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by Kim Krisberg
Texas construction workers who’ve lost their lives on unsafe worksites may be gone, but they certainly haven’t been forgotten. Earlier this week, hundreds of Texas workers and their supporters took to the streets to demand legislators do more to stop preventable injury and death on the job. They took their demands and the stories of fallen workers all the way the halls of the state capitol.
Just two days ago, workers from every corner of the Lone Star state made their way to Austin to take part in the Day of the Fallen, a day of action to memorialize construction workers killed on the job and to call for legislative action. Construction workers, local union members, students, worker rights advocates and supporters donned T-shirts that read “Day of the Fallen: We BUILD Texas, We deserve better,” held up signs and massive protest puppets, and, led by a local high school marching band, chanted their way to the doors of the state capitol building. Many participants hailed from worker centers from around the state, such as Fe y Justicia (Faith and Justice) Worker Center of Houston, Fuerza de Valle (Forces of the Valley) of the Rio Grande Valley, the Labor Justice Committee of El Paso and the Workers Defense Project of Austin, which organized the event. (Read more about these worker centers here, here, here and here.)
“The march today is to put a stop to poor conditions and call for better wages and just treatment for construction workers,” Luis Rodriguez told me via a translator just minutes before the march took off. Rodriguez, a member of the Workers Defense Project Construction Worker Committee, lost one of his fingers in 2010 while working as a carpenter on a job site. He said the injury was due to a lack of safety preparations. His employer didn’t have workers’ compensation insurance either — in fact, Texas law doesn’t require employers to carry such insurance.
During the Day of the Fallen, protestors reminded onlookers and legislators that Texas is the deadliest state for construction workers, with the highest construction worker fatality rate in the nation. According to data from Workers Defense Project, one in five construction workers is injured on the job, only 40 percent of workers are covered via workers’ comp, more than 20 percent of construction workers report not being paid for their work, and half don’t receive overtime pay. (For more details on Texas’ abysmal construction worker record, click here.) Hours before the march, nearly 200 workers and supporters visited the offices of Texas lawmakers to advocate for better working conditions for construction workers.
In a report released last month by Workers Defense Project and titled “Build a Better Nation: A Case for Comprehensive Immigration Reform,” authors Amy Price and Cristina Tzintzún wrote about the conditions facing Texas construction workers and the poor policies that perpetuate the unsafe and unfair conditions they face:
Texas is facing a crisis in construction. …Undocumented workers have few protections, resulting in deadly, illegal working conditions that lower standards for all workers laboring in the industry. Current policy has left employers with few options other then to hire undocumented workers, forcing them to put their businesses in legal jeopardy or remain unable to compete. A healthy economy requires sensible immigration policies that encourage growth, protect workers, and allow business to compete on a level playing field.
The report found that as many as 400,000 Texas construction workers are undocumented, noting that immigrant workers are often paid less and are more likely to experience wage theft and be injured or killed on the job when compared to their U.S.-born counterparts. Exacerbating the situation, immigrant workers often fear that reporting unsafe or abusive working conditions will lead to arrest or deportation. Regardless of the legal status of workers, employers are required to abide by federal and state employment law. The report notes that “undocumented construction workers play a vital role in building Texas and the United States, yet many remain excluded from the construction industry’s formal labor market. Comprehensive immigration reform that protects the rights of workers and honest businesses can halt the ‘race to the bottom’ that now characterizes the construction industry.”
The report offers a number policy recommendations, such as policy that protects the employment rights of undocumented workers and protects them from deportation if they come forward about workplace abuses. It also calls for a pathway to citizenship that ensures industries such as construction will be able to thrive in safe and fair environments.
Back at the march, Chris Wagner, a member of the International Brotherhood of Electrical Workers Local 520, told me he was taking to the streets to “bring light to dangerous working conditions…there’s not a lot of pressure (in Texas) on keeping jobs clean and orderly.”
