In 2012, the most recent year for which US Bureau of Labor Statistics (BLS) figures are available, 375 people died on the job in California – an average occupational fatality rate of more than one person every day. At the same time, research by Worksafe and other California labor advocates shows that while California’s workforce has grown by about 22 percent in the last 20 years, the number of safety inspectors for the 17 million people employed in the state’s 1.34 million workplaces has decreased by about 11 percent. This leaves California – which has the largest workforce of any US state – with the country’s lowest number of inspectors per workers of any of the twenty-one states with state-run occupational safety and health plan that cover private-sector workers. There are now so few California workplace safety inspectors that it would take 173 years for the California Division of Occupational Safety and Health (Cal/OSHA) to inspect each workplace in the state just once. This is almost four times longer than it would have taken California inspectors to complete this job in 1992 and means that California has about 10 times fewer inspectors for the state’s workforce than the International Labor Organization recommends.
Under the Occupational Safety and Health Act, states are encouraged to develop and run their own job health and safety programs which are monitored by the federal Occupational Health and Safety Administration (OSHA) that provides up to about 50 percent of an approved state’s plan’s operating costs. California and twenty other states plus Puerto Rico currently have plans that cover private and state and local government employees, while four other states and the Virgin Islands have plans that cover only public employees. Given California’s size and its historic and oft-looked to role as a national leader in environmental and other progressive policies, that Cal/OSHA has fallen so far behind in its oversight of workplace safety has potentially serious national implications, say California occupational health and safety experts.
The lack of workplace safety inspectors means that Cal/OSHA is routinely missing its required deadlines for initiating and completing inspections – including after serious incidents and to follow-up on corrections needed after an employer is cited for violations, says Garrett Brown, a recently retired 20-year veteran of Cal/OSHA. The severe understaffing stems from political decision-making that has left positions vacant and failed to effectively direct funding to worker and workplace-safety programs, says Brown, who worked as a field compliance officer for 17.5 years and Special Assistant to the Chief of the Division for his last 2.5 years at Cal/OSHA.
“We have great laws on the books that get completely ignored,” said Worksafe executive director Gail Bateson. For example, Bateson explained, California’s limits for occupational exposure to hazardous chemicals – many of which are more protective than federal regulations – are not being monitored or enforced. According to Worksafe’s Dying at Work in California report, an estimated 451,500 people were injured or became sick on the job in California in 2012, an increase of more than 10,000 since 2011. In addition, Bateson said, the agency is conducting few inspections that address health hazards, which require more time and are more complex than inspections addressing safety hazards alone. This means less enforcement, not only of California’s chemical exposure regulations, but also of the state’s other health standards, such as those addressing ergonomics and noise. Cal/OSHA’s current understaffing has also resulted in what Bateson called “a huge back-log” in following up on citations during any appeal and defense process.
Both Bateson and Brown point out that the true number of work-related injuries and illnesses is likely greater than that reflected in BLS figures. As the most recent AFL-CIO Death on the Job report notes of the US national occupational injury and illness numbers for 2012, “Nearly 3.8 million work-related injuries and illnesses were reported, but many injuries are not reported. The true toll is likely two to three times greater, or 7.6 million to 11.4 million injuries a year.” Bateson expressed particular concern about potential underreporting of injuries and illnesses among temporary workers, whose numbers have been growing particularly quickly in blue-collar and low-wage manufacturing and service industries.
An additional concern in California is how the lack of occupational health and safety resources is impacting the state’s Latino workforce. Figures compiled by the AFL-CIO report show Latino workers to be particularly at risk for fatal workplace injuries, with an occupational fatality rate that’s 9% higher than the overall national rate for workplace deaths (3.7 per 100,000 for Latino workers compared to 3.4 per 100,000 workers overall). In 2012, California was the state with the second-highest number (after Texas) of Latino worker fatalities and the highest number of foreign-born worker fatalities. Understaffing and insufficient resources at Cal/OSHA, says Brown, has contributed to a lack of inspectors who speak any language besides English. According to Brown, less than 15% of Cal/OSHA inspectors currently have such language skills.
In February, Public Employees for Environmental Responsibility (PEER) filed a formal complaint with federal OSHA about Cal/OSHA’s lack of staffing, basing its complaint on a report compiled by Brown. The complaint also points out that Cal/OSHA draws no money from the state’s general fund and alleges that available funding is not being adequately allocated to Cal/OSHA programs. PEER executive director Jeff Ruch said that while OSHA has asked PEER for additional information, OSHA has not yet responded to the complaint.
