Preventing Illness and Injury in the Workplace

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Preventing Illness and Injury in theWorkplace

April 1985

NTIS order #PB86-115334



R ecom m ended C i t a t ion :

Preventing Mness and Injury in the Workplace (Washington, DC: U.S. Congr ess, Officeof Technology Assessment, OTA-H-256, April 1985).

Library of Congress Catalog Card Number 84-601152

For sale by the Superintendent of Documents

U.S. Government Printing Office, Washington, DC 20402



Foreword

Congressional interest in work-related disease and injury led to the passage of the

Occupational Safety and Health Act in 1970. The Occupational Safety and Health Admin-

istration and the National Institute for Occupational Safety and Health were created

to administer that Act, which stated an ambitious goal: “to assure so far as possible

every working man and woman in the Nation safe and healthful working conditions. ”

This report responds to a request from the Chairman of the House Committee onEnergy and Commerce and a supporting letter from the Chairman of the Senate Com-

mittee on Labor and Human Resources. In this report, OTA examines three main topics:

identification of occupational hazards, including the available data on injuries and ill-

nesses; development of control technologies for reducing or eliminating workplace haz-

ards; and the incentives and imperatives that influence decisions to control hazards.

Workers, employers, health and safety professionals, and government officials have

all contributed to progress in this field. But improvements can still be made. More con-

certed effort and better use of existing methods would enhance hazard identification.

Further research could improve health and safety control technologies and contributeto their incorporation in U.S. workplaces. Employers’ decisions to control hazards might

be fostered by changing the incentives and imperatives that affect those decisions.

In preparing this report, OTA staff drew upon the expertise of members of the assess-ment advisory panel and contractors, as well as other experts in the field of occupa-

tional health and safety. Contractors’ reports are available from the National Techni-cal Information Service. In some cases, contractors’ opinions and viewpoints differ from

those in this report. Drafts of the final report were reviewed by the advisory panel,

chaired by Dr. Morton Corn; executive branch agencies, congressional staff, and other

knowledgeable individuals and groups. We are grateful for their assistance. Key OTA

staff involved in this assessment were Michael Gough, Karl Kronebusch, Hellen Gel-

band, Gwenn Sewell, and Beth Bergman. Denny Dobbin worked on this report while

on detail from the National Institute for Occupational Safety and Health.

Director

I l l



ADVISORY PANEL FOR PREVENTING ILLNESSAND INJURY IN THE WORKPLACE

Morton Corn, Chair Department of Environmental Health Sciences

The Johns Hopkins School of Hygiene and Public HealthBaltimore, MD

Duane L. Block Ford Motor Co.

Dearborne, Ml

Richard F. BoggsOrganization Resources Counselors, Inc.Washington, DC

Mark R. Cullen

Yale Occupational Medicine Program

Yale University School of MedicineNew Haven, CT

Philip E. Enterline

Graduate School of Public HealthPittsburgh, PA

Melvin W. First

Department of Environmental Health Sciences

Harvard School of Public Health

Boston, MA

Matthew GillenAmalgamated Clothing and

Textile Workers UnionNew York, NY

Melvin Glasser

Committee for National Health InsuranceWashington, DC

William J. McCarville

Monsanto Co.

St. Louis, MO

Wilbur L. Meier, Jr.Dean, School of EngineeringPennsylvania State University

University Park, PA

Samuel Milham, Jr.Washington State Department of Social

and Health Services

Olympia, WA

Kenneth B. Miller

Workers Institute for Safety and Health

Washington, DC

Ted E. PotterShepherd Chemical Co.

Cincinnati, OH

Milan RacicAllied Industrial Workers UnionMilwaukee, WI

Mark A. Rothstein

West Virginia University College of Law

Morgantown, WV

Marilyn Schule

Centaur AssociatesWashington, DC

Michael O. Varner

ASARCO, Inc.

Salt Lake City, UT

James L, Weeks

United Mineworkers of AmericaWashington, DC

Roger H. WingateLiberty Mutual Insurance Co. (retired)

Mirror Lake Post Office, NH

John Mendeloff, Special Consultant University of California—San Diego

La Jolla, CA



O T A P R O J E C T S T A F F – P R E V E N T I N G I L L N E S S

A N D I N J U R Y I N T H E W O R K P L A C E

Roger C. Herdman1and H. David Banta,

2 Assistant Director, OTA

Jacqueline C.

