From the Section Chair:

OHS Section Promotes Worker Health and Safety and APHA Integrity

It is a pleasure and honor to serve as Section chair as we begin the 21st century. I would like to thank Tom Robins for his great work over the past year. On behalf of the Section, I also want to thank Tom for his hard work and leadership on the APHA Development Task Force. Tom is one of only two APHA-wide Section representatives to this Task Force established to develop implementation and oversight procedure for fund-raising that reflects the Principles of Commercial Support approved by the Governing Council at the November Annual Meeting. It should be noted that these "principles" were approved despite grave concern expressed by the Section (and several other Sections) for the implication of this development activity on the integrity of APHA. Tom's nomination to the Task Force was supported by the leadership of these other Sections.

I would also like to recognize Mary Miller, for the numerous activities she took on in her role as past chair and in her ongoing role as very active Section member. Mary continues to maintain the excellent OHS Section Web Page. You can link to it from the APHA Home Page under the "Sections" location. Mary has also taken responsibility for coordinating policy activities within the Section. She has put together a list of the OHS Section resolutions passed since 1949, which will soon be posted on our Web page. Mary is looking for volunteers to assist her and other section members in a review of resolutions passed over the past 10 years to assess their current relevance and need for updating. An important aspect of this activity is a review of whether actions recommended in past resolutions have been undertaken and what has been the result. One Section member has offered to have graduate students review resolutions as part of a policy course. Section members interested in contributing to this effort, please contact Mary Miller.

This year is already an extremely active one for the Section on many policy fronts. OSHA's Proposed Ergonomic Standard was finally published in November 1999. APHA and the OHS Section have been fighting to move the ergonomic proposal to this public forum for the past several years. APHA has submitted written testimony to the OSHA docket and will testify at the Washington DC hearings beginning March 13. A copy of the written testimony is posted on the APHA Web Site. Thanks to Maggie Robbins for coordinating (and nearly single-handed writing) the Section testimony. Many Section members will be testifying for their own organizations at one or more of the three upcoming hearings (Washington, DC, Chicago, Portland.Ore).

The Section has also been active in responding to an ungrounded and underhanded attack on OSHA by its numerous opponents related to the publication and subsequent withdrawal of a letter of interpretation regarding OSHA coverage of home work. The letter which OSHA sent to an employer who planned on placing some of his employees in home offices has been grossly misrepresented by OSHA opponents and the media and is being used to attack OSHA as it approaches the upcoming ergonomic hearings. OSHA opponents have characterized the letter as "a big brother-like overreach" and "an outrageous extension of the Washington bureaucracy into the lives of working men and women across America" to quote several such opponents, rather than the logical application of health and safety standards as well as labor law to all workers regardless of their place of work. For the record, it should be noted that OSHA has conducted a total of three home inspections in its 30-year history involving quite hazardous operations including workers and their family members being exposed to lead and other toxic substances while working in their kitchens. Not a single home inspection was conducted in the past seven years under the Clinton administration. Anyone interested in contributing to a Section-sponsored resolution on home work can contact me at <lipscomb@son.umaryland>.

Another critical focus for the Section in the upcoming year is recruitment (and retention) of Section members. The Section has continued to lose members over the past several years from a high of more than1,500 in 1992 to less than 1,000 this past November. I would hope that Section activism on policy issues such as those listed above would alert every health and safety advocate not currently a member of APHA (and the OHS Section) to the benefit of belonging to the largest association of public health professionals worldwide. Please spread the word to colleagues, coworkers and students who are not members. The Section has several new activities under way to encourage Section membership. The Section selected and supported five students, labor representatives and/or COSH members to join the Section and travel to the Chicago meeting. We are hoping to have even more applicants for next year's scholarship fund. A second recruitment strategy is the APHA mentorship program. A number of Section members volunteered to serve as mentors to students/new members last year. Anyone interested in working on these or other membership recruitment activities please contact Derrick Hodge, section membership co-chair.