“We’ve got to change the mindset of leadership to make safety a real priority,” Wagner said.
When the hundreds of marchers made their way to the steps of the Texas capitol, they were joined by state Sen. José Rodriguez of El Paso. Rodriguez, who noted that “construction workers are vital the economy of the state and the nation,” said he will again push for legislation to ensure rest breaks on the worksite and to authorize the Texas Workforce Commission to impose penalties for employers guilty of wage theft.
“You deserve better than what you’re getting from the state of Texas,” Rodriguez said.
To learn more about the experience of construction workers in Texas, visit www.workersdefense.org.
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 an editorial published today in the Journal of Public Health Policy, Anthony Robbins, MD, MPA calls on the public health community to take on the social problem of distracted driving caused by mobile devices.
“Only a public health strategy is likely to weave government, commercial, community, and individual tools available in schools, workplaces, and neighborhoods, into a comprehensive approach to make people safer while on or near roads.”
Robbins argues that the problem is more complex than drivers behaving badly.
“Around the world, new communication technology is ever more ubiquitous [and] large commercial interests promote these communication technologies. It has always been a problem to keep powerful vehicles fully under control. To do so, society has built safer vehicles and designed safer roads. We have written laws to deter dangerous driving. Yet addictions have always challenged road safety efforts, because under the influence of drugs and alcohol, to which they may be addicted, drivers cannot choose to drive safely. Now comes a new addiction: the compulsion to be in touch, to communicate immediately. E-mail, Facebook, Twitter, and many elements of new media appear to be addictive, as the users feel a compulsion to communicate immediately.”
“How are commercial interests adapting to and enhancing user demand? The makers of telephones and other communications devices have made them faster and easier to use, and, of course, more attractive to look at. The telephone companies (Internet service providers) have spread their signals to reach almost everyone, everywhere, with more and more information sent and received per second. The makers of cars and trucks are creating a new image to sell their product. Buyers seem attracted by new in-vehicle environments that emphasize distractions and communication rather than the road ahead.”
“Phone makers, service providers, and automakers could be developing technologies to keep the driver focused on the road, but if they are doing so at all, it is very slowly and less visibly. …This is where the public health community is needed. Let’s take the lead and study the technologies, the laws, and the addictive behaviors so that we can develop an inclusive strategy to control distracted driving.”
“…To eliminate distracted driving, public health can do more than focus on the distracted driver who causes damage, injury, and death. A primary prevention strategy will lead us beyond the behavior of individuals to the corporations in the communications and automobile industries and government regulators. Let us target them to change the driving environment within which drivers make choices.”
Over the past half-decade, the US has seen a sharp increase in high-volume hydraulic fracturing — also called hydrofracking, or simply “fracking” — to extract natural gas from underground shale formations. States’ responses to fracking applications have varied, and in general public health concerns seem to have gotten far too little consideration.
The latest issue of the environmental and occupational health policy journal New Solutions is devoted to the issue of high-volume hydraulic fracturing (HVHF), and PDFs of all the articles are available for free online. It’s a great resource for anyone interested in learning more about the public health issues involved in hydrofracking, and I especially like the piece by Katrina Smith Korfmacher, Walter A. Jones, Samantha L. Malone, and Leon F. Vinci that describes how public health can contribute to the ongoing conversation on this issue. Here’s how they describe their big-picture view:
This commentary considers the entire life cycle of, and processes involved in, the expansion of HVHF, including site preparation, drilling and casing, well completion, production, processing, transportation, storage and disposal of wastewater and chemicals, sand mining, and site remediation. The rapid changes, scale of development, and pace of extraction made possible by HVHF could affect health directly or indirectly through changes in vehicular traffic, community dynamics, unequal distribution of economic benefits, demands on public services, health care system effects, impacts on agriculture, and increased housing costs. At the same time, economic growth resulting from HVHF may contribute to improvements in individual health status, health care systems, and local public health resources. The public health also requires assessing the long-term and cumulative impacts of this dispersed-site extractive industry, as well as the distribution of these impacts, particularly within low-income rural populations.
