Our local grocery store chain, H.E.B., sells packaged poultry under the private label “Natural Chicken.” It’s meant to appeal to customers who want to know that the chicken they intend to eat was treated more humanely than your typical chicken. The package label on H.E.B.’s Natural Chicken says:
- No cages ever!! Unlimited access to feed, water, and freedom of movement
- No additives or preservatives
- Always vegetarian fed
- No added growth stimulants or hormones
- No antibiotics
- Raised cage free
I stood in the refrigerator aisle and stared at the package for a while. I thought about the label and treating chickens well. But what about the workers who processed the chickens? What symbol could be on the label to signify that the workers had unlimited access to restrooms, just like the chickens had “unlimited access to feed and water”?
What could the label say to indicate that the plant’s working conditions were designed toward freedom from repetitive movement disorders for the workers? The chickens were afforded “freedom of movement.”
We’ve written many times here about the harsh working conditions for meatpacking and poultry workers. Employees at most of these plants can’t keep up with the fast pace of the production lines. The owner of one firm told an NPR reporter recently:
“We hire 100 people a week because we have 100 people who quit every week. We’re constantly short.”
Current and former workers testified in March 2014 before the Inter-American Commission on Human Rights and describe what it is like to be employed in the poultry and meatpacking industry. As Liz Borkowski, MPH reported, workers suffer from crippling injuries in their hands, arms and shoulders. Some are in constant pain, but when they complain about their work-related injuries, they are ignored or fired, or they quit. I’ve got to believe that someone who wants to know that the chicken they’re about to eat was humanely treated would want to know the same thing about the poultry plant workers.
“to ensure not only the safety of food itself but also the health, safety and respect of farm workers and their families.”
EFI focuses on production of fruits and vegetables, but might it serve as a model for other forms of food production? Among its more than 100 performance standards for food safety, environmental and labor stewardship, I see many that could be adapted for poultry and meat production. There are general requirements for appropriate safety training and personal protective equipment, but there are other indicators that go beyond mere compliance with OSHA standards. I think this one would be particularly appealing to poultry and meatpacking workers:
The Leadership Team evaluates each job, process, or operation of identical work activity covered by this section or a representative number of such jobs, processes, or operations of identical work activities involved at the farm and develops a Repetitive Motion Injury (RMI) Elimination Plan.
For any repetitive motions that are deemed to cause RMIs, the Leadership Team develops a work plan to correct the RMI exposure, or, if the exposure cannot be corrected in a timely manner, the exposure is minimized to the extent feasible. The Leadership Team recommends engineering controls, such as work station redesign, adjustable fixtures or tool redesign, and administrative controls, such as job rotation, work pacing or work breaks to minimize the risk of RMIs.
EFI has been pilot testing its standards at two California strawberry farms. It will be revising the standards and developing a certification system which would allow farms that comply with EFI’s standards to display a EFI logo (trust mark) on their products. I know that ramping up such a program will take time, and moving beyond strawberries to other produce will create some hiccups. But I’m holding out hope that the demand for good food by institutions and individual consumers will move beyond produce in the years ahead to meat and poultry processing.
When the U.S. Food and Drug Administration approved the first vaccine to protect against cancers caused by certain strains of the human papillomavirus, or HPV, public health advocates cheered its arrival and life-saving potential. Unfortunately, the new vaccine quickly became embroiled in a debate over whether immunizing young girls against HPV, a sexually transmitted disease, would lead to risky sexual behavior. A new study, however, finds that the vaccine is not associated with an uptick in STDs — an indicator that HPV immunization does not promote unsafe sex.
To conduct the study, which was published in February in JAMA Internal Medicine, researchers analyzed an insurance database of young girls ages 12 to 18 from 2005 through 2010. They compared STD rates among girls who were vaccinated against HPV with those who were not — the eventual data set included more than 21,600 girls who received the vaccine and about 186,500 girls who were not vaccinated. While they found that young girls and women vaccinated against HPV typically had higher STD rates before and after immunization when compared to their unvaccinated peers, there was no significant difference in the growth of STD rates between the two groups in the year following vaccination. In other words, the study findings led researchers to conclude that the HPV vaccine is not likely associated with an increase in unsafe sexual behavior.
