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From the Chair: Jane Lipscomb

APHA and Section Present a Strong and United Voice at the OSHA Ergonomics Hearings

The spring of 2000 will go down in occupational health and safety history as the season of the "ergonomics hearings.” Between March 13 and May 12, federal Occupational Safety and Health Administration heard testimony from more than 1,000 witnesses at informal public hearings held in Washington, DC, Chicago, Ill., and Portland, Ore. Numerous American Public Health Association members testified at the three hearings. I had the privilege of presenting APHA testimony on May 12, the final day of the hearings held in DC. My testimony largely summarized the superb written testimony principally authored by Maggie Robbins and submitted to OSHA earlier this spring. If any of you have not seen APHA's written comments, they can be found on APHA's Web site, <www.apha.org>. The comments also appeared in their entirety in the March issue of the publication "Inside OSHA.”

For those of you who did not have the opportunity to attend and experience the aura of the hearings, each day was organized into various panels of presenters from OSHA, National Institute of Occupational Safety and Health, other agencies, labor and employer groups, ergonomic experts and professional associations. Panel members were given anywhere from 10 to 20 minutes to present their testimony and then industry, labor and OSHA were each given equal amounts of time for questions. APHA was given 20 minutes for our testimony and 45 minutes to respond to questions. Our testimony supported the overall standard but urged strengthening of many provisions. Our major criticism was that the proposed standard, with its injury trigger for risk identification and hazard reduction, is contrary to the basic tenant of public health theory and practice, namely primary prevention. Baruck Fellner, an infamous attorney representing United Parcel Service, the leading corporate opponent of this standard, was given the first 15 minutes of questions. Apparently Mr. Fellner was present for most of the three months of hearings and relished his role in challenging, albeit rather ineffectively, agency, worker, labor and academic testimony. As expected, his questions were directed at the scientific basis for the work-relatedness of musculoskeletal disorders (MSDs), the contribution of non-work activity to the development of MSDs, and the vagueness of the provisions of this performance-based standard. Bill Kojola of the AFL-CIO directed labor's 15 minutes of questions at whether APHA supported the scientific basis for the standard; the role of disincentives such as "safety bingo" and post injury drug and alcohol testing in negatively impacting the reporting and recording of injuries; and the problems with an injury-based trigger for risk identification and hazard reduction. OSHA's questions focused on the composition of the membership of APHA, our 1997 APHA resolution supporting an ergonomics rule, and the role of epidemiology in establishing causation between workplace factors and MSDs. OSHA expressed its appreciation of the APHA testimony and the strong voice APHA projects based on our numbers and the broad range of our members' expertise. We also have an opportunity to provide OSHA with additional information in a post hearing submission.

Despite the fact that the ergonomics hearings have dominated many of our Section members' time and energy this spring, work has continued on a number of other critical worker health and safety issues. Section members representing health care workers have worked relentlessly over the past decade to protect workers from needlestick injuries. These efforts have recently borne fruit in the passage of legislation requiring the use of safer needles in at least 10 states. See the related article for a full discussion of this activity.

In April, OSHA responded to the negative media created by its detractors by releasing a new policy directive to clarify the agency's enforcement policies on "home work.” The directive states that OSHA will not inspect home offices under any circumstances but will respond to complaints involving potentially hazardous factory work being performed in the home. Copies of the directive can be found at <www.osha.gov>. It should be noted that only three "home" inspections have been conducted in the agency's history, and all three involved high hazard situations.

Also in April, Section leadership selected winners of the three Section awards from the numerous highly qualified nominees. Congratulations to Mary Miller, recipient of the Alice Hamilton Award; Susan Moirs, recipient of the Loren Kerr Award; and Margaret Keith and Jim Brophy, recipients of the International Award. I hope many Section members will be present at the November OHS Section awards luncheon to meet and recognize Mary, Susan, Margaret and Jim for their contributions in protecting workers from health and safety hazards. Thanks to the awards committee for its hard work and support of the awards.

Nominations for Section leadership appeared in the May issue of The Nation's Health. You will receive your ballot in June. Please have your voices heard and be sure to complete your ballot.

Membership recruitment continues to be a priority for our Section. An article in this newsletter tells of the efforts of the Section task force on recruitment strategies, with the goal of restoring our Section membership to the numbers of several years ago. As I noted in the previous newsletter, Section membership has fallen by nearly 33 percent since 1992. The task force challenges each current member to "act locally" with a “one–to–one” effort to bring one colleague or student into the Section before the end of the year. The 128th APHA Annual Meeting in Boston, Nov. 12–16, will be a great opportunity to engage potential members in the activities of the Section.