Health and Life Sciences Division

Clyde J. Behney, Health Program Manager

Michael Gough, Project Director

Karl Kronebusch, Analyst Denny Dobbin, Analyst

3

Hellen Gelband, Analyst Gwenn Sewell, Research Assistant’Beth Bergman, Research Assistant’

Virginia Cwalina, Administrative Assistant Rebecca Erickson, Secretary/Word Processing Specialist

Carol Guntow, Clerical Assistant Brenda Miller, Word Processor/P.C. Specialist

Contractors

Linda Starke (Editor), Washington, DC

Robert Arndt and Larry Chapman, University of Wisconsin

Margit L. Bleecker, The Johns Hopkins Medical Institutes

Corn, The Johns Hopkins University School of Hygiene and Public Health

Robert Goble, Dale Hattis, Mary Ballew, and Deborah Thurston, Clark University and Massachusetts Institute of Technology

Philip J. Harter, Washington, DC

John L. S. Hickey, Carol H. Rice, and Brian A. Boehlecke, University of North CarolinaINFORM, New York, NY

Marthe Beckett Kent, Kensington, MD

Judith R. Lave and Lester B. Lave, Pittsburgh, PA

Douglas MacLean and Mark Sagoff, University of Maryland

W. Curtiss Priest, Massachusetts Institute of Technology

Jerry L. Purswell and Roger Stephens, University of Oklahoma

Springborn Management Services, Inc., Enfield, CT

Ruth Ruttenberg, Washington, DC

.—‘From December 1983.

2Untll August 1983

‘Detallee from National Inst]tute for Occupational Safety and Health‘June 1983 -Ju]y 1984‘January-June 1983



Contents

Chapter Page

l. Summary and Options.....,,.....,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

2. Data on Occupational Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . . . . 29

3. Health Hazard Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 414. Safety Hazard Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

5. Technologies for Controlling Work-Related Illness . . . . . . . . . . . . . . . . . . . . . . . . . . 77

6. Technologies for Controlling Work-Related Injury . . . . . . . . . . . . . . . . . . . . . . . . . 103

7. Ergonomics and Human Factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

8. Personal Protective Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143

9. Hierarchy of Controls ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

10. Training and Education for Preventing Work-Related Injury and illness. . . . . . . . 189

11. A Short History of Private and Public Activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

12. Governmental Activities Concerning Worker Health and Safety . . . . . . . . . . . . . . . 21913. Assessment of OSHA and NIOSH Activities . . . . . . . ,.. . . . . . . . . . . . . . . . . . . . . 257

14, Decisionmaking for Occupational Safety and Health:

The Uses and Limits of Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275

15. Incentives, Imperatives, and the Decision to Control . . . . . . . . . . . . . . . . . . . . . . . . 297

16. Economic Incentives, Reindustrialization, and Federal Assistance for

Occupational Safety and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327

17. Preventing Work-Related Injury and Illness in the Future . . . . . . . . . . . . . . . . . . . . 345

Appendix A.–Supplemental Information on OSHA and NOSH. . . . . . . . . . . . . . . . . 359

Appendix B.—Working Papers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381

Appendix C.—Acknowledgments and Health Program Advisory Committee . . . . . . . 382Appendix D.—Glossary of Acronyms and Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423

vii



. . .

Summary and Options

.



Contents

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Associated Deaths, Injuries, and Illnesses . . . . . . . . . . . . . . . . .Identification of Occupat ional Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Technologies to Control Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Training and Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dissemination of Health and Safety Information . . . . . . . . . . . . . . . . . . . . . . . . .Incentives and Imperatives That Influence the Decision to Control Hazards .Reind ustrialization and Workp lace Health and Safety. . . . . . . . . . . . . . . . . . . . .

op tions for Controlling Workp lace Haza rd s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Data and Hazard Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Improved Control Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Edu cation,Training, and Informat ion Dissemination . . . . . . . . . . . . . . . . . . . . .Incentives and Imperatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .The Role of O SH A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Creation of an Occup ational Safety and Health Fund .. . . . . . . . . . . . . . . . . . . .The N eed s of Sma ll Busin esses . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Assessing Health and Safety Programs.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

4

6

7

10

11

11

15

16

16

18

19

21

22

24

25

26



—

1 s

Summary and Options

Occupational hazards are not spread evenly:

Some workplaces, such as banks and offices, havefew hazards; manufacturing is more dangerous;

and mining and construction are comparativelythe most hazardous, Certain hazards—some chem-

icals and forms of radiation—are concentrated in

particular places of work; others—powerful ma-

chines and fast-moving machinery—are foundpredominantly in manufacturing and construc-

tion. Each uncontrolled hazard is an opportunity

for preventing illness or injury.