While previous research has examined the same question, study co-author Anupam Jena, an assistant professor of health care policy and medicine at Harvard Medical School and an assistant physician in the Department of Medicine at Massachusetts General Hospital, told me that this study is the first to examine such a large cohort of vaccinated and unvaccinated girls. Jena noted that HPV vaccination rates in the U.S. are quite low, with less than half of teen girls receiving all three doses of the vaccine. (Considering that this vaccine is the first-ever medical therapy that can prevent cancer, he described such low immunization rates as “somewhat shocking.”) Federal health officials currently recommend that boys and girls receive the vaccine at ages 11 or 12 years old.
Jenna added that prior surveys have found that significant percentages of parents, about 20 to 30 percent, as well as pediatricians, more than 10 percent, do voice personal concerns that HPV vaccination could tacitly approve the initiation of sexual activity or promote unsafe sexual behaviors.
“It’s this context that makes it such an important issue to understand,” he told me. “I think it’s a reasonable concern and not one to automatically dismiss. There are studies that do suggest that sometimes there are unintended consequences of well-intended (medical therapies), so it’s not unreasonable that this can occur. That’s why we turn to science to answer these questions.”
In addition to finding no evidence that HPV vaccination leads to higher rates of STDs, the study also revealed interesting differences and characteristics that could be useful in clinical and public health settings. For example, researchers found that girls and young women living in the South were less likely to be vaccinated. Overall, vaccination rates increased with age. Vaccinated females had higher rates of STDs before and after immunization when compared with unvaccinated females, and vaccinated females were also more likely to be sexually active in the year prior to immunization. Jena noted that these last two findings might be of particular interest to physicians when determining which patients are most in need of safe sex information.
Study authors Jena, Dana Goldman and Seth Seabury write:
We found that, although vaccinated females had higher STI (sexually transmitted infection) rates after vaccination compared with matched controls, these differences existed before vaccination as well. Our difference-in-difference analysis that compared changes in STI rates over time between vaccinated and nonvaccinated females found no evidence of an association between HPV vaccination and higher STI rates. Even among females who were more likely to be sexually active before HPV vaccination as measured by contraceptive medication use, there was no evidence of increased unsafe sexual behavior.
So, how can these findings translate in practice and enhance vaccine promotion and education? I posed this question to Jena, noting that previous messaging research has found that simply providing parents with corrective information on vaccine safety isn’t likely to change any minds (for an example, see this study). Jena said that while it’s true that this study won’t likely result in a sudden rush of girls being vaccinated against HPV, “I do think this kind of study can move the needle a little bit in a few ways.” One way is through media dissemination, he said, and another is by providing pediatricians with a little more leverage during conversations with parents who seem on the verge of saying “yes” to the HPV vaccine.
“What we’ve done is add information to what is already known and hopefully that will be useful,” Jena said. “At the end of the day, the real push is how do you translate that information into something tangible that can actually improve vaccination rates.”
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Last month, my circa 1980 hand-held hair dryer finally gave out. It was a Christmas present during my first year in college. The motor on the cream-colored Conair didn’t exactly fail, but I had to jiggle the electrical cord in just the right way or it wouldn’t turn on. I bought a new one, and my old one went into the garbage can. But after reading a paper in the latest issue of the International Journal of Occupational and Environmental Health (IJOEH), I sort of wish I’d kept it. I knew I had an appliance relic on my hands, but now I’m curious to know whether it contained asbestos.
James Dahlgren, MD and Patrick Talbott published in IJOEH a case report of a 51 year-old former hairdresser from the US who died from peritoneal mesothelioma. This rare form of cancer is caused by asbestos exposure. She worked as a hairdresser in New York from 1976 to 1992 and reported using a hair dryer everyday on her clients.
“The patient used a blow dryer 1-2 feet away from her face, close enough to feel the expulsion of hot air from the dryer. She reported that the air was strong enough to blow her hair and bangs away from her face.”