The Boston Meeting offers much for OHS Section members. In addition to the wide range of interesting and informative papers that will be presented, the host committee has been extremely busy planning several labor history tours, the Section social and scholarship fundraising party. Please check the Section Web site for detailed program information as the Meeting date approaches. The fall newsletter will also feature the Section's preliminary program.

Recognizing that the pace and hours of work seem to increase as information technology (i.e., communication) “improves,” I hope everyone takes the opportunity to shut down the technology (yes, even e-mail and cell phones) and make time to enjoy some rest and relaxation this summer.

Jane Lipscomb

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Membership/Minority Recruitment Committee Report
by Carlos Eduardo Siqueira, Membership Committee co-chair

At our committee conference call on March 15 we (six committee members) discussed the drop in membership in our Section from a high of 1,500 in 1992 to less than 1,000 currently. Not only do we need to focus on reaching potential new members, but we also have to consider what we need to do to sustain the current ones.

The following points were discussed during the course of the meeting:

- Communities and areas with active members may want to develop some local activities to attract more members and sustain current ones.

[Note on the layout: these next four tabbed points are a subpart of the item immediately above, not separate items/paragraphs.]

We can also submit articles to the PHSC newsletter, either about our Section, our scholarship fund, or pertinent OHS issues. Currently the main way we interact with students officially is through the mentoring program sponsored by the Public Health Student Caucus and the Scholarship Fund.

The PHSC usually contacts all the Sections to recruit potential mentors. In the past that information has been circulated to the leadership roster and possibly the OSHAlert; now that we have a listserv that would probably be the better location for recruiting for this.

The Scholarship Fund brings students to the Annual Meeting. The program planners this year (and hopefully in the future) have reserved poster space for late breaker student presentations, and this would be appropriate for the scholarship winners (students and union representatives if appropriate).

Others connected with universities or other organizations that precept students can also promote student sponsorship to the organization and to the Annual Meeting.

- Student Fees: it was generally agreed that the student fees for APHA are definitely higher than other organizations ($10 for American Industrial Hygiene Association, $20 for American Conference of Governmental Industrial Hygenists, and $20 for Toxicology (not sure of the full name here). Perhaps this bears further discussion with APHA. In addition, the issue of joint membership fees, like with AIHA, American Association of Occupational Health Nurses, and American College of Occupational and Environmental Medicine, for instance, may need to be revisited.

Action Items:

- Discuss student fees and joint membership fees with APHA.

- Discuss possible role for NIOSH/ERCs.

- Identify an OHS membership committee member to liaison with the Student Caucus.

- Put the Careers Booklet on the Web site.

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Spring Into Safety: Youth Safety Campaign Kicks off Nationwide
by Colleen Baker, Missouri Division of Labor Standards and Young Worker Committee co-chair

The Missouri Division of Labor Standards kicked off, in grand style, our part of the national Child Labor Task Force's “Spring Into Safety” Campaign during the first week of May. We signed a Memorandum of Understanding with the U.S. Department of Labor, Wage and Hour Division. We also met with Missouri Gov. Mel Carnahan as he presented a proclamation to our department director, and to the regional administrator of the U.S. Department of Labor, Wage and Hour Division declaring May to be “Safe Jobs for Youth Month.”

Through various campaign activities around the country, we hope to raise awareness of two major concerns for working youth: their workplace health and safety and the impact of work on their education. The campaign was created by the joint federal/state Child Labor Task Force. The task force, created at the request of U.S. Secretary of Labor Alexis Herman, consists of representatives of 10 states and three from the U.S. Department of Labor, Wage and Hour Division. I'm fortunate enough to sit on this task force, representing both Missouri and all other states' labor standards agencies.

The campaign is endorsed by the organizations comprising the Task Force: the Interstate Labor Standards Association (ILSA), the National Association of Government Labor Officials (NAGLO), and the U. S. Department of Labor, Wage and Hour Division.

The campaign was introduced nationwide the first week of May. Labor standards agencies across the country planned activities throughout the month. We hoped to raise awareness about the fact that too many children are injured and killed at work each year. We wanted to demonstrate the link between abuse of child labor laws and youth injured at work.

In 1999, more than 233 of Missouri's 14– and 15–year–olds were injured seriously enough to file workers' compensation claims. Our division discovered more than 4,000 violations of Missouri's Child Labor Law. We hope, through this campaign, and our many other outreach efforts, that employers, parents, school officials and working youth will take advantage of the resources we make available to them. Our main intent is to teach everyone their rights and responsibilities under the child labor laws and basic safety guidelines for working youth.

