Tales from the Front: NACOSH Meeting September 14
From the Office of Adele Abrams, Esq., ASSE’s Federal Representative –
The National Advisory Committee on Occupational Safety and Health met at the Department of Labor in Washington, DC on September 14-15, 2010. Committee members in attendance included: Peg Seminario (AFL-CIO Director of Safety and Health); Bill Borwegan (SEIU Director of Safety and Health; Roy Buchan (Colorado State University Occupational Health Section); Denise Pouget (Assistant Fire-EMS Chief, Alexandria, VA); Chair Michael Silverstein (Assistant Director, WA Division of Occupational Safety and Health); Emery Knowles (Manager of Industrial Hygiene and Safety, Northrup Gruman); Joe Van Houten (Senior Director Worldwide EHS at Johnson & Johnson); Peter Dooley (LaborSafe); Susan Randolph (Clinical Assistant Professor, Occupational Health Nursing Program, UNC-Chapel Hill); and Linda Rae Murray (Chief Medical Officer, Cook County Dept. Of Health). Committee contacts included: Keith Goddard (NIOSH); Deborah Page Crawford (OSHA); Sarah Shortall (OSHA); and Paul Middendorf (NIOSH).
On Tuesday September 14, 2010, Dr. John Howard, Director of NIOSH, gave a general update on NIOSH activities. He said that NIOSH was closely watching the status of the World Trade Center bill (S. 1334, H.R. 847) which would Congressionally authorize the World Trade Center Health Program, rather than NIOSH having to rely on appropriations bills each year without specific Congressional instructions on how the program should be operated. . Dr. Howard provided a list of issues that are in priority status for the CDC: HIV; obesity/diet/exercise; food safety; teen pregnancy; tobacco; environmental health; immunization; emergency preparedness; and motor vehicle injuries (he noted that this is the leading occupational hazard for workers today).
NIOSH is currently working on or is in the process of working on: eliminating black lung (collaborating with MSHA); entering into an interagency agreement with OSHA regarding nano with the objective to design a risk management model; addressing food flavorings and lung disease; fatigue issues; electronic medical records and what is considered information that has meaningful use; chest radiography surveillance (changing from flat film to digital); working with the Ryan White HIV Act; and the youth education project creating safety and health curriculums for high school students.
Following Dr. Howard’s update, comments included the issue of the aging workforce as a focus for NIOSH (Dr. Howard said that NIOSH has been working on this for a while and has three WorkLife Centers in the US; NIOSH is also working with OPM and OMB on this issue); the lack of agricultural safety and health prominence in the field of Occupational S&H (Dr. Howard agreed to some extent but noted that there are 10 agricultural centers in the US that provide education and outreach on agricultural S&H); safe patient handling; and the extension of work hours that has cropped up during the recession, causing S&H hazards due to exhaustion.
The next presentation was on the Gulf Oil Spill Response. Deborah Berkowitz of OSHA and Dr. Howard provided a summary of how OSHA and NIOSH responded during the crisis and all the steps taken to insure the safety of workers. Ms. Berkowitz said that OSHA’s job was to keep BP’s feet to the fire in regard to providing workers with proper training, safety equipment, and implementation of safety protocols. OSHA made 4,000 site visits, 6,000 exposure assessments, and reviewed 80,000 exposure assessments provided by BP. She said that at the peak, there were 6,000 boats involved and 37,000 workers. Ms. Berkowitz noted that OSHA used the learning experiences from the Exxon Valdez clean-up and 9/11 to inform the decisions of procedure.
Dr. Howard spoke very generally, stating that OSHA and NIOSH did a good job of interacting with the power structure (Coast Guard). He said that OSHA needs to have a clearer autonomous role in disaster situations, where it will not be the “hand-maiden” to FEMA , the Coast Guard, or any other agency (he referred to the Stafford Act). Dr. Howard said that NIOSH had a roster of 52,000 people who worked on the oil spill, and had obtained samples of the dispersant and unadulterated crude oil from the spill (pre-dispersant). He felt it was imperative to look at community behavioral stress issues.
The OSHA update was provided by Deborah Berkowitz and two people from the Directorate of Standards and Guidance. Ms. Berkowitz noted that the new Enhanced Enforcement Program already has 27 companies on its list after one month in operation. Twenty-three of the companies have less than 100 employees and 24 of them are construction companies. Fatalities have been the main catalyst for 24 of the 27 companies to be under enhanced enforcement. At the end of the fiscal year, there will be 18 egregious cases on OSHA’s docket as compared to last year with only 4 cases. In regard to the OSHA’s record keeping NEP, 25 inspections have been initiated so far, and the program will continue next year.
Grain silo deaths have become a hot topic for OSHA. Dr. Michael’s sent a letter to 3,300 grain companies demanding that they follow OSHA standards given the recent spate of deaths. What OSHA has discovered is that companies are just not following the standard. OSHA’s Illness and Injury Prevention Program (I2P2) was referred to as the “find and fix” program, meaning the goal is to find what the hazards are and fix them. The difficulty in addressing the outdated PEL’s system was discussed with OSHA looking for any suggestions from the Committee.