When she chose a career as a cosmetologist, she likely didn’t know she’d be exposed to asbestos. Dahlgren and Talbott indicate that from 1976 to 1982, she only used hairdryers that contained asbestos (and were manufactured by Conair, General Electric, Gillette.) A hairdresser with mesothelioma is not an anomaly. The authors mention a mesothelioma disease registry covering residents of northern Italy. For the period 2000 to 2009, the registry identified 30 cases of mesothelioma in former hairdressers.
The matter of asbestos and blow dryers came to light in 1979 when a local Washington DC television station (WRC-Channel 4) teamed up with the Environmental Defense Fund to investigate which hair dryers on US store shelves contained asbestos. Their reporting embarrassed the Consumer Product Safety Commission (CPSC) for failing to act more quickly to address the millions of consumer products—from electric blankets and lamp sockets, to ironing board pads and pottery clay—that contained asbestos.
A headline in the Washington Post’s March 29, 1979 edition read:
“Some Hair Dryers Give Off Asbestos: CPSC confirms carcinogen report”
The story noted:
“As many as five million hand-held electric hair dryers emit potentially dangerous levels of cancer-causing asbestos particles, government regulators confirmed yesterday. Officials of the Consumer Product Safety Commission (CPSC) said they have hastened efforts to determine which hair dryers now on the market are dangerous.”
The next day, the Washington Post followed-up on the story:
“The CPSC yesterday summoned the 10 leading manufacturers of home hair dryers to a Washington conference next week to discuss whether the asbestos insulation in some of them presents a health hazard.”
Among those called to the meeting were Conair, GE, Gillette, Norelco, JC Penney, Sears Roebuck & Co, Sunbeam and Schick.
A couple of months later, the CPSC approved the “voluntary corrective action proposals” offered by 11 hair dryer manufacturers. They agreed to replace or refund the dryers from consumers who contacted them.
The CPSC’s voluntary recall was substantiated by an investigation conducted by National Institute for Occupational Safety and Health (NIOSH), at CPSC’s request. Dahlgren and Talbott mention NIOSH’s findings in their case report, writing:
“The study noted that the flow rate of hand-held blow dryers was …ample to force asbestos fibers into the environment and providing opportunity for fiber inhalation. Additionally, the degradation of hair-dryer asbestos linings with age was another source of airborne exposure.”
Sears, Penney’s and others balked at the idea that the blow dryers posed a health hazard, although they admitted that the dryers contained asbestos. A May 21, 1979 joint CPSC and manufacturers’ statement includes this from Sears:
“Sears stopped sales of hair dryers containing asbestos on April 4, 1979, although Sears does not believe the use of such dryers poses a health hazard.
In keeping with its longstanding policy of ‘Satisfaction Guaranteed or Your Money Back’ and because of public concern, Sears has instructed all its stores and catalog facilities to replace affected hair dryers or, if the customer prefers, to give a full refund.”
As for Penney’s:
“On March 29th Penney says that it stopped sale on all of its hair dryers that contained asbestos. Penney’s maintains that current evidence does not indicate that its hair dryers with asbestos present a health hazard, and the company is not asking customers to return these products.
However, if a Penney’s customer is concerned because a J.C. Penney hair dryer contains asbestos, the company will follow its normal policy of customer satisfaction. Depending on the dryer, it will repair or replace the dryer at no cost to the consumer or refund the dryer’s full purchase price at any of its retail stores.”
Later that year, the CPSC announced that one model of hair dryer—-the Rocket Blower—was tested by NIOSH with alarming results:
“the dryer was putting out asbestos fibers at a higher level than hand-held dryers previously test ‘by about a factor of three.’ The reading was .11 fibers per cubic meter of air.”
[The current OSHA permissible exposure limit for an 8-hour shift is 0.1 fibers/m3.]
The CPSC explained the Rocket Blower is:
“in use across the country in beauty parlors catering to black customers with Afro hairstyles.”