The exact numbers of workplace-related deaths

and injuries are disputed, but OTA estimates that

there are about 6,000 deaths annually—about 25 per working day—due to injuries. Depending on

how injuries are counted, between 2.5 million and

11.3 million nonfatal occupational injuries occur

each year. Each working day there are about

10,000 injuries that result in lost work time and

about 45,000 that result in restricted activity or

require medical attention. There is so little agree-ment about the number of workplace-related ill-

nesses that OTA does not take a position on thecontroversy about the “correct” number. Most

deaths and injuries occur one at a time or in smallnumbers in the Nation’s more than 4..5 million

workplaces.

OTA finds that controls for health and safetyare often developed for specific workplaces and

not d isseminated to others. This results in du plica-

tion of effort as employers faced with the same

or similar problems are u naw are of successful con-

trols and thus do their own research and devel-

opment. As well as being economically inefficient,

the unshared knowledge about controls may con-

tribute to injuries and deaths.

Occupational hazards accompanied the indus-trial development of the Nation. In the 19th cen-

tury, for instance, advances in manufacturing andtransportation exposed workers to new hazards,

including boilers, train couplings, and powered

saws, Scaldings, burns, missing fingers, hands,

and arms, and other injuries were the unplanned

consequences of work.

Because the relationship between these hazards

and injuries is usually immediate and direct, rec-ognition of the hazards is relatively straightfor-

ward. The connection between occupational haz-

ards and illness is more difficult to pin down.

Although a number of skin and respiratory dis-

eases and some kinds of poisoning caused by

metals are definitely associated with work,

deciding whether other i l lnesses stem from

workplace exposures is difficult.

This century has seen some examination of the

role of the workplace in injury, illness, and death.

Motor vehicles used in work are involved in thou-

sands of accidents, resulting in many injuries anddeaths. Construction remains a relatively danger-

ous trade: Powerful earth-moving and erection

machines, high scaffolding, and falling objects are

hazards continually faced by construction work-

ers. Painful and sometimes incapacitating re-petitive-motion disorders are associated with

assembly-line work. Chronic diseases, respiratory

conditions, and cancers have been linked with ex-

posures to hazards in a variety of workplaces.

The control of workplace health and safetyhazards can be divided into three steps: hazard

identification, development of controls, and thedecision to control, The first two steps are largely

technical and require specialists. The third step

involves generalists, managers, and employers,and may actually occur before hazards are fully

identified and controls are developed.

The control of illnesses and injuries is not the

sole purview of any particular sector of society.Employers and employers’ associations, workers

and trade unions, universities, and the Federal and

State governm ents hav e initiated research directed

at identifying and controlling hazards, and all

have participated in decisions to control dangers

that have been identified. Federal involvement hasincreased over the years, and in 1970 Congress

mandated a direct Federal role in all aspects of

occupational safety and health, including the set-

ting of mandatory nationwide standards for safe

and healthful workplaces.

3



4 . Preventing Illness and Injury in the Workplace

The Chairman of the House Committee on

Energy and Commerce requested that the Office

of Technology Assessment undertake a study of

technologies to control occupational illnesses and

injuries. Both his letter and a supporting letter

from the Chairman of the Senate Committee on

Labor and Human Resources, called for a broad-based study. In addition to requesting examina-

tion of the general subject of control technologies,

the chairmen asked for evaluation of the avail-

able data and systems for collecting data about

work-related deaths, injuries, and illnesses; anal-

ysis of incentives and imperatives that influence

the decision to control hazards; and a discussionof the opportunities for bettering occupational

health and safety as the country enters a period

of reindustrialization. Because of the many roles

given to Federal agencies by the Occupational

Safety and Health (OSH) Act, the activities of the

Federal Government are important to u nderstand-ing developments and problems in designing, de-veloping, and disseminating control technologies,

in collecting and analyzing data concerning oc-cupational health and safety, and in providing

incentives and imperatives for the adoption of controls.

The

q

report is organized in five parts:

This chapter summarizes the findings of the

report and presents the options for improving

FINDINGS

Occupationally Associated Deaths,Injuries, and Illnesses

Currently available data are sufficiently ac-curate and comprehensive to describe the approx-imate number of occupational injuries and deathsdue to such injuries, although these data are stilllimited and, in particular, offer little guidance for

prevention. Data about occupational illnesses are far less accurate and comprehensive.