Dr. Howard returned to discuss flu precautions, including the options of mandatory flu vaccinations for health care workers. He said that health care workers have the highest risk of getting the flu. It was noted by one committee member that in any discussions regarding flu pandemics, there should be also a discussion about mandatory paid sick days so that people will not be forced to come to work sick and expose co-workers to the flu.
On September 15th, the focus was on two subgroups that NACOSH is considering forming, one to address how the agencies (OSHA/NIOSH) match resources with needs, and the second on how to make safety and health an imperative. It was recognized that these are both very broad subjects, and need to be better defined. In general discussion, Peg Seminario noted that NACOSH’s role is to provide advice to the agencies, not just to discuss safety and health issues. Emory Knowles agreed the role was to advise, especially on standards development, and he urged continuation of the excellent, evolving relationship between OSHA and NIOSH. If resources are limited, he suggested there may have to be greater utilization of consensus standards. Bill Borwegen suggested that OSHA has been “stuck in an industrial mindset” and as the economy shifts focus, so must OSHA.
Dr. David Michaels, the OSHA Assistant Secretary, presented the agency view and said that OSHA is eager to look at lessons learned from the Gulf cleanup experience, and that OSHA learned the benefits of interagency cooperation (with NIOSH, Coast Guard etc.). It raised awareness of issues of heat and fatigue – neither of which OSHA addresses in standards. This extends beyond emergency workers to agricultural workers, construction and even those who erect cell towers. Long hours are known to adversely affect the ability to work safely. Medical residents have apparently petitioned OSHA for a rule on hours of work, and some companies (e.g., Alcoa) have placed limits and will not let workers exceed 60 hours/week.
Michaels also addressed injury/illness data surveillance and said that safety professionals and employees need to be involved in examining accidents and near misses. Injury data helps OSHA to target resources. He said OSHA can collect more information, by law, than it currently requests and suggested that state plan data surveillance should be examined to see what could be learned for development of federal programs. He admitted poor quality of data with regard to occupational illnesses, because of the long latency periods and failure to report on OSHA logs. There was discussion of whether data could be mined from worker’s compensation agencies or other public health departments, but there may be some legal issues associated with this.
Chairman Michael Silverstein said many work-related illnesses remain beneath the radar, and many injuries also do not make it into the OSHA logs. This triggered a lengthy discussion of incentive program (or “disincentive” programs as some called them) and how workers will not report an injury due to peer pressure. One member questioned why such programs are not a violation of section 11C of the OSH Act. Michaels explained that if a worker chooses not to report an injury, OSHA cannot take action, but if a worker reports an injury and is denied a benefit (e.g., pizza, or a raffle ticket under an incentive program) as a result, that would be an 11C violation.
Seminario suggested that a lot of activity concerns what the I2P2 program should look like (for OSHA and MSHA regulated companies) and the goal is to change the culture to encourage employees to report injuries and near misses. Workers’ fear of reporting has come up repeatedly in the investigations into BP and Big Branch by OSHA/MSHA.
Knowles brought up the PELs issue, saying the process is broken and OSHA should aggressively move to require Best Available Control Technlogy (BACT) when processes are set up, and to utilize control banding thereafter. Michaels said that Congress gave EPA permission to require BACT and it would take an act of Congress to give OSHA this authority. OSHA must look at each chemical individually, but he encouraged NACOSH to explore the issue more, and that perhaps control banding could be part of controls under I2P2. Michaels added that the basic idea of I2P2 is embraced by unions and some employers but others are not clear on what it means. OSHA must do a survey on employer costs, and a SBREFA panel before issuing a proposed rule, so there is a lot of time to consider the issue. He would like NACOSH to have a committee working on this, reviewing information from stakeholder meetings, and making recommendations to OSHA.
Another issue addressed by Michael was outreach to vulnerable populations. OSHA is working with their area offices so they can respond quickly when they get employee complaints not in English. This issue is very important to OSHA and Michaels asked for NACOSH’s help.
After a break when Dr. Michaels departed, there was additional discussion about injury/illness surveillance. Knowles questioned whether the goal was for surveillance or enforcement. A subgroup will look at these issues in the next meeting, including the role of incentive programs in affecting reporting. Seminario also noted that NIOSH should be involved because they have data. Linda Murray said that NACOSH is an advisory group, not a research group, and urged that it not get bogged down in trying to do “peer review” type studies. The chairman responded that NACOSH must provide credible advice while not being “paralyzed” by studies. The goals of the first subgroup will be to determine how surveillance systems can be changed to better protect safety and health, and employee rights. This includes examining: (1) How are current systems of I/I surveillance designed; (2) what are the systems used for; and (3) what role do incentive/disincentive programs play.
Another issue discussed was the need for OSHA to be more proactive in addressing protection of emergency workers, and Knowles suggested that OSHA could develop contingency plans in advance for types of emergencies that could be anticipated, rather than being in a reactive mode. He urged OSHA to think strategically.