The OHS Section was extremely active at the November APHA Annual Meeting held in Chicago. The Section sponsored more than 30 Sessions and other activities. Highlights included a memorial for Jim Keogh, longtime worker advocate and active Section member who died unexpectedly earlier in the year. Jim was also recognized at the awards luncheon with his wife, Debby Wertheimer, and daughter, Sara, accepting the Alice Hamilton Award in his name. Other award recipients were June Fisher, who received the Lorin Kerr Award for her lifetime of work to protect the health of health care workers, in particular her work with front line health care workers and others to promote the use of safer needles to prevent needlestick injuries. Fernanda Giannas, a safety engineer in the Brazilian Ministry of Labor, received the International Award for her activism and work while fending off death threats from companies whose unsafe work practices she had exposed in her efforts to protect the health of Brazil workers from asbestos and other workplace hazards in this highly industrialized country. As in the past, the Section was very active on the policy front, submitting and assisting in the approval of three resolutions on the topics of safer needle devices, diesel exhaust and the use of union hotels for future APHA Annual Meetings (co-sponsored with the Labor Caucus).

Finally, as many of you have noted, this year I have been very fortunate to have a chair-elect who has taken responsibility for the OSHAlert listserv. Many thanks to Denny Dobbin for assisting the Section in this increasingly important activity. The OSHAlert was established a number of years ago as a means of communication around critical policy issues requiring immediate action.

SUBCOMMITTEE REPORTS

Occupational Health Nursing Subcommittee

Subcommittee members expressed concern during our brief meeting at APHA that the OHS Section and the Occupational Health Nursing subcommittee are losing nurse members to the Section on the Environment. We discussed inviting all nurses with an interest in OH and EH to join the OHN Subcommittee. We are so few, and our interests certainly overlap, that it makes sense to join all the nurses with an interest in OH and EH into one subcommittee. Discussion was truncated due to time constraints, but will continue throughout the year.

The Needlestick Prevention Panel sponsored by the OHN Subcommittee in honor of Meta Snyder went well and brought together national experts and expert/activists who inspired us all to keep working in our respective states to force use of safe needle devices. Efforts to upload the panelists' presentations to a Web site under development at the University of Maryland are under way.

There is a needlestick video conference planned for March from New England. We are looking for a hospital practitioner that may be interested in being interviewed. Ellen Cepetteli is doing this out of UVM.

A new listserv for nurses interested in environmental health will be launched from and moderated by the University of Maryland School of Nursing. Anyone interested in subscribing should contact Kate McPhaul.

We are renewing efforts to coordinate CEUs for nurses for as many OH sessions as possible. The ability to earn CEUs draws nurses from outside our Section with obvious benefits as well as providing us with CEUs for sessions we attend. Let me know if our efforts meet your needs. Feel free to call me at (410) 706-4907 if you can help organize this project.

Finally, the AOEC is assisting the OHNs in reaching out to our nurse colleagues in public health by submitting an abstract to the Public Health Nursing Section highlighting the public health advocacy of several member OHNs in their OH practice. This case-based panel aims to raise awareness of environmental/occupational hazards for public health nurses and to encourage PHNs to get involved by collaborating with OHNs.

Kate McPhaul, MPH, RN
Carol Somers, RN, ScD

Industrial Hygiene Committee
1999 Chicago Annual Meeting

A small number of IHs met as the Industrial Hygiene Committee at the Annual Meeting in Chicago. Although individual committee members were active during this year's Annual Meeting, the committee itself was not. Those attending the Annual Meeting were interested in the past year's activities of the Social Concerns Committee (SCC) working with the American Industrial Hygiene Association (AIHA). Our discussion eventually turned to considering the following questions: (1) How can progressive IHs most influence the "ideology" and practice that define the "profession", and (2) How do we maximize progressive IH influence on national and international EOH and S policies? We decided that this discussion should continue in Boston in 2000 at the 128th Annual Meeting as a formal presentation that will include IH activists with varying perspectives. Although the specifics will focus on IH activities, the discussion is relevant to progressive EOH and S activists in the other "professions" that constitute the Section.