Deaths

The National Safety Council (NSC, a privateorganization) and the U.S. Bureau of Labor Sta-

tistics (BLS) of the Department of Labor compile

q

q

q

q

occupational health and safety that have been

developed during this assessment.

Chapters 2, 3, and 4 describe the data avail-

able on workplace deaths, injuries, and ill-

nesses and discuss methods for identifyinghealth and safety hazards.

Chapters 5 through 10 consider various con-trol technologies and current efforts to train

and educate employers, managers, employ-

ees, and health and safety professionals.

Chapters 11 through 16 discuss the factors

that are involved in the decision to control

hazards. They review the activities of Fed-

eral agencies, the role of economic analysisin decisionmaking, the influence of variousincentives and imperatives on decisionmak-ing, and the opportunities for installing con-

trols during a period of reindustrialization.

Chapter 17 looks at opportunities for pre-

venting occupational injury and illness in thefuture.

(The contractors’ reports and OTA workingpapers prepared for this assessment are available

through the National Technical Information Serv-

ice of the U.S. Department of Commerce. )

data about occupationally related deaths.

most reliable estimates are derived from the

Th e

BLS

Annual Survey, although the survey data do not

include the Nation’s entire work force. OTAs adjustment of the BLS figures yields an estimate of

about 6,000 deaths annually from occupationalinjuries, or about 25 deaths each working day.Occupational fatalities usually occur as isolatedevents that kill only one or, at most, a few work-

ers and attract little publicity.

Currently collected data can be used to iden-

tify the most hazardous industries and the types

of accidents that most commonly result in death.The most dangerous industry is mining, which

had 44 fatalities per 100,000 full-time workers in



Ch. 1—Summary and Options q5

1982. It was followed by the construction, agri-

culture, and transportation industries (29, 28, and

22 fatalities per 100,000 workers, respectively).Falling below the all-industry average of 7.4 per

100,000 are manufacturing, wholesale and retail

trade, and the service industries, all of which had

about 4 fatalities per 100,000 workers. The fi-

nance, insurance, and real estate industries had

the lowest rate of about 2 fatalities per 100,000workers.

BLS data show that about half of the fatal oc-

cupational injuries involve motor vehicles, off-

the-road industrial vehicles, and falls. Comple-

menting those findings, an examination of every

on-the-job fatality in the State of Maryland dur-

ing 1 year found that transportation vehicles, non-

road vehicles, and gunshots were the leading

causes of fatal injuries. Truck drivers were the

most frequent victims of transportation vehicleaccidents; most gunshot deaths occurred during

holdups.

Injuries

The OSH Act requires employers to keep rec-

ords of: 1) injuries that caused 1 day or more’s

absence from work or “restricted activity” at

work, and 2) injuries that required medical atten-

tion but caused less than a day of missed work. BLS estimates that in 1983 there were 2.1 million“lost-workday” injuries and 2.6 million “medicaltreatment” injuries in the private sector, which

covers about three-fourths of the work force. In- juries to Federal, State, and local government employees may add another 0.4 million lost work-day injuries and 0.5 million medical treatment cases. Adding those nu mbers, there were app rox-imately 5.6 million occupationally related injuries.

The National Center for Health Statistics (NCHS),which uses different definitions for injuries and

prepares estimates for the entire work force, esti-

mates a total of 11.3 million occupationally re-

lated injuries in 1981.

BLS and NCHS have separately estimated that

workplace-related injuries lead to the loss of, re-spectively, 36.4 million and 60 million to 70 mil-

lion days of work annually. Projections from

NCHS data are that workers spend about 44 mil-

lion days in bed because of disability and haveover 200 million days of restricted activity. The

NSC has estimated that for 1980 the total costsof work injuries amounted to $30.2 billion.

The leading types of disabling, nonfatal injuries

are overexertions (largely injuries to the back),which occur in many industries. Injuries in man-

ufacturing and construction often involve mov-ing machinery and falls.

