other professionals knew how to use all such products safely, and that personal protective equipment would provide adequate protection. CDPH also found that contractors said they wanted to have the ongoing option of using DCM-based products and were surprised that available alternatives were not 100 percent safe. Workers surveyed by CDPH reported that a paint-remover made without methylene chloride worked far less well than one containing DCM.
At the same time, the CDPH survey found conractors and retailers reporting a decrease in sales and use of DCM-based products. Despite this apparent trend, the CDPH researchers concluded: “Consumption [and] demand will not shift unless policy and regulations change and R&D [research and development] rushes in to meet new demand.”
So where does this leave US workers and do-it-yourselfers?
While Europe has banned methylene chloride-containing paint-removers and is phasing out a hazardous replacement, U.S. store shelves remained filled with the most toxic of these products. While waiting for the outcome of regulatory deliberations, the EPA “recommends that consumers check” product labels and take precautions to reduce exposures. At the same time, California public health experts have concluded that warnings – and current regulations – offer inadequate protection. And so, this situation raises what are now familiar questions about the U.S. chemical regulatory system’s ability to restrict even the most obviously hazardous substances.
Elizabeth Grossman is the author of Chasing Molecules: Poisonous Products, Human Health, and the Promise of Green Chemistry, High Tech Trash: Digital Devices, Hidden Toxics, and Human Health, and other books. Her work has appeared in a variety of publications including Scientific American, Yale e360, Environmental Health Perspectives, Mother Jones, Ensia, Time, Civil Eats, The Guardian, The Washington Post, Salon and The Nation.
Local New Jersey officials integrate worker safety into restaurant inspections; collect new insights on occupational risks
Food safety is at the top of the list for local restaurant inspectors in Rockaway Township, New Jersey. Recently, however, inspectors tested out the feasibility of adding a new safety checkpoint to the menu — the safety of restaurant employees. The effort was a success and one that organizers hope will ultimately lead to safer working conditions for food service workers statewide.
“Workers need a voice,” said Peter Tabbot, health officer for the Rockaway Township Division of Health. “This is a small way that we can help provide a bit of that voice.”
The new occupational health and safety effort is a collaboration between the Division of Health and the Office of Public Health Practice at Rutgers School of Public Health. According to Mitchel Rosen, director of the Office of Public Health Practice, he and his colleagues had been discussing the idea of integrating workplace safety into the restaurant inspection process for some time and approached the health department about piloting such an intervention. The result is a 16-point checklist (adapted from a similar effort in San Francisco) that takes less than 10 minutes to implement on site as well as new data and insights into the potential — and preventable — hazards that workers face.
Tabbot said that because health department inspectors are the only ones routinely monitoring health and safety at local restaurants, they’re uniquely positioned to improve worker safety.
In a presentation about the effort during the American Public Health Association’s (APHA) 142nd Annual Meeting last November in New Orleans, Rosen and Tabbot noted that there are few studies on the occupational health and safety risks facing restaurant workers, who are often foreign-born, typically earn low wages and are rarely unionized. At the same time, restaurant workers often work long hours in hazardous environments and many don’t receive proper safety training, lack health insurance and don’t have access to paid leave for illness and injury. According to a 2012 report from the Center for Poverty Research and Center for Health Care Policy and Research at the University of California-Davis, in 2010, food service and preparation workers experienced workplace-related injuries and illnesses that cost more than $2 billion in medical care and lost productivity. Restaurant workers can experience a range of work-related injuries, such as cuts, burns, strains, sprains and other musculoskeletal injuries.
“One reason we did this is because we don’t have a lot of information (on restaurant workers) other than national statistics, but we know there’s a significant occupational group at risk here,” Tabbot told me. “We know there are risks, but we also know it’s a group that wouldn’t necessarily reach out to the health department.”
Rockaway inspectors (officially known as environmental health specialists) piloted the new workplace safety checklist from September 2013 to February 2014 during the regular inspections of full-service restaurants. During that pilot period, 47 of the jurisdiction’s 232 full-service restaurants received an inspection that included the new workplace safety checklist. The checklist, which was developed to facilitate an observational assessment that doesn’t require inspectors to interview workers or management, included questions such as:
- Do workers have dry potholders, gloves, mitts or rags to prevent burns?