A national trend
This trend of decreasing resources for workplace safety and health inspections is “a national phenomenon,” said Brown. While California currently ranks last in its ratio of inspectors to workplaces and in inspection rate, the federal OSHA now only has enough inspectors to inspect each US workplace once every 139 years, says the AFL-CIO report. Between the state and federal OSHA programs, this means one inspector for every 67,847 workers.
Occupational Safety and Health State Plan Association chair and Administrator for Oregon OSHA Michael Wood points out that as state budgets tightened over the past few years, less money “has been spent to support state OSH plans.” State OSH plans get matching funds from federal OSHA, but Wood explains that it’s been well over a decade since there’s been any meaningful increase in support for state occupational safety and health programs. “Is this having a measureable effect on worker protection? I think it is,” said Wood. Just because every state is not experiencing a “crisis doesn’t mean there isn’t a problem,” he said.
“If this can happen in California, a state that has what’s considered the country’s premier state occupational safety and health plan and under a Democratic administration, it could happen anywhere,” said Brown.
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, Ensia, The Washington Post, Salon and The Nation.
Ricardo Ramos, 49 suffered fatal traumatic injuries on Saturday May 10 while working at a meat processing plant located near Zeeland, Michigan. Garrett Ellison with MLive provides some initial information on Ramos’ death.
- The facility is operated by Hillshire Brands. Workers there make Jimmy Dean sausage.
- Ramos was working on the overnight shift. He was part of the crew that cleans and sanitizes the facility, including the equipment and conveyors. A co-worker said Ramos was pulled into a piece of machinery.
- Ramos’ wife said her husband was working overtime to pay the household bills. He leaves behind three daughters age 10 years, 7 years, and 11 months.
Michigan OSHA (MIOSHA) will conduct an inspection of the plant. If the agency’s inspectors identify violations of health or safety regulations, the company will be cited. In 2006, MIOSHA conducted a partial inspection of the Hillshire Brands’ Zeeland plant. No citations were issued.
Each year, more than 100 workers in Michigan are fatally injured on-the-job. The Bureau of Labor Statistics reports 137 work-related fatalities in Michigan during 2012 (most recent available data.) Nationwide, at least 4,628 workers suffer fatal traumatic injuries.
The AFL-CIO’s annual Death on the Job report notes:
- MIOSHA has 63 inspectors to cover more than 240,000 workplaces.
- MIOSHA’s average penalty for a serious violation is $542.
MIOSHA has until mid-November to issue any citations and penalties related to the incident that stole Ricardo Ramos’ life. It’s likely they’ll determine that Hillshire Brands’ safety program was inadequate and Ramos’ death was preventable. It was no “accident.”
Most of us probably expressed some appreciation yesterday for our mothers. Despite the brunches, flower sales, and media attention lavished on moms each Mother’s Day, though, US policy doesn’t express as much appreciation for mothers (or fathers) as it should. Jennifer Senior shared this graphic on Twitter:
When Australia passed a new parental leave law in 2010, the US became the only industrialized nation that does not provide paid leave to mothers of newborns. As Senior pointed out in her tweet, Pakistan is more progressive than the US in this regard (mothers there get 12 weeks of paid maternity leave). Ideally, paid parental leave would be available to both mothers and fathers; this is the case in more than 50 out of 178 nations, notes Amanda Peterson Beadle at ThinkProgress.
Some US employers do offer paid maternity or parental leave; analysis of 2006-2008 Census data found that fewer than half of women who were working during the pregnancies of their first births used paid leave following those births. For those without sufficient paid-leave benefits, the Family and Medical Leave Act allows new parents (mothers and fathers of new birth, adopted, or foster children) up to 12 weeks of unpaid leave. FMLA leave is only an option for around 60% of the US workforce, though, because it’s only available to employees who’ve worked at least 1,250 hours over the past 12 months (e.g., 24 hours per week) for employers with 50 or more employees. The fact that FMLA leave is unpaid also means that many of those who are entitled to its benefits simply can’t afford to take off the allowed time.