Illnesses

Three factors generally contribute to incomp lete

recording of occupational illnesses: 1 ) many oc-

cupational diseases are indistinguishable from

nonoccupational illnesses, 2) the occupational

causes of diseases are often not recognized by

employers and employees, and 3) diseases with

long latencies often occur after employment or ex-

posure has ceased. Thus the BLS Annual Survey

estimate of 106,000 such illnesses in 1983 consists

mostly of diseases, such as acute dermatitis, thatare easily diagnosed and readily connected withworkplace exposures. Serious diseases—respira-

tory and necrologic disorders and cancers—are

not generally captured in the BLS records of

workplace-related illnesses.

Arguments about the number of occupationallyrelated diseases may obscure the important fact that occupational illness is preventable. For in-stance, a decade-long debate about the number of occupational cancers has been resolved to most

people’s satisfaction, and it is generally accepted

that occupational cancers represent something like5 percent (20,000 annual deaths) or less of all can-cer deaths. The more important considerations arethat workers in some industries have borne and still bear a disproportionate amount of risk and that, once causes of occupational disease are iden-tified, controls can be adopted to reduce risks.

Some Caveats on Available Data

Accurate data are necessary to know the mag-

nitude of the workplace health and safety prob-lem, to target prevention programs, and to assess

the progress in controlling illnesses and injuries.

Many factors other than control programs, how-ever, can influence the number of illnesses and

injuries. For instance, it has been known for some

time that injury rates fall during periods of high

un emp loyment because younger, less skilled w ork-

ers are laid off first and there is more time for



6 q Preventing Illness and Injury in the Workplace

maintenance of plant and machinery. OTA finds

that the slowdown in business activity between

1980 and 1983 was the most important factor in

the decrease in injury rates during that period.

Moreover, national injury rates are related to thelevel of business activity, going up as bu siness ex-

pands, down as it contracts. The Occupational

Safety and Health Administration (OSHA), on

the other hand, points to these declines as a meas-

ure of the success of its new progra ms that em ph a-

size a cooperative approach between the agency

and employers.

Over the last decade the identification and con-

trol of health hazar ds, especially of substances sus-

pected of causing cancer, has received much at-tention. Yet the available data about workplacediseases, even if accurate, would not yet revealany effects from a recent reduction in exposures

to carcinogens, Given the long time between ex-posure to cancer-causing substances and devel-

opment of the disease, years or decades may pass

before cancer rates are affected. An even greater

problem in relying on figures in this area, how-

ever, is the inaccuracy of occupational illness

data. In 1981, only 234 occupational cancers were

reported to workers’ compensation systems in 29

States, which contain about half the Nation’s

work force. That number can be compared to the

4,000 to 12,000 cancers that are estimated to oc-

cur from asbestos exposure alone.

Identification of Occupational Hazards

Health

Toxicology, occupational medicine, and epi-

demiology provide the means for identifying thechemical, physical, or biological causes of occupa-

tional illnesses. Identifying an association or pos-

sible association between an exposure and disease

often ignites a dispute. Employers, who have in-

vestments to protect and are perhaps reluctant to

accept the idea that employees have been harmed,

will require more evidence than workers seeking

an explanation for disease among them. It is clearfrom these controversies that the results of toxico-

logic texts often lead to further study rather than

efforts to control a hazard ; that p hysicians’ reports

of associations, depending on the disease and ex-

posure, may or may not be accepted as convinc-

ing; and that epidemiologic evidence linking ex-

posures and disease is most convincing.

The traditional role of toxicology has been to

provide information about the mechanisms of dis-

ease causation. Especially since the late 1960s,

however, toxicology has been used to investigatechemicals in an attempt to predict their effects inhumans. The bulk of the effort has been directed

toward identifying chemical carcinogens, but

some attention is now being directed toward

necrologic and reproductive health hazards.

Physicians, both those who specialize in oc-cupational medicine and those in private practice,have identified many health hazards. As an ex-

ample, reports of asbestos-associated lung can-cer cases in the 1930s were an early clue about

that occupational hazard. More recently, a phy-sician noticed an excess of liver cancers in vinylchloride workers. His observation led to a very

successful effort to reduce exposures to that sub-

stance. Importantly, physicians speak to work-

ers, and it is workers who are often the first to

be aware of hazards.

Epidemiology, the systematic investigation of

possible associations between exposures and dis-

eases, has confirmed important suspicions about

work-related illnesses. The now universally ac-knowledged case against asbestos, for example,

rests on ep idemiologic stud ies. Positive epidemio-logic results showing that an exposure is associ-

ated with a disease are the most convincing evi-dence of a substances toxic effect. Unfortunately,the power of epidemiology to detect small risks

is limited, and evidence obtained from toxicology

that a substance is toxic can often be neither con-

firmed nor denied by epidemiologic studies.