They describe potential public-health impacts, including:
- Contamination of surface and ground water, use of massive quantities of water that might be needed for other purposes, and the challenge of treating millions of gallons of of wastewater;
- Air pollution from drilling operations and from increased vehicular traffic;
- Noise and light contributing to stress among residents living near fracking operations;
- Strains on local healthcare and emergency response resources;
- Occupational health issues including high injury rates and exposure to hazardous chemicals;
- Increased exposure (for workers and communities) to respirable crystalline silica — which can cause lung disease — due to the dust produced by mining and transporting frack sand; and
- Greenhouse-gas-producing emissions from all stages of the process. (The authors write, “Natural gas is more efficient and clearn-burning than coal … However, some projections suggest that obtaining natural gas through HVHF actually produces more greenhouse gas emissions than does coal production and burning.”)
The authors then describe a public-health response to fracking, based on five perspectives from a framework described by Howard Frumkin and colleagues in 2008: Prevention, risk management, co-benefits, economic impacts, and ethical issues. A prevention-oriented approach includes steps such as requiring discolosure of chemicals used in fracking operations (not currently required under federal law), baseline monitoring of environmental and health quality, and conducting health impact assessments. Risk management includes considering cumulative impacts of HVHF over time. Co-benefits “result when actions yield benefits in multiple arenas,” such as water-quality monitoring that identifies non-fracking-related water issues that might not have been detected otherwise.
Consideration of economic impacts must account for the boom-and-bust cycle typical of energy developments and long-term as well as short-term costs, the authors urge. They remind us, “The history of environmental health includes many examples of long-term remediation costing more than prevention,” and note, “The distribution of costs and benefits from HVHF is highly variable.” This variability in costs and benefits informs their recommendations on ethical issues, which include considering the burden fracking will place on future generations, vulnerable populations, and communities that are already economically and geographically disadvantaged. They recommend “informed, ongoing, and meaningful participation by affected communities” to promote ethical decisions.
Of course, it’s much easier to employ a public health perspective to make ethical, prevention-oriented decisions when public officials call on public health practitioners before issuing permits for hydrofracking or any other activity with such far-reaching potential health impacts. A policy statement adopted by the American Public Health Association at least year’s annual meeting criticizes the limited involvement of public health in fracking:
[As] of 2012, public health professionals have had a limited role in policy-making, regulatory, and planning decisions regarding HVHF. Public health professionals should actively engage in the full range of decisions relevant to HVHF, from education of health care providers and local health departments to local land use policy, administrative and budgetary decisions, and state and federal air and water quality policies. Policies that anticipate potential public health threats, use a precautionary approach in the face of uncertainty, provide for monitoring, and promote adaptation as understanding increases may significantly reduce the negative public health impacts of this approach to natural gas extraction.
Also in 2012, the Institute of Medicine held a workshop on the health impacts of shale gas extraction, and many of us wished such a session had been convened before HVHF activities became as widespread as they are today.
It’s to the credit of the team behind this issue of New Solutions that the articles don’t just bemoan the problems with hydrofracking, but recommend steps we can take from now on to improve public health outcomes. (You can download all the articles here.) Getting states and the federal government to implement such steps will still be a challenge.
Most of the tributes to former Surgeon General C. Everett Koop, who died yesterday at age 96, are quick to remind us that he became a household name. As the New York Times‘ story notes that “is a rare distinction for a public health administrator.” Dr. Koop’s notoriety could be attributed to his “long silver beard and white braided uniform,” as TIME magazine noted, to his pronouncements in 1986 about the health effects of second-hand tobacco smoke, and for his eventual warnings about the risk factors associated with contracting HIV. The USA Today‘s obituary about the Reagan-era Surgeon General recalls that his mailing in 1988 to 107 million households about HIV/AIDS “came in a sealed packet with the warning that ‘some of the issues involved in this brochure may not be things you are used to discussing openly.’” In more recent years, the former Surgeon General wrote about the health perils of obesity and managed care, and rejected evidence on the adverse consequences of phthalates on human health.