In a policy statement urging US lawmakers to make paid sick, medical, and family leave broadly available to US workers, the American Public Health Association summarizes some of the many public-health benefits of maternity leave (which is more widely studied than non-gender-specific parental leave):
Maternity leave is one of the most studied forms of employment leave, and, depending on its duration, it is associated with a variety of public health benefits. These benefits include prolonged gestation and reductions in cesarean deliveries, more well-baby visits, decreased infant mortality, longer periods of breastfeeding, and improved mental health of new mothers. In some studies, these positive effects are identified only when the maternity leave is paid.
California, New Jersey, and Rhode Island have all established social insurance systems that use payroll-tax funds to replace a portion of workers’ salaries for several weeks when they miss work to care for new children or seriously ill family members. And the Family and Medical Leave Insurance Act, or FAMILY Act, introduced into the US Congress by Senator Kirsten Gillibrand (D-NY) and Representative Rosa DeLauro (D-CT) in December, would create a similar system covering the whole nation. I summarized the Act’s provisions when it was introduced:
A new office within the Social Security Administration would administer the system, which would be funded by a payroll tax (two-tenths of one percent of workers’ wages, or $1.50 per week for the average worker). Eligible employees could receive 66% of their monthly wages, up to a capped amount, for up to 12 weeks while dealing with their own serious health conditions, bonding with a new birth or adopted child, or caring for a family member (including a domestic partner) with a serious health condition.
… The FAMILY Act would address major gaps left by the FMLA. Family and medical leave would be paid, and it would be available to workers regardless of whether they work full-time or part-time, how long they’ve worked for their current employer, and how large their employer is. Anyone who pays into Social Security and is eligible for Social Security Disability Insurance benefits would be able to receive partial salary replacement under the FAMILY Act.
If the FAMILY Act becomes law, it will help demonstrate that the US truly does value the important work parents do.
In New York, construction is the deadliest industry, with immigrant workers experiencing half of all occupational-related fatalities. Across the country in California in 2012, transportation incidents took the unenviable top spot as the leading cause of workplace fatalities. In Massachusetts in 2013, it’s estimated that upward of 500 workers died from occupational disease, at least 1,800 were diagnosed with cancers associated with workplace exposures and 50,000 workers experienced serious injury. In Wyoming, workplace deaths climbed to a five-year high in 2012, from 29 in 2011 to 35 in 2012. And in Tennessee, even though occupational fatality rates have averaged about 37 percent above the national rate for the past four years, it would take 69 years to investigate every covered worksite with current levels of enforcement staffing.
These and many more worrisome statistics were published in honor of Workers’ Memorial Week of Action, April 21–28, and Workers Memorial Day on April 28. In addition to the National Council for Occupational Safety and Health’s (National COSH) report “Preventable Deaths 2014: The Tragedy of Workplace Fatalities,” which was released last week and highlights the thousands of U.S. workers who died at work in 2012, many state groups released their own statistics and stories as well.
• The New York Committee for Occupational Safety and Health (NYCOSH) released “Examining New York’s Workplace Deaths and the Construction Industry,” which reported that construction industry deaths and injuries could have been prevented if appropriate safety measures had been taken. NYCOSH found that throughout the state for the years 2010, 2011 and 2012, at least one OSHA safety standard violation was cited in more than half — 66 percent — of inspections.
• Worksafe in California published “Dying at Work in California: The Hidden Stories Behind the Numbers.” In California, the largest number of occupational fatalities occurred in the transportation and material moving industry, followed by construction and extraction; installation, maintenance and repair; and farming, fishing and forestry. The report cited the Pump Handle’s Celeste Monforton in calling for putting names to the faces of those who’ve died on the job — “it’s an act of remembrance and solidarity, and it should be accompanied by a deep commitment to prevent the next loss from happening in the first place,” the report stated.
• The Massachusetts Coalition for Occupational Safety and Health published “Dying for Work in Massachusetts: Loss of Life and Limb in Massachusetts’ Workplaces.” According to the report, falls of all types accounted for about a fifth of occupational fatalities, with the majority of such falls happening in the construction industry. Unfortunately, citing severe understaffing at OSHA, the report found that it would take more than 123 years for the agency to inspect each workplace within its jurisdiction in Massachusetts.