The National Institute for Occupational Safetyand Health (NIOSH) conducts various epidemio-

logic investigations and also makes Health Haz-

ard Evaluations (HHEs), short-term studies con-

ducted in response to private and public sector

employee or employer requests. HHEs are de-

signed to “determine the toxic effects of chemical,biological, or physical agents . . . in the work-

place through medical, epidemiologic, and indus-

trial hygiene investigations.” HHEs, which be-

come public reports, have identified and verified

the workplace origins of some illnesses.



Ch. l—Summary and Options . 7

Information that could be useful for generat-

ing and examining hypotheses about relations be-

tween exposures an d health effects is currently col-

lected by some industries, but it is not clear that

the data are often analyzed and the conclusions

used to decide upon controls. Even data collected

by the Federal Government are not used as muchas they could be. Useful data are collected by dif-

ferent agencies, but concerns about individualprivacy have restricted linking data from different

sources. Although several committees of govern-

ment scientists have explored ways to remove the

restrictions, little has been done.

Safety

The idea that “unsafe workers” are a major con-tributor to injuries has hampered efforts in injuryprevention. In the 1920s, a researcher concludedthat nearly 90 percent of injuries were due to

workers’ “unsafe acts” and 10 percent to “unsafeconditions. ” Although this ratio of “unsafe acts”

to “unsafe conditions” is often referred to, it isnot supported by other research. Unfortunately,

efforts are still made to separate injury causes into

“unsafe acts” and “unsafe conditions, ” whileneglecting th e often comp lex interactions between

workers and machines that can lead to injuries.

Additional efforts to apply epidemiologic tech-niques to injury analysis should be encouraged.

Technologies to Control Hazards

A generalized model of occupational injury and

illness is derived from the public health model of

infectious disease transmission. The model has

three parts: sources of hazard, transmission of the

hazard, and workers. Methods for controlling

workplace illnesses and injuries are intuitively

simple. Health and safety professionals generally

follow a “hierarchy of controls” approach that isrelated to this general model:

first, containing the hazard—whether it is a

substance or some physical, electrical, or me-

chanical energy —at its source;

second, interfering with transmission of thehazard to the worker; and

third, providing the worker with protective

clothing and equipment.

The first two types of controls, controlling at the

source and controlling transmission, are com-

monly called “engineering controls. ”

Controlling Health Hazards

Control at the source can be accomplished bydesign or modification of process or equipment

or by substitution of less hazardous materials.

This approach offers the greatest opportunist y for

prevention, especially when incorporated in the

initial installation of equipment into a plant. For

example, redesigned dry-cleaning equipment elim-

inates the need for someone to transfer chemically

treated clothes from one machine to another and

thus prevents worker exposure to that particular

chemical. Similarly, the very successful control

of vinyl chloride exposures involved process

changes that reduced the number of times work-

ers’ had to clean reaction vessels, thus loweringexposures during maintenance operations. An il-

lustration of control by substitution is the use of

steel shot instead of sand in abrasive blasting op er-

ations. This eliminates worker exposure to silica

dust, which can lead to silicosis.

Ventilation is the method most often used to

control transmission of health hazards. Local ex-

haust ventilation uses an air stream to remove

contaminants from work areas. Familiar examples

of this include laboratory fume hoods and the

local exhausts above many kitchen ranges. Simi-

lar devices are installed for many types of work-place hazards. General dilution ventilation re-

duces worker exposure by supplying “fresh” air

to the workplace and usually involves the heat-

ing/ air-conditioning systems of a plant. These sys-

tems can be modified to increase the amount of

airflow and thus dilute airborne hazards. Recent

changes in building ventilation aimed at con-

serving energy use air recirculation techniques.If not done properly, some of these altered sys-

tems may increase worker exposures.

Other ways to control transmission include iso-

lating the source and preventing toxic materials

from becoming airborne. Worker exposures to as-bestos and cotton textile dust were reduced by

enclosing dusty carding machines. More gener-

ally, automating processes and locating equipment



8 Preventing Illness and Injury in the Workplace

in rooms or buildings away from workers reduces

exposures. A common technique for preventing

dust from becoming airborne is to spray water

on the material.