The voluntary recall didn’t work so well. In “Home Hazards Change with Technology,” (October 30, 1980) The New York Times’ Ralph Blumenthal wrote:
“…last year asbestos fibers were discovered blowing out of hair dryers, prompting a recall–although only 3 million of the 18 million made with asbestos were ever fully accounted for.”
Reading Dahlgren and Talbott’s article and looking back on the voluntary recall, I can’t help but think of individuals with mesothelioma and other asbestos-related cancers. Some of them have shared their stories, and many of them certainly wonder where and how they were exposed to asbestos. As Linda Reinstein, President of the Asbestos Disease Awareness Organization, is quick to point out:
“If we don’t know where asbestos is, we can’t manage our risk.”
Linda’s husband Alan died in 2006 from mesothelioma.
If I’d read Dahlgren and Talbott’s article sooner, my old blow dryer wouldn’t have ended up in last month’s garbage. Before throwing it away, I would have satisfied my curiosity by comparing its serial number to those in CPSC’s old voluntary recall notices. A match to the list would have been a powerful example of how asbestos-containing products remain in our homes, workplaces and communities.
Last week, Vox’s German Lopez highlighted a recent study that demonstrates how improving access to the most effective contraceptives can slash the rates of unintended pregnancies and abortions among teens. After the Colorado Family Planning Initiative (CFPI) started providing free IUDs and implants to low-income women at family planning clinics, the teen birth rate and abortion rate dropped sharply. Lopez notes that the teen birth rate has been declining nationwide, but Colorado’s has dropped more quickly: “Between 2008 and 2012, the state went from the 29th lowest teen birth rate in the nation to the 19th lowest.”
A study by Sue Ricketts, Greta Klingler, and Renee Schwalberg, published in Perspectives on Sexual and Reproductive Health’s September 2014 issue, describes the project and research findings in greater detail. In 2009, the Colorado Department of Public Health and Environment began using private money from an anonymous foundation to allow Title X family planning clinics to provide long-acting, reversible contraceptive (LARC) methods for free. (Title X centers provide cost-effective family planning and related preventive health services to low-income men and women; Kim wrote about Massachusetts Title X providers last year.) The funding supported purchase of IUDs and implants as well as training for providers and staff and technical assistance. Ricketts and her colleagues explain why in the past LARC methods have not been widely used by adolescents, despite being recommended:
LARC methods—implants and IUDs—have been shown to be effective in reducing rates of unintended pregnancy among adolescents, and their use in this population is endorsed by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the World Health Organization.[1, 2] Compared with the pill, patch and ring, LARC methods have low failure rates and a reduced likelihood of noncompliant use, which make them particularly suitable for adolescents. Increasing the use of these methods is a recommended strategy to reduce rates of unintended pregnancy. Among all users of Title X–funded family planning clinics in 2011, however, the IUD and implant were used by only 2% of clients younger than 20.
A number of barriers to LARC use among young women and others at high risk of unintended pregnancy have been described. Two barriers are the low level of awareness among consumers and providers of the availability, safety and appropriateness of LARC methods for both parous and nulliparous young women and the time required for counseling about these methods.[5, 6] In addition, high initial costs pose a substantial barrier to greater utilization. In the longitudinal Contraceptive CHOICE Project in St. Louis, 70% of women aged 14–20 chose LARC methods when cost was not a factor. Between 2008 and 2010, the researchers observed declines in the abortion rate, the proportion of abortions that were repeat procedures and the teenage birthrate in the St. Louis area. Furthermore, these rates were lower than those in comparable areas without the study program.
Under the Affordable Care Act, private insurers must cover all FDA-approved forms of contraception, including LARCs, without cost-sharing. States’ Medicaid programs must also cover contraception, but Medicaid eligibility varies substantially from state to state. Uninsured women may still find the costs of LARCs, which can total several hundred dollars, too high. As Ricketts et al note, several states have either waivers or state plan amendments that allow them to use Medicaid funds to offer family-planning services to low-income women, but Colorado does not. (The Kaiser Family Foundation summarizes state waivers and SPAs if you want to see what your state offers.)