The mass murders at Sandy Hook Elementary and the death by gun fire of other youngsters like Chicago student Hadiya Pendleton, 15, drew my attention to another article by C. Everett Koop. In 1992, he wrote an editorial for the Journal of the American Medical Association entitled “Time to Bite the Bullet Back.” Koop and co-author George Lundberg, MD argued that violence is a public health issue that could be addressed more effectively by an interdisciplinary approach. The Surgeon General indicated that his views on gun violence were informed by his 1985 Workshop on Violence and Public Health.
“No society, including ours, need be permeated by firearm homicide. …The right to own or operate a motor vehicle carries with it certain responsibilities…we propose that the right to own or operate a firearm carries with it the same prior conditions.”
Their criteria were:
- be of a certain age and physical/mental condition
- be required to demonstrate knowledge and skill in proper use of that firearm
- be monitored in the firearm’s use, and
- forfeit the right to own or operate a firearm if these conditions are abrogated.
“These restrictions should apply uniformly to all firearms and to all U.S. inhabitants across all states through a system of gun registration and licensing for gun owners and users. No grandfather clauses should be allowed.”
Many–too many–tears have been shed for victims of gun violence. President Obama has offered a proposal to address the problem, and some Members of Congress have proposed their own fixes. I think that Dr. Koop would agree that there is no one, single action to solve the problem, but shame on the U.S. if we don’t even try.
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The two-year anniversary of OSHA’s proposed silica rule being stuck at the White House Office of Management & Budget (which Celeste wrote about here) attracted some media attention. NPR’s Nell Greenfieldboyce did an in-depth story on the hazards of airborne silica exposure, which increases the risk of lung cancer and the lung disease silicosis, and the lengthy White House inaction on OSHA’s proposal. Her piece includes a story from one worker who saw the damage of silica exposure firsthand:
Tom Ward, a 44-year-old mason who lives and works in Michigan, knows just how bad silicosis is. When he was a kid, his dad developed silicosis, after working as a sandblaster. Ward remembers his father coming home one day and collapsing.
“The last day he worked he came in and fell down and pretty much, you know, fell apart basically, and said, ‘I can’t do it no more,’ ” says Ward.
His father got the official diagnosis of silicosis at age 34 and died at age 39. “So we watched him slowly suffocate for five years,” says Ward.
Ben Goad reports in The Hill that OMB’s apparent willingness to move forward on the rule seemed to stall after trade groups lobbied on the issue:
By placing the item on its regulatory agenda in 2011, the administration signaled a willingness to move ahead with the rule. That year, at least 50 people from at least 35 organizations met with OMB’s Office of Information and Regulatory Affairs (OIRA) in nine disclosed meetings about the substance, disclosure records show.
More than a dozen trade groups and K Street shops reported lobbying on the issue in 2011.
The flurry of activity was followed by months of apparent inaction at OMB. It has since become a cause célèbre of pro-regulation groups and safety advocates, who have criticized the administration for slow-walking controversial regulations during Obama’s first term.
Some of the frustration was directed at former OIRA administrator Cass Sunstein, a devotee of cost-benefit analysis who served as regulatory gatekeeper until his departure from the administration in August.
Critics also questioned whether the delays were politically motivated.
Worker-health advocates weighed in with opinion pieces, AFL-CIO president Richard Trumka with a Huffington Post piece “White House Inacation on Silica is Deadly for Workers” and National Council for Occupational Safety and Health executive director Tom O’Connor with the Charleston Gazette op-ed “Two years old, Silica Rule remains mired at OIRA.”