• The Wyoming Coalition for Occupational Safety and Health released “Preventable Deaths: Safety and Health in Wyoming.” The report began with the story of Anthony Simmons, who died after falling from a wall while working for a home-building company. In the story, Simmons’ father said: “He should have been required to wear a harness. He shouldn’t have been on that wall to begin with. Maybe this all could have been avoided.” Simmons’ family received only $10,000 in workers compensation benefits, which barely managed to cover burial expenses.
• The Knox Area Workers Memorial Day Committee published “Tennessee Workers — Dying for a Job: A Report on Worker Fatalities in Tennessee, 2012 & 2013.” The report highlighted state-specific data and published a list of workers who have died, along with their employers and causes of death as well as stories of many of the workers who lost their lives. Take, for example, Larry Chubbs and Michael Tallent:
Larry Chubbs worked at TAG Manufacturing in Chattanooga, a company that makes metal components of large construction equipment. On May 8, 2012, Larry was operating a blasting machine that cleans and descales large steel parts. He lost his life when an unsecured floor panel of a catwalk gave way and he fell into the machine’s moving parts. The Chattanooga Times Free Press reported that “when workers found Chubbs’ body in the machine, they found the panel from the catwalk with him.” He was 54 years old.
Michael Tallent had turned 27 only a month before the accident that took his life. Michael was working as a craneman’s helper for W&O Construction Co. at the Kuwahee Wastewater Treatment Plant, a Knoxville Utilities Board facility on Neyland Dr. in Knoxville. …As the crew began to move a load of sheet metal pilings, the crane’s main hoist line came into contact with overhead power lines, resulting in Michael being struck by a fatal bolt of electricity.
• The Fe y Justicia Worker Center in Houston, Texas, published “Worker Memorial Day: Deaths at Houston Workplaces in 2013,” which stated that nearly every week in Texas’ largest city, a worker loses his or her life on the job. The report highlighted local worker initiatives, such as the center’s Domestic Worker Program, “La Colmena,” which is working to educate house cleaners and janitors about the health risks associated with cleaning products and suggest alternative options.
• The Occupational Health Clinical Centers of New York released “Low-Wage Work in Syracuse: Worker Health in the New Economy.” The report, which surveyed 275 low-wage workers, found that wage theft, unsafe work conditions and symptoms associated with workplace exposures were common experiences. The average pay among those surveyed was $9.65 (federal minimum wage is $7.25), about a fifth of workers reported not being paid overtime and 3 percent said they never get paid for overtime.
Just yesterday, AFL-CIO released its yearly report on workplace fatalities in “Death on the Job: The Toll of Neglect.” According to the report, more than 4,600 workers lost their lives in the United States in 2012 due to workplace injuries and an estimated 50,000 died from occupational diseases. That means we lost nearly 150 workers every day from preventable workplace conditions. North Dakota, Wyoming, Alaska, Montana and West Virginia were home to the highest fatality rates; Massachusetts, Rhode Island, Connecticut, New Hampshire and Washington reported the lowest rates. North Dakota’s rate was five times the national average and one of the highest worker fatality rates ever reported for any state.
The yearly memorial day and call to action also attracted a good bit of media attention as well. For a comprehensive list of news coverage, visit National COSH. And, of course, the Pump Handle’s Liz Borkowski wrote about Workers Memorial Day here, noting that “stories of workers who’ve been killed on the job, or who’ve developed fatal work-related illnesses, remind us of how awful the toll of unsafe workplaces can be, and how important it is to improve workplace health and safety.”
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Brett Bouchard, 17, was working at Violi’s Restaurant in Massena, NY last month. Press reports indicate he was cleaning out a pasta-making machine when the equipment severed his right arm at the elbow. He was rushed to a local hospital which later transferred the young worker to Massachusetts General Hospital.
Nationally, there are thousands of work-related amputations each year. The Bureau of Labor Statistics (BLS) estimates that 5,100 U.S. workers suffered an amputation injury in 2012. But we’ve written here before about the limitations of BLS’ estimates for work-related injuries. Those limitations include that its “Survey of Occupational Injuries and Illnesses” (SOII) relies exclusively on self-reported data by employers and some categories of workers are not covered by the reporting requirement (e.g., individuals working on small farms and some government employees.) These limitations and others result in an undercount by BLS of the true magnitude of work-related amputations (and, for that matter, all other injuries.)