AIHA/SCC activities in Chicago

We discussed the need to respond to a draft AIHA position paper on workplace reproductive hazards. Subsequently, Rebecca Cohen and Jean Grassman prepared a formal response to the SCC that will be considered when the position is accepted by the AIHA Board.

Other APHA members have been active in shaping AIHA policies, including Jean Grassman, Jon Rosen and Garrett Brown. Jean has been developing a draft position on genetic monitoring in the workplace. Jon Rosen chairs a task force he initiated on workplace violence and is a member of the OSHA 2005 task force. Finally, Garrett Brown recently accepted Steve Levine's (AIHA President) request to chair a new task force looking at international EOH and S practices and the role that His can play to eliminate "sweatshop" practices.

Global Issues Caucus

During the months preceding June 1999, the SCC circulated a call for a meeting of AIHA and ACGIH members meeting in Toronto. Forty-five people attended the meeting and discussed various aspects of EOH and S in the "global" economy. Participants agreed that there should be a cross-organizational committee to address these issues. Despite our good intentions, we have not found someone who can play a more central role in making this happen. Anyone interested in assisting this effort should contact Jim Albers or Jean Grassman. 

For more information about the IH Committee, contact Jim Albers.

Submitted by Jim Albers

SECTION AWARDEES

Dr. Linda Rae Murray Receives the National Black Caucus of Health Workers' Hildrus A. Poindexter Award at the APHA Annual Meeting

by Andrea Kidd Taylor

On Wednesday, Nov. 10, 1999, our Section's own Linda Rae Murray was keynote speaker at the National Black Caucus of Health Care Workers' Hildrus A. Poindexter Annual Awards Dinner. Linda was also a recipient of the award. Dr. Poindexter was an author, scholar, educator and physician who spent the majority of his life serving others, first as an assistant professor of bacteriology, preventive medicine, and public health at Howard University's College of Medicine, then as medical director of the U.S. Public Health Service, conducting most of his work in West Africa. Past recipients of this prestigious award have been June Jackson Christmas, George L. Lythcott, George "Mickey" Leland (posthumously), Deborah Prothrow-Stith and others. It was most fitting that Linda's accomplishments were acknowledged and recognized by her peers and her name added to the list of public health activists. As stated in the program "Linda Rae Murray, MD, MPH, a public health scientist, is known for her persistent and extremely articulate advocacy for the poor and disadvantaged as well as for her commitment to public health and social justice. She is recognized nationally and in Canada as an expert and consultant in occupational and environmental health."

Congratulations, Linda! We are proud of you!

by Janie Gordon and Kate McPhaul

James P. Keogh (Jim) received the Alice Hamilton Award in a bittersweet tribute that celebrated his contributions to worker health and safety and mourned his recent death. Jim's co-workers Kate McPhaul and Janie Gordon presented the award, which was accepted by Jim's wife, Deborah Wertheimer.

The audience responded with appreciative laughter when Kate read from Jim's correspondence to employers and enforcement agencies that had balked at doing the right thing regarding several patients. (Names were removed, of course!) Jim's great wit and dry humor shone through, as did his strong advocacy on behalf of his patients. No one could speak the truth more eloquently than Jim could.

The range of Jim's contributions were highlighted: patient care, medical education, public health advocacy and occupational health research. His unique ability to see and address both the small and big picture simultaneously without sacrificing either was lauded. Jim's work always involved active outreach to workers, local unions and community physicians. He pressed for worker protections for asbestos and lead, beginning with an individual patient but always quickly moving to prevention.

Debbie Wertheimer accepted the award and read a report that Jim and Debbie's son, Josh Keogh, had written about what a fighter Jim was for people who couldn't fight for themselves. Josh's words left us sad but also energized to continue to fight for better, safer and healthier jobs for working men and women.

By Darryl Alexander

Twenty-one years ago, Dr. Fisher was struck by the enormous risk of blood-borne pathogen infection to healthcare workers from exposure to patient blood and the high incidence of needlestick injuries that resulted in infection. She was also convinced that these serious, often deadly work-related infections were completely preventable. Since then she has worked tirelessly with frontline health care workers on methods to eliminate exposure to contaminated blood.