Another issue is that young women covered by their parents’ insurance may not want to use that insurance when seeking family-planning services. Title X centers will provide confidential services on a sliding-scale fee basis, so young women can receive the services they need even if they don’t hand over an insurance card. Having such policies means that it can be hard for Title X providers to afford to stock a lot of IUDs and implants, though. Ricketts and colleagues explain that these LARC methods can cost clinics $300-$500 even with special pricing; they report, “Clinics had historically struggled to meet the demand for these two methods within their limited budgets and sliding-fee requirements, and many offered only limited numbers of LARC insertions.”
The bottom line here is that the privately funded CFPI made it possible for Colorado’s Title X providers to greatly improve their clients’ access to LARCs. Before the initiative, only 5% of Title X female clients ages 15-24 used LARC methods; by 2011, that climbed to 19%. Statewide, the birth rate for teens ages 15-19 dropped 26%. Researchers also examined abortion rates for this age group in 37 counties where Title X-funded clinics are located and those in 27 “non-CFPI” counties. They found a 34% drop in abortions among teens ages 15-19 in CFPI counties, and a drop of 29% in non-CFPI counties. Ricketts and her colleagues point out that teens living in non-CFPI counties may well cross county lines to receive family-planning services, so the initiative may have helped lower abortion rates statewide.
Lowering teen birth and abortion rates is a worthwhile public health goal on its own, but state officials with competing funding priorities will also want to know whether funding LARCs for lower-income women might let them reduce spending in other areas. The WIC infant caseload is a leading indicator of low-income births, because researchers can access WIC caseload data well before birth certificate data are finalized, Ricketts et al explain. (WIC, or the Special Supplemental Program for Women, Infants and Children, provides nutrition education and supplemental food for low-income pregnant and postpartum women and for children up to age five who are determined to be at nutritional risk.) Ricketts and her colleagues report:
Continuing a decades-long trend, the number of infants receiving WIC benefits grew steadily in the two years preceding the Colorado Family Planning Initiative, from 24,513 in January 2007 to 26,766 in December 2008 (Figure 2). In 2009, when CFPI began, the number leveled off; it ended the year at 26,862. Subsequently, the number rose to 28,978 in March 2010 and then dropped sharply; by March 2013, it had fallen to 22,407, a level well below that for any month since early 2005. The number of infants served by WIC, which had risen 18% between January 2007 and March 2010, fell 23% in the following three-year period.
Having fewer state residents with incomes low enough to qualify them for various forms of assistance translates to lower expenditures on a variety of programs. In just a few years, Colorado’s experience has demonstrated that investing in LARC accessibility can translate quickly into savings. Benefits to the women receiving LARCs may be harder to quantify, but are substantial. “This initiative has saved Colorado millions of dollars,” said Governor John Hickenlooper in a news release announcing the findings. “But more importantly, it has helped thousands of young Colorado women continue their education, pursue their professional goals and postpone pregnancy until they are ready to start a family.”
I hope these findings (and many others published over the years showing an excellent return on family-planning investments) will prompt other states to increase their investments in family planning for lower-income women. The trend in several states and at the federal level, though, has been for family-planning budgets to fall or remain stagnant despite growing demand. Some of this is likely due to overall budget-cutting pressure, and some to hostility toward women being able to control their reproductive timelines. The evidence is clear, though: improving women’s access to effective contraception pays off financially and for public health.
Read the article.
NPR reporter Daniel Zwerdling reports on the failure of hospitals to protect nursing staff from preventable and often debilitating injuries, writing that nursing assistants and orderlies suffer three times the rate of back and musculoskeletal injuries as construction workers. In fact, federal data show that nursing assistants experience more injuries than any other occupation. Zwerdling starts his piece with the story of Pennsylvania nurse Tove Schuster:
While working the overnight shift, (Schuster) heard an all-too-common cry: “Please, I need help. My patient has fallen on the floor.”
The patient was a woman who weighed more than 300 pounds. So Schuster did what nursing schools and hospitals across the country teach: She gathered a few colleagues, and they lifted the patient as a team.