Finally, control at the worker may include ad-

ministrative procedures, work practices, and the

use of personal protective equipment. Adminis-trative procedures include worker rotation among

jobs to reduce the number of people exposed full-

time, as well as the scheduling of jobs and proc-

esses that generate hazards at times when few

workers are present. Work practices are simply

job procedures and methods that are designed to

reduce hazards. Personal protective equipment,

such as hard hats and respirators, are described

in more detail below.

Controlling Injury Hazards

Workplace injuries generally involve transfersof energy, and thus controlling them could be ap-

proached as a task of preventing the transmission

of energy. For example, mechanical energy can

be transmitted to stationary workers by falling

objects, such as bricks on a construction site. Con-

trols could involve securing the bricks so they do

not fall, setting up overhead barriers to prevent

any falling bricks from striking workers, andissuing hard hats to the workers.

However, the terminology, analytical methods,

and procedures of safety professionals have usu-

ally differed from those used in controlling healthhazards. Safety engineers have tended to use

codes, standards, and models of “good practice”

that are oriented around particular topics: fire pre-

vention, electrical safety, machinery design, plant

layout, etc.

Recommended “good practice” often involves

common sense and the personal experience of

safety engineers, with relatively little scientific

analysis, systematic data collection, epidemiol-

ogy, or experimental research. In addition, as

mentioned, the view that many or most injuries

are due to so-called unsafe acts has interfered withthe incorporation of injury controls into the de-

sign of plant and equipment.

Nevertheless, injury prevention can be incor-

porated into the design of workplaces. Controls

can be introduced to prevent electrical shocks,

falling objects, the collapse of buildings and

trenchs, and workers falling or being crushed by

machinery and equipment.

Manufactur ing involves the appl ica t ion of

energy to materials to shape them into usable

products. Woodworking, hot metalworking, and

cold metalworking are three processes with sig-

nificant hazards. A number of traditional control

techniques are available to reduce these hazards.

These include the installation of guards to pre-

vent hand s and fingers from getting caught in ma-

chinery and material from flying out and strik-

ing workers. Machinery and processes can also

be redesigned to minimize the need for workers

to place their arms or legs near moving machin-

ery parts. Interlocks and two-hand controls are

available to prevent machine operation when

guards have been removed or when a worker’s

hands are inside the machine. Finally, personalprotective equipment, such as face shields and

goggles, are available to reduce the risk of injury

from flying objects.

Fires and explosions cause deaths and injuries

as well as large economic losses. For both those

reasons, efforts to prevent them have resulted in

careful attention to good plant design, control of

the ignition sources of fires, installation of warn-

ing alarms and systems to extinguish fires at early

stages, and plans for quick evacuation of burn-ing buildings.

Finally, employers often set up formal injuryprevention programs. Because management has

the primary responsibility for prevention of work-

related injury and illness, a successful program

must start with a strong commitment from man-

agement. The stronger the commitment at the top,

the greater the likelihood of success. Typical man-

agement efforts to prevent work-related injury in-

clude establishing company policies, incorporat-

ing injury prevention into plant design, carefully

investigating reported injuries to identify hazards,

keeping accurate and comprehensive records,

placing workers in appropriate jobs, and conduct-

ing safety training for workers and supervisors.

Personal Protective Equipment

Hard hats, safety shoes, and protective eyewear

are examples of personal protective equipment.



. —— —

Ch, l—Summary and Options . 9 —

In many cases, especially construction, there are

no practical engineering substitutes for such de-

vices. Respirators and hearing protectors guard

against hazardous dusts, fumes, vapors, and loud

noises.

Obviously, personal protective devices must beworn to be effective, and their successful use re-

quires both that equipment and instruction be

made available and that use be properly super-

vised. There is evidence that safety equipment,

such as hard hats and safety toe shoes, is worn

when required by employers. Because of the clear

connection between those devices and injury pre-

vention, it is reasonably easy to argue that safety

equipment will provide immediate benefits. On

the other hand, the value of wearing a respirator

to protect against a disease that may not mani-

fest itself for several years or a few decades may

not be as immediately clear. In addition, mostrespirators and hearing protectors are uncomfor-

table and hamper communication, and respirators

make breathing more labored. Finally, there is abody of engineering knowledge that can be ap-

plied to reducing or eliminating the need to use

respirators and hearing protectors.

Unlike engineering controls that are often tai-

lored to a particular workplace, personal protec-tive equipment is manufactured and sold for use

at many diverse sites. Some Federal regulationsrequire the use of personal protective equipment.