An outgrowth of this work is the Training for the Development of Innovative Control Technology (TDICT). Organized in 1989 by Dr. Fisher, this unique project brings together product designers, industrial hygienists and frontline healthcare workers to promote the development and use of control technologies to prevent occupational exposure to blood. The fundamental premise of the project is that the frontline worker is the expert regarding his or her own work, and needs to be involved in all stages of the development, evaluation and selection of the technology used in work. This unique collaboration has been the basis of Dr. Fisher's criteria for 13 categories of safety equipment. These criteria have been developed as guides for frontline healthcare workers to evaluate and select the best devices for use.

The most notable result of Dr. Fisher's work has been the impact on safe sharp and needle device design, development and use by healthcare facilities. The criteria have become benchmarks for manufacturers in the design of newer generations of such devices.

Dr. Fisher has served as a major resource for the California State Legislature in the development of landmark legislation mandating control technology to prevent occupational exposure to blood.

Dr. Fisher continues to work on preventing work-related injuries and illnesses among urban transit operators. In 1978, when she first organized the occupational health clinic at San Francisco General Hospital for the employees of the City and County of San Francisco, she observed that bus and light rail operators appeared to have elevated rates of high blood pressure. Dr. Fisher then organized a research team from the School of Public Health, University of California, Berkeley to examine this problem.

That research effort evolved into the MUNI Health and Safety Project that has been in existence since 1982. Dr. Fisher has been the director since its inception. As such, she has been instrumental in the international expansion of the project that now is the longest running and most consistent research effort to examine and improve the working conditions of transit workers around the world. The project has published widely in the scientific literature and more that five doctoral dissertations have emerged from the project.

Dr. Fisher assured that the project worked closely with labor and management and formally included them in the process as "The Working Committee."

Dr. Fisher's work on the health and safety problems of urban transit workers will serve as an innovative model by other public health and occupational health specialists for the identification and elimination of work-related hazards in a broad range of settings.

Dr. Fisher has demonstrated through all her work that the active involvement of affected populations strengthens public health research and intervention activities. Her work and approach are well worth examining by all public health professionals and should inform the work of all public health institutions.

International Award - Fernanda Giannasi.

by Barry Castleman

Fernanca Giannasi is an engineer and a labor inspector in the state of Sao Paulo; she also teaches at the universities on industrial injury investigation and prevention. An activist on issues including asbestos and nuclear hazards, she is the leader of the movement to control asbestos hazards and ban asbestos in Brazil, and founder of the country's leading asbestos victims' group. She has the respect of the media and the deepest appreciation of the unions in Brazil. When she returned to Osasco, the industrial suburb of Sao Paulo where she works and established the asbestos victims' group, she was honored by the people there for having received the International Award. There were also reports of her receiving the award in the leading newspaper of Sao Paulo.

The APHA award is a continuation of the extraordinary international support Fernanda has received. In late 1998, the big asbestos company in Brazil filed charges to get a criminal court to prosecute her for criminal defamation over an Internet notice she had sent. Letters asking the judge to dismiss the charges poured in from professional organizations (including APHA and SOEH), unions, asbestos victims' groups and federal legislators from around the world. This received publicity in Brazil, and the judge threw out the charges early in 1999.

Fernanda has now filed a civil suit against the responsible parties asking reimbursement of her legal costs and unspecified amounts in "moral damages." The asbestos company announced after a stockholders' meeting in late 1999 that it would plan for a future beyond asbestos and take more seriously the criticisms of people calling for a ban.

International support such as this Section's International Award has been important to Fernanda Giannasi in offering some additional security and protection for her courageous efforts in Brazil. She is the single parent of a daughter who will be 4 in February.