This campaign is one of many being addressed by the Child Labor Task Force. Additional initiatives include taking a proactive stance on implementing the National Research Council's Protecting Youth at Work recommendations. Others include more coordinated outreach and enforcement efforts between state and federal agencies responsible for protecting working youth. Keep an eye out for the Task Force's momentum as it continues to build!

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NIOSH Awards recognize Scientific Merit and Exceptional Service
Submitted by Janie Gordon, University of Maryland School of Medicine and Scholarship Committee chair

The National Institute for Occupational Safety and Health (NIOSH) today presented annual awards to recognize the scientific excellence of publications by NIOSH scientists and engineers, and to honor exceptional service in the field of workplace health and safety.

The Alice Hamilton Award for 2000 was presented to four NIOSH publications from 1999 for high scientific merit. The award was presented in the categories of biological sciences, educational materials, engineering and physical sciences, and human studies. The publications were judged by outside scientific panels under several criteria, including the complexity and originality of the research, the significance of the research for addressing serious or prevalent workplace hazards, and the clarity of the presentation. The award is named for Dr. Alice Hamilton, a pioneering researcher and occupational physician.

NIOSH also presented its first annual James P. Keogh Award for Outstanding Service in Occupational Safety and Health, honoring the late Dr. James P. Keogh, a scientist and advocate for worker health and safety who died in June 1999 at the age of 49. Each year the award recognizes a current or former NIOSH employee for outstanding service in protecting workers' health and safety.

The Keogh Award for 2000 was presented to Dr. Richard A. Lemen, whose contributions to asbestos research furthered the development of better criteria for controlling asbestos exposures in the workplace and the prevention of asbestos-related diseases. Dr. Lemen joined the U.S. Public Health Service as a field industrial hygienist in 1970 and served in many capacities in NIOSH before his retirement, including positions as NIOSH Deputy director and acting director.

"Alice Hamilton and Jim Keogh set high standards for our field," said NIOSH Director Linda Rosenstock, MD, MPH. “We are pleased to honor their memories by recognizing this year's award recipients, who have carried on their tradition of scientific leadership and personal dedication to worker health and safety.”

The winning recipients of the Alice Hamilton Award for 2000 include:

- A study that uses innovative approaches to identify the biochemical reactions that occur in the cells and the genes following exposure to the industrial metal chronium VI. Understanding these effects will help scientists better predict and prevent cancer risks from chromium VI exposures.

- A training video that provides clear, meaningful instruction to miners for preventing death or serious injury from rock falls, a major hazard in underground mines. The video has been adopted widely in mine safety training programs.

- A study evaluating new engineering controls for asphalt paving equipment. The study is part of a landmark partnership under which NIOSH has worked closely with industry, labor and other federal agencies in significantly reducing worker exposures to asphalt fumes in asphalt paving operations.

- A study that provides the first rigorous attempt to substantiate NIOSH's revised lifting equation. The lifting equation is widely used for assessing whether manual lifting tasks involve increased risks for painful, costly back injuries, and which factors are responsible for the increased risk.

The winners of the Hamilton and Keogh Awards were announced at a ceremony in May at NIOSH's Alice Hamilton Laboratory in Cincinnati, Ohio. Dr. Nicholas Ashford, professor of technology and policy at the Massachusetts Institute of Technology, presented the keynote address for the ceremony. The ceremony was simultaneously broadcast to NIOSH's Robert A. Taft Laboratories, also in Cincinnati, and to NIOSH's other facilities in Morgantown, W.Va; Pittsburgh, Pa.; Spokane, Wash.; Atlanta, Ga.; and Washington, D.C.

A complete list of the Alice Hamilton Award winners and honorable mentions can be found on the NIOSH web site at <www.cdc.gov/niosh/hamward.html> or by contacting Fred Blosser at (202) 260-8519.

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Resolutions
by Jim Cone, Resolutions and Policy Committees co-chair

Members of the OHS Section submitted four resolutions for consideration by APHA at the upcoming Annual Meeting. They are described briefly below.

1. Public Health Benefits of a Living Wage — Among other provisions, urges support for “living wage” ordinances and legislation that has the effect of raising the income of the lowest income segments of the population as an explicit target for public health intervention, and urges the reversing of the growing disparities in income, education and health outcomes as an explicit objective within the Healthy People 2010 goals.
   
2. Public Health Impacts of Job Strain and Work Organization — Among other provisions, urges that quality job design and improved work organization be recognized as the keys to an economically effective and socially necessary program of upgrading the quality of life for all and improving public health; urges that employers join with workers and their unions to redesign jobs along sustainable principles of social equity instead of short-term profitability and “lean production.”
   