A paper by researchers at Michigan State University, for example, calculated that the BLS system misses about 70 percent of work-related burns in their state. The researchers also looked at amputations and they identified more than twice the number than the BLS’ figure. Other limitations in BLS’s estimate, some of which also relate to the self-reporting component of the survey, are employers falsifying their records, and some not understanding what is supposed to be recorded. In addition, some injuries may not be included on employers’ injury logs because workers are reluctant and/or discouraged from reporting injuries to their bosses. Others who’ve compared BLS’ annual estimates to alternative data sources (e.g., hospital records, workers compensation claims) also find that the government-reported figures substantially understate the number of work-related injury and illness case (e.g., here, here, here, here, here, here, here.)
In recent years, BLS has been more willing to acknowledge the limitations of its estimates of work-related injuries. Attention from Members of Congress compelled BLS to provide grants to several States and university-based researchers to confirm and quantify the undercount. Three papers funded by those grants have been published recently in the American Journal of Industrial Medicine (AJIM). One written by Les Boden, PhD of Boston University School of Public Health, another by Sara Wuellner, MPH and David Bonauto, MD, MPH of the Washington State Department of Labor and Industries, and the third by a collaboration of researchers from the Massachusetts Department of Public Health (MDPH), UCLA, Boston Children’s Hospital, and Boston University School of Public Health. Leticia Davis, ScD, EdM, director of the MDPH’s Occupational Health Surveillance Program is the lead author.
This third paper addresses work-related amputations in Massachusetts. Davis and colleagues set out to calculate the magnitude of the undercount of amputations reported in BLS’s SOII estimate. They linked and compared the number of amputations cases in the BLS system to hospital and workers’ compensation records. For the period 2007-2008, using the self-reported employer data, BLS estimated there were 210 cases of work-related amputations in Massachusetts. Using the multi-source dataset, the authors identified 787 cases for the same time period. Davis and colleagues report that 41 percent of the actual amputation cases in SOII were not classified properly by the employers as amputations. Instead they were reported as “other injuries,” such as cuts, lacerations or crushings. We can speculate on the reasons for those errors, such as employers trying to misrepresent the severity of the employees’ injuries, or needing better instructions on how to classify injuries on their OSHA logs.
The authors classified each of the 787 case as “SOII eligible” (n=406), “SOII ineligible” (n=96), and “unknown SOII eligibility” (n=285.) They calculated the ratio of the multisource “SOII eligible” cases to BLS’s published estimates. They reported a 48 percent minimum estimate of the undercount.
Davis and colleagues reiterate, as other researchers have also done, that a multi-source surveillance system would provide much better data than BLS’s current system. They note, however, the practical challenges in attempting to design and implement such a system nationwide. Each state, for example, has different workers’ compensation laws and data collection systems, and policies regarding release of hospital records.
BLS called on researchers (and provided funding) to confirm the existence of an undercount and quantify its magnitude. Three of those studies are now published in AJIM. BLS is also sponsoring interviews with employers to learn their practices for recording work-related injuries on OSHA logs, and a study of historical trends in the undercount comparing SOII and workers’ compensation data. The results of these assessments will likely appear also in the literature.
In last year’s news release announcing the most current SOII data, BLS wrote:
“Several studies by outside researchers conducted in the mid 2000′s questioned the completeness of BLS injury and illness estimates from the SOII.
And added that the agency:
“established an ongoing research program to explore potential undercounting of workplace injuries and illnesses.”
At some point in the next few years, I hope we’ll see BLS do something else in addition to funding studies. When the agency releases its SOII data, BLS should mention the conclusions of these studies. I’d suggest, for example, something like the following for the paper by Davis and her colleagues:
“a study examining work-related amputations in Massachusetts found that SOII underestimated by at least 48 percent the number of amputation cases.”
That would be a further step to inform the public and policy-makers on the validity of SOII with respect to the true incidence of work-related injuries.
Seventeen year-old Brett Bouchard’s disabling injury is a reminder that thousands of work-related amputations occur in the U.S. every year. With better data on the magnitude of the problem, there might be more interest in preventing them.