“I had her legs — a corner of one of the legs, anyway,” says Schuster, who was 43 years old at the time. “And as we swung her up onto the bed, I felt something pop. And I went ‘ooo.’ ”
She finished the shift in pain and drove straight home to bed.
But after Schuster woke up late that afternoon, her husband, Matt, heard her shouting. He says he ran to the bedroom and found her crawling across the floor. “I thought it was a joke at first,” he says. “And she says, ‘I can’t walk.'”
During Zwerdling’s investigation, he found that the traditional way nurses have been taught to move patients — bending the knees and keeping the back straight — is actually quite dangerous. And while some hospitals have been successful at reducing lifting-related injuries using special machinery and intensive staff training, most hospitals have not taken such action. But perhaps most alarming was this finding from the article:
Many hospital administrators overlook injuries among the nursing staff partly because they’re preoccupied with other priorities. Industry sources told NPR that nursing employees have traditionally ranked low in the hospital industry’s hierarchy.
“Too many hospital administrators see nursing staff as second-class citizens,” says Suzanne Gordon, author of Nursing Against the Odds. “Historically, hospital administrators have viewed nurses as a disposable labor force.”
To read the full investigative article, visit NPR.
In other news:
Salon: Writer Luke Brinker reports that Illinois Gov. Bruce Rauner has “dramatically escalated his war against labor unions,” signing an executive order this week that allows public employees to opt out of paying “fair share” fees that support collective bargaining. (Whether a union member or not, all employees in unionized workplaces benefit from collective bargaining activities, thus the application of fair share fees.) According to Brinker, Rauner has called the fees unconstitutional; however, the Supreme Court has upheld such fees as legal as long as they’re not used to fund political activities. The story reads: “Bruce Rauner’s scheme to strip the rights of state workers and weaken their unions by executive order is a blatantly illegal abuse of power,” AFSCME Council 31 Executive Director Roberta Lynch told the Sun-Times in a statement yesterday. “Perhaps as a private equity CEO, Rauner was accustomed to ignoring legal and ethical standards, but Illinois is still a democracy and its laws have meaning.”
The Hill: Senate Republicans are moving to block the National Labor Relations Board from speeding up union elections. Reporter Tim Devaney writes that labor officials and Democrats argue that the rule is needed to prevent companies from delaying such elections and intimidating workers. Currently, it takes about 38 days from the time a petition is filed to hold an election, but the new NLRB rule could shorten that time to closer to 10 days. Opponents, however, are describing the measure as an “ambush” election rule and a “sneak attack” on businesses.
The New York Times: Reporter Rachel Abrams writes that Ashley Furniture, one of the world’s largest furniture makers, has been hit with $1.7 million in fines related to unsafe working conditions at its plant in Arcadia, Wisconsin, that have resulted in more than 1,000 injuries. OSHA cited the company for dozens of violations, with U.S. Labor Secretary Thomas Perez describing Ashley Furniture as an OSHA “frequent flier.” The company has also been placed in OSHA’s Severe Violator Enforcement Program for its failure to fix a number of safety issues. Abrams quotes Perez as saying: “I don’t quite understand how the worker can be to blame when the fact of the matter is, the machines lacked the proper safety mechanisms, which are not that expensive. This is not splitting the atom.”
USA Today: Oil refinery workers from Ohio to California have gone on strike, joining the biggest refinery work stoppage since 1980, according to reporter Mike Snider. He writes that the initial strike began after a negotiation breakdown between United Steelworkers and BP. As of this weekend, more than 5,000 workers nationwide had joined the strike. In a Huffington Post blog post, United Steelworkers International President Leo Gerard writes that during previous negotiations, workers “struggled” to get their employers to include strong safety language in their collective bargaining agreements. In the post, Gerard remembers the workers who lost their lives in the 2010 Tesoro refinery blast in Anacortes, Washington; investigators eventually found that the piece of machinery that triggered the explosion was known by management to be faulty. Gerard quotes a striking worker: “A big part of this strike is that none of us wants to be the next person to lose his life for no good reason.”