3. Expanded Family and Medical Leave — Urges, among other provisions, support for President Clinton's proposal to earmark $20 million in the federal budget for competitive planning grants to help states and other entities explore ways to make family and medical leave more affordable and that paid family and medical leaves should be provided to all workers, not just those fortunate enough to work for a medium to large-sized company or agency.
   
4. Protecting and Expanding OSHA Jurisdiction over home workplaces — Among other provisions, urges that OSHA regulations be enforced in home offices and home workplaces, including employer responsibilities such as employee training, improvement in work pacing and equipment, reporting of homework injuries and illnesses on the OSHA log 2000.

The next step for the resolutions is review by the APHA Joint Policy Committee and suggestions to the authors with a preliminary acceptance or rejection, based on the proposal as submitted. The revised resolutions (or reasons why changes are not accepted by the author) then are resubmitted to the JPC, for publication in the August issue of The Nation's Health (usually — it may be a different month this year) and opportunity for public comment in preparation for discussion at the Monday afternoon 2-5 PM hearings

conducted by the JPC at the Annual Meeting.

For full text of the resolutions or for further information on the resolutions process, contact Resolutions Committee chair Jim Cone at <jcone@igc.org> or (510) 622-4319. For text of the resolutions you can also visit our Section Web site (see electronic information sidebar).

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Book Review: Europe Under Strain
by Maggie Robbins, California Labor Federation

Europe Under Strain: A report on trade union initiatives to combat workplace musculoskeletal disorders. Rory O'Neill. TUTB - European Trade Union Technical Bureau for Health and Safety. 1999. ISBN 2-930003-29-4

This is not a technical book on ergonomics. And despite its subtitle, it is more than a report on union initiatives. “Europe Under Strain” reframes the discussion of ergonomics entirely from the way we usually talk about it in the United States. O'Neill puts forward the view that preventing ergonomic injuries isn't solely, or even mainly, about identifying and controlling physical "risk factors" of job tasks. It is about workers having enough control over their jobs that they can keep from being overworked, overstressed, worn out and thrown away. It is about changing work so no job degrades and alienates the workers doing them. In this book the term "job design" isn't referring to the physical engineering of the job, though that is included, but rather to the entire concept of how work is done and the jobs "designed" to accomplish that work. Ergonomist Philippe Negroni, associated with a French trade union, puts it this way: "For many people, work is tough. They are on the bottom rung of the ladder, and nobody is interested in what they do, at least that's how they see it. What is being challenged here is the way in which the work is justified."

The stated objectives of this short book are twofold. First, to demystify technical, scientific, medical and political arguments on musculoskeletal disorders (MSDs); second, to be a union source book on different approaches to tackling MSDs. The book meets these goals and goes beyond them. It is ceaselessly pro-worker and values the knowledge, wisdom and ability of workers to improve work life. The writing style is different from publications we see from unions in the United States. It is wordier and less linear in its approach. After wandering through its 120 pages, speckled with case studies, summaries of legislation, analysis, compilations of data, photographs, drawings and sample union fact sheets and posters, you've had a whirlwind tour of a world of ergonomics activism (mainly from Europe but also the United Kingdom and the United States).

Did you know that the European Union has a framework directive which mandates member nations strive to eliminate "repetitive and monotonous work? Can you imagine the U.S. Department of Labor even considering such a rule? Can you imagine U.S. workers demanding such a rule any time soon? Consider: this is an ergonomics rule at its core, which seeks to eliminate the structure of some jobs that make them damaging to the body and spirit of the workers doing them. There are more discoveries to be mined from “Europe Under Strain” — whole new ways of viewing the struggle over workplace safety.

This book does not have a U.S. distributor. Maggie Robbins has copies available for $15 plus $3 postage (which is below cost). If you would like a copy of this book, contact Maggie at <mrobbins@wiggle.sf.ca.us> or (415) 431-3841.

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Ten States Enact Safer Needle Laws
by Bill Borwegen, director of Health and Safety, Service Employees International Union

It has been a long and bumpy road that began at the 1990 APHA Annual Meeting in New York City. In conjunction with the Meeting, a group of unions and OHS Section members participated in the first safer needle coalition meeting. Service Employees International Union published a safer needle guide less than two years later. Since that time, 1,000 patents and 250 safer needle devices have been developed; more than 100 safer needle and other sharps devices are on the market. Yet as long as the nation's largest corporations continue to recklessly market cheaper inherently dangerous, obsolete, conventional needles, most healthcare workers will continue to be denied access to this life-saving technology. As a result too many workers, including our own OHS Section member, Meta Snyder, will succumb to bloodborne infections transmitted by this most common of all occupational injuries.