Middle East respiratory syndrome (MERS) is a viral respiratory illness characterized by fever, cough, and shortness of breath, and it has been fatal in 30% of the cases identified since the disease was first reported in Saudi Arabia in 2012. It is caused by a coronavirus (MERS-CoV) and has been shown to spread between humans by close contact; new research suggests the virus may also be transmitted to humans from camels. Cases have been identified in multiple countries in the Arabian Peninsula, and a spike in cases in April — more than 200 in Saudi Arabia and the United Arab Emirates that month — has raised concerns. According to the European Centre for Disease Prevention and Control, 495 cases have now been reported worldwide. On May 2, CDC announced the first US case of MERS, in a patient who traveled from Saudi Arabia to Indiana.
The patient, a man in his sixties, lives in Saudi Araba and was working in a hospital in Riyadh where MERS patients were being treated. He flew from Riyadh to London to Chicago on April 24th, and then took a bus to Indianapolis. He experienced flu-like symptoms on April 27th and sought hospital treatment on April 28th. On May 2nd, CDC’s laboratory confirmed that he had MERS. The Chicago Tribune’s Juan Perez Jr. and Andy Grimm report on measures being taken to reduce the risk of the virus spreading:
Medical workers at an Indiana hospital who now have contact with the man are required to wear gloves, masks, gowns and eye protection. He’s being held in a room designed especially for patients with respiratory infections, segregated from the hospital’s air circulation system.
… As the man’s condition appears to improve and nobody else has shown evidence of infection, officials provided the most detailed account to date of the seriousness of care with which public health and Centers for Disease Control and Prevention have taken to investigate and contain the potential spread of MERS in the United States.
Roughly 50 hospital nurses, clerks, aides, dietary experts and other workers who came into contact with the patient before his infection was confirmed are on paid leave — isolated inside their homes as experts watch for signs of symptoms and test for infection during the virus’ known incubation period.
The man no longer needs the oxygen he received during the first part of his hospital stay, and is expected to be able to resume his visit with his family members, who have been asked to remain at home and to wear face masks if they leave. As of May 5th, none of the Indiana hospital workers tested positive for MERS. Because the incubation period can be as long as 14 days, they will be tested again 14 days after their initial contact with the patient.
Maggie Fox of NBC News notes, “The virus has not been known to spread on airplanes or buses. Most cases have been among people caring for sick patients or in very close contact with them.” Nonetheless, CDC is contacting the man’s airplane seat mates.
In order for officials to implement these kinds of control measures promptly, they need to quickly be able to identify a patient who may have MERS (or another serious contagious disease). In a CDC press briefing announcing the identification of this first US MERS case, Anne Schuchat, head of CDC’s National Center for Immunization and Respiratory Diseases, explained, “Because of the patient’s symptoms and travel history, Indiana public health officials tested for MERS-CoV.” Communication between healthcare providers and public-health officials is essential so that providers know what to look out for — in this case, flulike symptoms combined with recent Middle East travel — and can quickly take the necessary measures when a potential case shows up.
In its Healthcare Provider Preparedness Checklist for MERS-CoV, CDC reminds providers to stay up-to-date on the symptoms and case definitions for MERS-CoV, review infection control policies and recommendations (including personal protective equipment for healthcare personnel), be ready to deal with suspected cases in ways that minimize opportunities for the virus to spread, and know how to report potential cases, know how to communicate with state and local public health agencies.
CDC does not currently recommend that people change their travel plans; instead, its website (updated May 2nd) states:
If you are traveling to countries in or near the Arabian Peninsula, CDC recommends that you pay attention to your health during and after your trip. You should see a doctor right away if you develop fever and symptoms of lower respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in or near the Arabian Peninsula. Tell the doctor about your recent travel.
A Washington Post editorial notes that millions of pilgrims will visit Saudi Arabia for Ramadan in July and the hajj in October.
More than a decade ago, SARS — severe acute respiratory syndrome, which is also caused by a coronavirus — emerged in China’s Guangdong province and spread to 25 other countries, killing 774 of the 8,000 people who fell ill. Helen Branswell of The Canadian Press noted that many of the confirmed SARS cases were healthcare workers: 20% worldwide, and 43% in Canada.
China faced intense criticism for long delays in informing the public and sharing information with outside doctors after it first identified that the disease was spreading. Following the SARS outbreak, the World Health Organization revised the International Health Regulations to require members states to report disease outbreaks and to strengthen their surveillance and response capabilities. Prompt and complete sharing of information — both domestically and internationally — can help hospitals, public-health officials, and others prepare to respond promptly to potential and confirmed disease cases in order to limit the outbreak’s spread.