And at the Coshnet Blog, Dorry Samuels reports on recent research by the Center for Construction Research and Training (CPWR) that found “wet cutting” methods to reduce airborne crystalline silica concentrations by 85%.
In other news:
Charleston Gazette: After a series of recent mineworker deaths, West Virginia Governor Early Ray Tomblin ordered a “safety stand-down,” during which state mining operations would pause for a review of safety laws and best practices. The US Mine Safety and Health Administration announced a coordinated effort, but neither state nor federal officials proposed new inspections or enforcement efforts.
Occupational Safety and Health Administration: Following the death of 21-year-old Lawrence Daquan “Day” Davis, a temporary worker who was crushed to death by a palletizer machine on his first day on the job in Jacksonville, OSHA has cited Bacardi Bottling Corp. for 12 alleged safety violations, two of them “willful.”
National Partnership for Women & Families (Paid Sick Days blog): In Washington state, the House Labor and Workforce Development has approved two bills on paid sick days and family and medical leave insurance; Vermont’s legislature has introduced a paid sick days bill; and Philadelphia City Council members have introduced an earned sick days ordinance.
New York Times: Although drone pilots do their work miles away from battlefields, they experience PTSD and other mental-health problems at the same rate as pilots deployed in Iraq and Afghanistan, a Defense Department study finds.
Reuters: NOAA researchers warn that as the planet’s climate gets hotter and wetter, people will have to limit outdoor work far more than they currently do in order to avoid heat stress.
by Kim Krisberg
For many migrant farmworkers, the health risks don’t stop at the end of the workday. After long, arduous hours in the field, where workers face risks ranging from tractor accidents and musculoskeletal injuries to pesticide exposure and heat stroke, many will return to a home that also poses dangers to their well-being. And quite ironically for a group of workers that harvests our nation’s food, one of those housing risks is poor cooking and eating facilities.
A group of researchers and advocates recently decided to take a closer look at such facilities among migrant farmworker communities in North Carolina, home to an estimated 150,000 farmworkers during peak season and one of the largest such worker populations in the country. While a number of previous studies have uncovered the substandard housing conditions migrant farmworkers often experience, this was the first study to zero in on kitchen and eating facilities. The study, which was published in the March issue of the American Journal of Public Health (AJPH), found that the most common violations were improper refrigeration temperature, cockroach infestation and drinking water contamination.
“For migrant farmworkers, this is an occupational hazard because their housing is part of their jobs,” said Sara A. Quandt, a co-author of the study and a professor in the Wake Forest University Division of Public Health Sciences’ Department of Epidemiology & Prevention. “About two-thirds are guest workers and provision of housing is part of the terms of employment, so they don’t have a lot of choice in where they live. …They arrive, they go to work, they work very long days and very long weeks, and their employers are responsible for the provision and maintenance of their housing.”
To conduct the study, Quandt and her colleagues studied more than 180 migrant farmworker camps in 16 eastern North Carolina counties. They inspected the cooking and eating facilities using standards from the North Carolina Department of Labor (the agency charged with inspecting migrant farmworker housing) and also took drinking water samples. The housing types ranged from barracks to old houses and trailers; kitchen facilities also varied, from those built to look like a commercial kitchen to the type of kitchen you’d find in a small apartment. Study authors Quandt, Phillip Summers, Werner Bischoff, Haiying Chen, Melinda Wiggins, Chaya Spears and Thomas Arcury write:
Food contamination during storage or preparation, lack of appropriate kitchen facilities, and undercooking can increase the risk of food-borne illnesses. In the long term, absence of safe food storage or cooking facilities can constrain the type of foods consumed and lead to elevated chronic disease risk. For example, the inability to safely store fresh fruits and vegetables can lead to low consumption, a known risk factor for diabetes and cancer.