The Occupational Health and Safety Section will be awarding scholarships which include registration for the 2000 APHA Annual Meeting, (Nov 12 - 16, 2000, Boston, Mass.), a one year membership in APHA and $200.00 for conference expenses. We hope to strengthen the participation of students and union representatives in APHA and our section. We recognize that we need the involvement of workers and new health & safety professionals to make our workplaces & communities healthy and safe.  GO TO SCHOLARSHIP FUND FOR MORE INFORMATION.

• Application for: STUDENTS
• Section Member Applying for: UNION REPRESENTATIVE

Clinical Practice Reviews Now Online

A series of clinical practice reviews developed by the New York State Occupational Health Clinic Network is now available online. The reviews were published in the January 2000 issue of the American Journal of Industrial Medicine (Vol. 37, No. 1).

This issue of the AJIM will be available online through a link at the NYS Department of Health's Web Site. This free access has been provided by the New York State Department of Health (NYS DOH) and will be available until Dec. 31, 2001.

The special issue, titled "The Diagnosis and Treatment of Occupational Diseases: Integrating Clinical Practice with Prevention," includes peer-reviewed articles developed by clinicians in the Clinic Network. The nine clinical practice review topics are: asbestos, lead, solvents, CTS, other upper extremity CTDs, low-back disorders, NIHL, asthma and medical evaluation for respirator use.

The Nominations Committee has discussed the possibility of the Chair and the Secretary positions being two-year terms. This could minimize the need for getting new officers up to speed every year and officers would be able to make better use of the experience they gain. On the potential down side, it might be too long for some people to commit to and become more difficult to recruit nominees. It also becomes an extended period of time if past chairs and chair-elects continue to remain active with current leadership.

The APHA Constitution does allow us to do this if we want to. We are proposing that we discuss this item at the Annual Meeting business meeting in Boston.

Letter to the Editor

The Fall 1999 issue of the newsletter has a review by Marianne Brown of the book, "Hazards of the Job From Industrial Disease to Environmental Health Science" by Christopher C. Sellers. In the 1950s and 1960s, I was Assistant Health Commissioner of Cincinnati and a Professor at the Kettering Laboratory of the University of Cincinnati. I have heard Robert Kehoe describe how he first investigated the cause of deaths resulting from tetra-ethyl lead and then helped to devise a procedure to avoid the hazard from this very toxic compound. Brown quotes Sellers as assuring "the Tide Water Associated Oil Company that leaded gasoline could not poison workers who were exposed during manufacture."

This statement must have been taken out of context to give the conclusion that Kehoe was either a blithering idiot or speaking in complete disregard of his own published writing and speaking. I do not know Sellers or his credentials. I do know that Kehoe did as much as anyone to work for control of lead poisoning in children and adults based on what was known at the time about the metabolism of lead and its effects. He initiated the process of blending TEL at the refinery rather than at the gasoline pump and for many years had his own physicians check every person working on the blending to insure they were not being harmed and at the same time had the Ethyl Corporation safety people check the operation for compliance with safe procedures.

It has become common to criticize pioneers in occupational and environmental health for their failure to know what wasn't known at the time they did their work. It is unfortunate that Ms. Brown was insufficiently familiar with the subject matter to question Sellers interpretation of Kehoe's comments. Kehoe was a very active member of APHA and of the Occupational Health Section. I find it impossible to accept that he would make such a statement without some sort of modifier, to the effect, that it would be impossible if they adhered to the safety procedures which had been instituted.

Mitchell R. Zavon, MD, CIH
Past Chair, Vice Chair, Secretary
Occupational Health and Safety Section, APHA

OHS WEB PAGE : The section's Web page, is at to Mary Miller for consideration.

OSHAlert: OSHAlert is a list of e-mail addresses of those who wish to receive information about items that require action, letters to Congress on OSH-related legislation, testimony on OSHA rule-making, and other significant information which is time-sensitive and requires action. To "subscribe" (or "unsubscribe") to this list, place the action you require in the subject field in an email to Denny Dobbin and Jane Lipscomb,  and you will be included. If you have send it to Denny Dobbin and Jane Lipscomb for consideration. Please make the item brief and concise and mention the action required and deadline.

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