- Are range tops overcrowded with cookware?
- Are there non-slip mats/floors? Is there proper storage for knives?
- Is there adequate ventilation?
- Do slicing machines, grinders or food processors have machine guards?
- Are minimum wage and worker’s compensation posters visible where employees can read them?
Rosen said that collecting baseline workplace safety information was a primary goal of the pilot project as well as determining whether inspectors could easily integrate the checklist into their work. In fact, Tabbot and Rosen said inspectors were involved in the project from the beginning to ensure that the new checklist wouldn’t compromise their relationships with restaurant owners or impede their primary duties. Tabbot noted that engaging inspectors from the start was key to gaining their active support.
“Because we included them from the very first discussion, we had their buy-in from the get-go,” Tabbot said. “They really invested themselves in it and really did embrace it.”
During the APHA meeting, Tabbot and Rosen presented the results of the pilot project. Here are some of the findings:
- 58 percent of restaurants inspected did not display posters with minimum wage information where workers could read them
- 62 percent did not visibly display worker’s compensation posters
- 62 percent did use non-slip mats
- 61 percent employed proper storage for knives
- 83 percent did not have anything blocking the exits
- 65 percent had fully stocked first aid kits available to workers
- 71 percent used dry potholders to prevent burns.
Overall, Rosen said about two-thirds of restaurants included in the pilot project scored “fairly well” on the safety checklist.
“But we can do better than that and we should be doing better than that,” he told me.
Because the pilot phase zeroed in on collecting information, inspectors did not discuss checklist results with owners or managers unless they observed an imminent danger, such as a blocked exit, Tabbot said. Plus, there are few restaurant-related occupational health and safety standards on the books that local public health officials can actually enforce, he noted. (Rosen added that there were no legal issues involved with piloting the checklist, which was well within the authority of local public health officials.)
While Rosen and Tabbot said new regulations aren’t always the answer — for example, because local inspectors have such good relationships with restaurant owners, simply making safety recommendations could result in safer work environments — they said expanded use of the checklist as well as richer data could impact policy. For instance, Rosen noted that if more health departments adopt the checklist and gather related workplace safety data, local health officials could make a much stronger case for developing more robust statewide protections for restaurant workers.
The Rockaway Township Division of Health plans to continue using the safety checklist later this year.
“A lot of times, workers don’t know they deserve any rights — they’re happy to have a job or find it difficult to speak up and say ‘we need better protections,’” Rosen told me. “But (a project like this) takes the burden off the worker and puts more of the burden on the owner to ensure a safe and healthy workplace.”
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Richard Johnson, 31 suffered fatal traumatic injuries on Monday, January 12, 2015 while working at Southwest Fabrication’s facility in Phoenix, AZ
- It was the worker’s last shift at the company (he was moving on to a new job.)[His aunt alerted me that this report is incorrect.]
- “His clothes got entangled in a metal fabrication machine.”
- A former employee indicated he was involved in a serious incident at the plant in September 2014. ‘No one ever talked to me about safety or how to use the equipment. … ‘My shirt got caught around the spinning bar. I was pulled into the machine. Eventually, my shirt ripped off and I got free.’”
- The incident occurred around 8:30 am.
- The company, which has 50 employees, was cited in 2005 by Arizona OSHA for two safety violations.
Each year, about 100 workers in Arizona are fatally injured on-the-job. The Bureau of Labor Statistics reports 90 work-related fatal injuries in Arizona during 2013 (preliminary data, most recent available.) Nationwide, at least 4,405 workers suffered fatal traumatic injuries in 2013.
The AFL-CIO’s annual Death on the Job report notes:
- Arizona OSHA has 30 inspectors to cover more than 130,000 workplaces.
- The average penalty for a serious violation in Arizona is $891.
Arizona OSHA has until the end of mid-July 2015 to issue any citations and penalties related to the incident that stole Richard Johnson’s life. It’s likely they’ll determine that Johnson’s death was preventable. It was no “accident.”