Researchers found eight of the 15 standards assessed were violated in about 10 percent of farmworker camps. Coliform bacteria was detected in water samples from nearly 35 percent of kitchens; in more than 65 percent of inspections, at least one fridge had a temperature greater than the safe level of 45 degrees; and about 21 percent of kitchens were rated as unsanitary for food preparation.
Cockroach infestation was found in nearly 46 percent of kitchens inspected and rodent inspection in nearly 29 percent. More than 25 percent of kitchens had improper or damaged flooring and about 12 percent had structural issues, both of which up the risk for animal and insect infestation. Farmworker camps with H-2A visa holders, which permits legal entry in the country for seasonal agricultural work, were home to significantly fewer violations than camps with undocumented workers.
Having previously worked with migrant farmworkers and spent time in their homes, Quandt told me she wasn’t particularly surprised by the findings. However, she said she was surprised by the high number of refrigerators operating at above-safe temperatures — temperatures that make it easier for bacteria to quickly multiply. She said that some of the fridges were simply in disrepair, while in some housing, overcrowding meant the fridge was opened so often it was hard to maintain safe temperatures.
“But in many cases, they’re just old fridges and in dwellings that are extremely hot in the summer, so it’s very difficult for them to cool adequately,” Quandt said.
Quandt said the danger of food- and water-borne illness is far greater than issues of malnutrition, though migrant farmworkers often report food insecurity problems tied to low wages as well. She noted that it’s difficult to track the health outcomes that could stem from poor kitchen facilities, especially as many related diseases are likely under-reported among farmworkers and there are other reasons such workers would experience gastrointestinal distress, such as extreme heat or overexposure to nicotine from tobacco leaf harvesting.
“These are folks who are working with food crops, so if in fact they do have (food- and water-borne) illnesses those may well be passed on to consumers and that’s something we really haven’t looked at in this country,” Quandt told me. “Growers aren’t necessarily getting rich, but some of the only elasticity they really have is labor, so you scrimp on what you pay people and where they live. That is the human cost of the food that we eat in this country.”
Quandt said one message she and her colleagues want to get across with the study is that the current inspection system in North Carolina isn’t adequate — “it’s not uncovering problems that are threats to health and safety.” She said not only is the inspection system underfunded, but inspections only take place before housing is occupied, unless a specific complaint is lodged after occupancy. Melinda Wiggins, executive director of Student Action with Farmworkers and a co-author of the AJPH study, said inspectors would uncover many of the violations the researchers did if they returned after housing was occupied. For example, inspectors don’t examine kitchen facilities in the midst of overcrowded conditions or in the middle of the growing season when housing looks very different.
Wiggins also told me the state often spends its limited resources inspecting the same migrant farmworker housing over and over again, instead of directing its efforts at some of the most egregious violators, which are often farms employing workers without H-2A visas. She said it’s this type of housing that inspectors rarely see — “we want (the state) to think about how to be more creative with its limited resources to really focus on the worst violators,” she said. Wiggins and fellow advocates have previously tried to push more comprehensive farmworker housing standards through the state’s General Assembly, but were unsuccessful. However, they’re going to try again this spring. The AJPH study findings have already been translated into a user-friendly policy brief that will be used to educate legislators.
“Poor housing in general is a huge issue that impacts farmworkers,” Wiggins said. “Because otherwise, we’re talking about a fairly healthy population. But when they’re put in the situation of hazardous work and hazardous housing, they become one of the most unhealthy populations around.”
Quandt noted that not all the farmworker housing they see is bad — “we saw some really exemplary places and these are growers who have really made an effort.” Still, she said inspection policies should change to truly protect farmworkers’ health.
“Many people will say, ‘Well, these places are still better than where they live in Mexico,’ but farmworkers just scoff at that,” she said. “They may be poor, but they don’t live in conditions like this.”
To read the AJPH study, click here. To read about how it is possible to create healthy living conditions for migrant farmworkers, check out this account of a brand new healthy and green farmworker community in Florida.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for the last decade.