On the heels of this victory, a coalition of SEIU locals, other unions and organizations have been working to pass laws in all 50 states. As of today, the coalition has succeeded in enacting nine additional states safer needle laws (Georgia, Iowa, Maryland, Maine, Minnesota, New Jersey, Tennessee, Texas and West Virginia) with three more states passing bills that now await their governors' signatures (Alaska, New Hampshire and Ohio). An equal number of states are currently continuing to consider such legislation.

This state–by–state grassroots campaign has been necessary due to a continuing lack of leadership at the U.S. federal governmental level. It would be much simpler to amend the OSHA Bloodborne Pathogens Standard to require the use of the most effective safer needle and other sharps devices — not trying to pass 50 separate and frequently quite different state laws. Federal action has been slow and tentative:

- CDC has long resisted doing more regarding safer medical devices, most recently in its failure to include safer needle information in the 1998 edition of its Infection Control Manual for Healthcare Personnel, citing “space limitations.”

- NIOSH has done more. This past fall NIOSH issued an “Alert on Preventing Needlestick Injuries in Health Care Settings.” NIOSH is also making grant funds available to study the effectiveness of recently passed safer needle laws. This research is critically important, as we are beginning to learn that many of the so-called “safer” needles are nothing more than retrofitted conventional needles. Too many of these products have been rushed to production and are poorly designed.

- After years of ambivalence about this issue, in May 1999, U.S. Secretary of Labor Alexis Herman announced that OSHA would issue a compliance directive, amend the bloodborne pathogens standard and update their record keeping rule to require that contaminated needlesticks be recorded. To date, OSHA has only issued its November 1999 non-regulatory compliance directive. In April, in response to this relative inaction, the National Advisory Committee on Occupational Safety and Health (NACOSH), after being apprized of the situation, issued the following statement: "NACOSH believes that the issue of needlestick injuries is urgent and should be addressed quickly through regulatory action. The committee requests that the OSHA assistant secretary address this issue at the June 6 meeting and present an operational plan for acting on this issue."

- Also in May 1999, the U.S. Congress introduced HR 1899, a bipartisan bill that has 180 co-sponsors, including more than two dozen Republicans. This bill, if enacted, would streamline the OSHA rule–making process and require OSHA to amend the bloodborne pathogens standard within one year. We are hopeful that a Congressional hearing will be held before this current session ends. APHA and many other groups are supporting this bill, with sole opposition currently by the American Hospital Association.

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New from Tulane University: OHS MPH by Internet
by Peggy Farabaugh, clinical assistant professor, Tulane University School of Public Health and Tropical Medicine

The Center for Applied Environmental Public Health (CAEPH) at Tulane University School of Public Health is pleased to announce two Internet-based MPH (Masters of Public Health) degree programs. In addition to our MPH in Occupational Health and Safety Management, we are offering a NEW program, the MPH in Occupational Health.

The Occupational Health (OH) program is designed for physicians, nurses and other health professionals who work in occupational health programs or clinics. The 2-year, part-time program will provide the academic year required for board certification in preventive medicine/occupational medicine. The 36-hour curriculum includes study in biostatistics, epidemiology, health services management and administration, environmental health, toxicology and occupational health.

The Occupational Health and Safety Management (OHSM) program is designed for mid-career occupational health and safety or industrial hygiene professionals, who seek to expand management options. The 36-hour curriculum provides study in four areas: health and safety principles and issues; data analysis for management decision making; behavioral aspects of the workplace; and management. It integrates management principles as applied to health and safety.

These 2-year, interactive programs are the only truly synchronous (real-time, live interaction) distance MPH programs available. MPH students attend real time class over the Internet by logging onto CAEPH's Web site and receiving audio broadcast from the instructor with corresponding screens and teaching aids. Each course is broadcast in the evening (usually once a week) for 2-3 hours with breaks for questions and discussion. A delayed Web site replay may also be accessed. A sense of community and collaboration is facilitated with group assignments, networking, on-line chat rooms, bulletin boards, conference calls and e-mail.

For more information, visit our Web site at <http//caeph.tulane.edu/mph_occupational_health.htm> or call (800) 862-2122 ext. 2 or send an e-mail to <dlinfo@mailhost.tcs.tulane.edu>. Persons interested in the OH program should also visit our Web survey to give us feedback regarding the delivery and timing of this program, <http//129.81.241.145/occhlthsurvey/occhlthsurvey.html>.