The Coalition of Immokalee Workers’ Fair Food Program has garnered praise from the White House to the United Nations for its innovative strategies to improve working conditions among farmworkers in Florida. The program, which began in 2010, works by getting big buyers to agree to only purchase tomatoes from farms that adhere to worker protection rules and ensure that workers are educated on their rights and responsibilities. Businesses that have signed on include Taco Bell, Chipotle and, recently, Wal-Mart, which according to a New York Times article chronicling progress on Florida farms, sells 20 percent of the nation’s fresh tomatoes. In reporting on the work behind the success as well as challenges ahead, the New York Times’ Steven Greenhouse wrote:
So far, the agreements between retailers and growers are limited to Florida’s tomato fields, which in itself is no small feat considering that the state produces 90 percent of the country’s winter tomatoes.
But gaining the heft and reach of Walmart — which sells 20 percent of the nation’s fresh tomatoes year-round — may prove far more influential. To the applause of farmworkers’ advocates, the retailer has agreed to extend the program’s standards and monitoring to its tomato suppliers in Georgia, South Carolina and Virginia and elsewhere on the Eastern Seaboard. Walmart officials say they also hope to apply the standards to apple orchards in Michigan and Washington and strawberry fields in many states.
…But progress is far from complete. Immokalee, 30 miles inland from several wealthy gulf resorts, is a town of taco joints and backyard chicken coops where many farmworkers still live in rotting shacks or dilapidated, rat-infested trailers. A series of prosecutions has highlighted modern-day slavery in the area — one 2008 case involved traffickers convicted of beating workers, stealing their wages and locking them in trucks.
“When I first visited Immokalee, I heard appalling stories of abuse and modern slavery,” said Susan L. Marquis, dean of the Pardee RAND Graduate School, a public policy institution in Santa Monica, Calif. “But now the tomato fields in Immokalee are probably the best working environment in American agriculture. In the past three years, they’ve gone from being the worst to the best.”
In other news:
The Charleston Gazette: In the wake of January’s Elk River chemical spill in West Virginia, federal officials are developing an “inhalation screening level” for MCHM, a coal cleaning chemical that spilled by the thousands of gallons into the river, contaminating drinking water for residents in nine counties. According to the article, the U.S. Environmental Protection Agency is developing a “‘health protective inhalation screening level’ that may be used, along with information on monitored air concentrations of MCHM, during the site cleanup process ‘to advise the public when exposure to MCHM is not anticipated to be harmful.’” However, state officials say EPA’s work may not be done in time to use during the site cleanup or when dismantling the tanks that contained MCHM. (The Gazette also covered a new federal rule to cut occupational coal dust exposure, which Celeste Monforton wrote about here as well.)
San Antonio Express-News: A decades-old refinery in San Antonio, Texas, is back in the news after an official with the San Antonio River Authority said the refinery’s latest owners aren’t living up to safety promises, with two spills in the span of five weeks. The refinery has a history of fires, accidents and pollution — for example in 2010, “a tanker truck explosion and a series of other blasts at the plant left a driver badly burned and sent thick black smoke skyward. It took firefighters nearly six hours to contain the fire.”
Government Accountability Project Blog: The project’s legal director, Tom Devine, testified before Congress in honor of Workers Memorial Day on whether private-sector whistleblower protections are strong enough to support safe workplaces. In his testimony, Devine noted that a founding pillar of occupational health and safety are laws that protect those who speak up about violations. He said that while whistleblower protections contained in the Occupational Safety and Health Act are the nation’s oldest and most used whistleblower protections, they’re also the country’s weakest whistleblower protections. Click here to watch the Senate subcommittee hearing.
Shreveport Times: An article about worker safety in New York dairies starts out with the story of Francisco Ortiz, who was killed after being caught in a machine that had reportedly been failing for some time. The local sheriff’s office deemed it an “accident,” though surely occupational health and safety advocates would say otherwise. Ortiz’s death was among many that helped jumpstart a worker center-led campaign to improve safety on diary farms. Campaign organizers noted that even though OSHA is planning a series of unannounced inspections this summer, rules that limit OSHA authority to farms with 11 or more nonfamily employees means that many workplaces will continue to fly under the radar.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Getting down and dirty with boots on the ground is one trait of a successful community organizer. It could also describe the work of the most-skilled epidemiologists. ATSDR scientist Frank Bove, ScD’s past experience with the first—an organizer from 1975 to 1982–makes him especially effective at the second.