Upworthy: Check out the new documentary, “The Hand That Feeds,” a film about immigrant and low-wage workers who are organizing against the odds for fair wages and working conditions. (We’ve posted the trailer below.) And visit the filmmakers’ Kickstarter campaign, which is raising funds to release the documentary nationwide, to learn more about the film and its subjects.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Marvis L. Myers, 31, suffered fatal traumatic injuries on Friday, February 6, 2015 while working for the City of Columbia, SC. WISTV reports:
- The incident occurred at a construction site on Pulaski Street near College Street.
- The victim was underground “working on pipe repairs when a cave-in occurred.”
- He was “6 to 8 feet below ground level”
- The incident happened about 11:40 am local time.
The incident is being investigated by South Carolina OSHA (SC-OSHA). The agency is in one of the 25 states that operates its own federally-approved occupational health and safety program. The approval of these programs, among other things, is contingent on providing the agencies’ protections to their respective state and local government employees. About 2 percent of SC-OSHA’s inspections involve public sector workplaces.
SC-OSHA will be examining the circumstances the led to Mr. Marvis L. Myers’ death, including why the excavated area in which he was working was not properly shored-up to prevent a cave-in. The City of Columbia may receive citations and penalties for violations identified by SC-OSHA. The most recent SC-OSHA inspections in the city occurred in March 2012 following injuries suffered by a firefighter. No citations were issued.
About 8 million state and local public sector employees are not covered by OSHA. They are employed in states were federal OSHA has regulatory authority over private sector workplaces, but no authority over public sector ones. When a public sector employee is killed on-the-job in one of these states, there is no OSHA inspection.
Each year, about 70 workers are killed on the job in South Carolina. The Bureau of Labor Statistics reports 72 work-related fatal injuries in South Carolina 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:
- SC-OSHA has 24 inspectors to cover more than 101,000 workplaces.
- The average penalty for a serious violation in South Carolina is $492.
SC-OSHA has until the early July 2015 to issue any citations and penalties related to the incident that stole Marvis L. Myers’ life. It’s likely they’ll determine that Myers’ death was preventable. It was no “accident.”
It’s a persistent conundrum in the field of public health — how can we open people’s minds to positively receiving and acting on health information? Previous research has found that combining health tips with messages of self-affirmation may be a particularly effective strategy, but researchers weren’t entirely sure how self-affirmation worked at the neurological level. Now, a new study has found that self-affirmation’s effects on a particular region of the brain may be a major key to behavior change.
In even simpler terms, researchers involved this new study — which examined how self-affirmation alters the brain’s response to health messaging — found that precisely activating a certain region of the brain could be a central pathway toward positive behavior changes. The findings could point to a relatively low-cost way to yield behavioral changes that could impact some of the nation’s costliest conditions and risk factors, from obesity to tobacco use. Plus, the findings illustrate one way to deliver health messages in a fashion that allows those most at risk to see value in what might otherwise be viewed as judgmental and threatening.
“It seems like we can change neural activity using this simple intervention and it does relate to behavior change down the road,” said study lead author Emily Falk, an assistance professor of communication at the University of Pennsylvania Annenberg School for Communication. “Self-affirmation is a cheap, scalable intervention…and it turns out to have huge effects for a relatively low investment.”
To conduct the study, which was published in February in the Proceedings of the National Academy of Science, Falk and her fellow researchers used functional magnetic resonance imaging to study a region of the brain involved in processing self-relevance known as the ventromedial prefrontal cortex (VMPFC). To begin, sedentary study participants were first given a list of values — such as family and friends, religion or politics — and asked to rank them in order of meaningfulness. The study sample was then broken into two groups — both groups received the same behavioral health information, but only one group was first primed with a self-affirmation message based on their values ranking. The control group received similar self-affirmation messages, but they were based on values unimportant to them.
Study participants were also fitted with a device that measured their activity levels for a week prior to the study and for a month after the initial intervention. In addition, participants continued to receive text message reminders for a month following the initial intervention. The text reminders would include one self-affirmation message and one health tip. For example, Falk told me a self-affirmation text might prompt the person to think about a time in the future when friends and family might need advice; while the health tip would explain that inactivity puts a person’s health at risk or that the best parking spots are those furthest away from the store. Falk and study co-authors Matthew Brook O’Donnell, Christopher Cascio, Francis Tinney, Yoona Kang, Matthew Lieberman, Shelley Taylor, Lawrence An, Kenneth Resnicow and Victor Strecher write:
VMPFC has been consistently associated with behavior change in response to health messages in prior work. This prior research has suggested that the link between VMPFC activity during health message exposure and behavior change may stem from a recipient’s ability to process a health message as self-relevant or as having value to oneself. Thus, we hypothesized that if affirmation allows people to see otherwise-threatening information as more self-relevant and valuable, delivering self-affirmation before health messages should increase neural activity in VMPFC during message exposure.
And that’s exactly what researchers found. According to the study, people who received relevant self-affirmation messages before getting the health advice showed higher levels of activity in the VMPFC region of the brain at the time of receiving the health messages. However, study participants who were prompted to think about values not ranked as important to them, showed lower levels of activity in that particular part of the brain. And not only did the relevant self-affirmation messages light up the region of the brain associated with positive valuation, it also resulted in actual behavior change. Those who received relevant self-affirmation showed a steeper decline in sedentary behavior in the month following the initial intervention, while those who didn’t receive relevant self-affirmation maintained their baseline levels of sedentary behavior.
Falk told me that previous research has found that brain activity in the VMPFC region tends to be a complimentary predictor of behavior change — in other words, brain activity seems to provide additional information that goes above and beyond what researchers gain from simply asking people questions. However, researchers were somewhat stumped as to why that was the case. At the same time, self-affirmation was emerging as an effective health messaging strategy, but researchers didn’t really know how self-affirmation worked at the neurological level. Falk said this study helps bring all those pieces together.
“We wanted to find a way to precisely engage that region of the brain and self-affirmation is a good tool to do that,” she told me. “The next step in the research is figuring out how to do this at scale, and I do think that’s a possibility.”
To request a full copy of the study, visit the Proceedings of the National Academy of Science.
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 story was about US immigration policy, but my-oh-my what it said about working conditions in poultry processing plants.
NPR’s Jim Zarroli reported from Georgia on the impact on businesses of the state’s 2011 law targeting undocumented immigrants. The president of Fieldale Farms, a poultry processing company, indicated he used to rely heavily on workers from Latin America and admitted that the documents of some may have been forged. But under the new law, undocumented workers are avoiding jobs in Georgia, and this is causing a problem for Fieldale Farms and other employers in the state. Fieldale Farms’ president Tom Hensley told Zarroli:
“We’ve had to hire middle-aged Americans who have not been used to working in an industrial facility and they have difficulty keeping up with the machines.”
Hmmm….difficulty keep up with the machines. Workers just can’t keep up. I wonder….could it be that the machines are running too fast?
If your average middle-aged Georgian can’t keep up with the poultry processing lines, does it seem right for a company to be expecting immigrant laborers to work at that pace?
When I hear about jobs that expect, by design, for people to contort themselves and work beyond their physical capacity, I know it’s a recipe for injuries. I can’t help but wonder if that’s what is going on when the poultry company president said this to Zarroli:
“We hire 100 people a week. Because we have 100 people who quit every week, out of 5,000 employees. We’re constantly short.”
How many of those 100 people who quit do so because the work has taken a toll on their hands, wrists or other body parts? Doesn’t being ‘constantly short’ just compound the work pace problem? If those middle-aged Americans can’t keep up, how much worse is it when they have to do the job of two people? It’s a vicious cycle that can only be fixed by companies fitting the task to the worker, not the other way around.
What I wouldn’t do to track down those 100 former Fieldale Farms’ employees who quit last week. It would be enlightening to learn why they quit. And it’s too bad our official data on work-related injuries isn’t more than just a survey of employers. What if there was a complementary annual survey of workers? One question to ask would be: Did you quit a job last year because you were hurt or ill from your work?