Last month, Bove was recognized by the Boston University School of Public Health with the 2014 David Ozonoff Unsung Hero Award for his work. Bove has been the lead researcher in the Agency for Toxic Studies and Disease Registry’s (ATSDR) investigation of U.S. Marine Corps base Camp Lejeune. For nearly a decade, ATSDR has been examining the relationship between adverse health effects of former residents of Camp Lejeune and the association with contaminants in their drinking water. Between the 1950′s and late 1980′s the water provided to residents from the base’s water treatment plants were contaminated with high concentrations of TCE, PCE, vinyl chloride and benzene. Our colleague Dick Clapp has written about the Camp Lejeune here and also testified before Congress about it.
David Ozonoff, MD, MPH for whom the award is named, witnessed Bove’s expertise on the Camp Lejeune project as the ATSDR scientist maneuvered as both an epidemiologist and the community organizer. Ozonoff served in 2005 on an expert panel that made recommendations to Bove’s team on the feasibility and usefulness of conducting additional health studies of the Camp Lejeune population. One of the panel’s seven recommendations, in fact, the first one listed was “future studies should be conducted in full partnership with the exposed community.” The panel wrote:
“In contrast with many other places where toxic contamination of the environment has been a concern, the population at Camp Lejeune is relatively transient. Most of the population of potentially exposed individuals from Camp Lejeune is now widely spread throughout the United States and in some instances, around the world. This creates challenges in tracking individuals, in contacting and interviewing them where necessary, in gaining permission for access to their medical records (if necessary), and in communicating study findings to them. …Community members, with a personal involvement and concern about health effects associated with their past exposures, must be fully involved in any future research effort. These individuals can work closely with researchers and serve a liaison function with members of the more broadly exposed population(s) from Camp Lejeune.”
Some researchers would cringe at this directive. They’d say of the residents “they aren’t scientists, they aren’t capable.” Bove disagrees. He told me:
“Community participation always—always—improves the science. It makes the science relevant to the community.”
ATSDR established a community assistance panel which first met in February 2006. Meeting three to four times per year, the CAP has held 29 meetings. Bove has attended each and every one of them. I was hard pressed to identify many other participant, except the key community leaders, with such a stellar record of attendance. (Dick Clapp, DSc, MPH, who served as a technical adviser to the community group, had nearly a perfect record. Clapp’s philosophy of community-based research mirrors Bove’s.)
I can see another, more important practical reason to embrace the participation of engaged and vocal representatives of the effected community. They, better than ATSDR or most other government agencies with hat-in-hand, can convince lawmakers to not only be supportive of the cause, but to demonstrate support in the most concrete way: $$$. The Camp Lejeune study could not be done on the cheap.
The body of literature developed by Bove’s work is impressive. Besides the government reports, Bove and colleagues have published some of their work, most recently: “Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study,” (February 2014); “Evaluation of exposure to contaminated drinking water and specific birth defects and childhood cancers at Marine Corps Base Camp Lejeune, North Carolina: a case-control study, ” (December 2013)
In total, more than 750,000 individuals lived at Camp Lejeune during the four-decades of contamination. A slew of specific adverse health conditions, such as leukemia, breast cancer and miscarriage, including from pre-natal exposure, have been associated with exposure to the contaminated water.
The decades long saga of water contamination at the U.S. Marine Corps’ Camp Lejeune has been the subject of national news stories, the film “Semper Fi: Always Faithful,” and a new book “A Trust Betrayed: The Untold Story of Camp Lejeune and the Poisoning of Generations of Marines and Their Families.” Those who’ve followed the story will recognize the names: Jerry Ensminger, Mike Partain, and Tom Townsend. They are the key protagonists are who have made their mission holding the Marine Corps and DOD responsible for poisoning residents of the military base. Their efforts, and clearly the scientific evidence provided by Bove’s team, led Congress to pass “The Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012.”
Ensminger and the others are deserving of the credit they’ve received for seeing that the Marine Corps and DOD are held responsible for their misdeeds related to the poisonings at Camp Lejeune. It’s hard to imagine they’d have had the same success without Frank Bove, ScD’s involvement. He may be unsung, but certainly a public health hero.