There are, however, no Federal standards for itsperformance (with the exception of respirators);instead, the Government relies on manufacturers

to produce and sell equipment that meets stand-

ards adopted by voluntary standards organiza-

tions, The American National Standards Institute

(ANSI) is the source of most such standards.

In the mid-1970s, NIOSH purchased samples

of personal protective equipment and tested them

against ANSI standards. Many items failed. For

instance, the lenses on 11 of 24 models of a type

of protective eyewear splintered or shattered w hen

subjected to the ANSI test for impact resistance;

only 4 of 19 models of hard hats passed all the

ANSI-specified tests. These results are especially

discouraging because the employer who purchases

the equipment and the workers who depend on

it must rely on the manufacturer to produce a

good product.

The standards, often not met, are themselveslimited. Plastic lenses are tested for resistance to

penetration, whereas glass lenses are not; NIOSHcommented that it would expect most glass lensesto fail the test if it were required. Similarly, hard

hats are tested for resistance only to vertical im-

pacts. No tests ar e requ ired for off-center impacts.

The only type of personal protective equipment

that is tested and certified by the Federal Gov-

ernment is respirators. NIOSH certifies respirators

using laboratory test methods that, in some cases,

were developed years ago. Efforts to update the

certification requirements have progressed slowly

and may take years to complete.

The few tests carried out in the workplace under

conditions of normal use show that respirators

often do not provide the level of protection ex-

pected from the laboratory measurements. Thepoorer performance may be due to inappropriate

use or maintenance or overestimation of perform-

ance based on laboratory tests.

The Environmental Protection Agency (EPA)

formerly required that hearing protectors be rated

for effectiveness. The effectiveness of probably

all hearing protectors is overrated because of sys-

tematic errors in tests conducted to comply with

the EPA requirements.

Hierarchy of Controls

Using engineering solutions to control hazardsat their source or in the pathway of transmissionis more reliable and less burdensome to the worker than personal protective equipment, Once in-

stalled, these controls work day after day with

minimum routine intervention beyond mainte-

nance and monitoring.

In keeping with the tenets of professional orga-

nizations such as the American Industrial Hygiene

Association and the American Conference of

Governmental Industrial Hygienists (ACGIH),

OSHA had permitted use of personal protective

equipment only when engineering controls were

not feasible, not capable of reducing exposures

to the required levels, or in the process of beingdesigned and installed. This approach has been

criticized by some employers who argue that they

should be able to substitute personal protective

equipment more freely for other types of controls.



10 . preventing Illness and Injury in the Workplace

In 1983, OSHA announced its intention to re-

consider its policy of relying first on engineering

controls for airborne health hazards. In a more

specific action, OSHA in 1984 proposed a reduc-

tion in permissible exposure to asbestos. The

agency proposes to allow the use of respirators

to attain the new standard. If this regulation be-comes final, it will almost certainly provide an

argument for primary reliance on respirators in

meeting other standards. Such a change must con-

sider the poor results attained with those devices.

OTA’s analysis of the literature indicates that

respirators provide the protection that is claimed

for them only in workplaces that provide scru-

pulous supervision of maintenance and use. Those

conditions are rare. To turn away from the hierar-chy of control without careful verification of the

levels of protection afforded by personal protec-tive devices is likely to increase exposures to

health hazards.

Training and Education

OTA finds that programs to educate workersan d health and safety professionals have rarely

been evaluated, and that evaluation is necessaryto know about their effect. Although not sup-

ported by evaluation, there appears to be generalagreement that they succeed. Evaluation is diffi-

cult because of the difficulty in determining what

causes changes in illness and injury rates. Never-

theless, such efforts should be encouraged.

NIOSH funds Educational Resource Centers

(ERCs). The centers are to educate occupationalhealth and safety professionals, to offer continu-

ing education programs, to conduct research, and

to provide regional consultation services. They

are required to provide interdisciplinary educa-

tion with contributions from occupational medi-

cine and nursing, industrial hygiene, and safety

engineering. These requirements set ERCs apartfrom other health and safety professional educa-

tion programs.

In 1981, with $12,1 million funding, the ERCs

graduated over 780 professionals from degree pro-

grams and trained over 12,000 professionals in

continuing education programs. Since then the

President’s budget has proposed cutting the ERC

funding to zero, and Congress partially restored

funding to $5.8 million in both fiscal year 1982

and 1983. Decreases in Federal funding will prob-

ably result in fewer degree and training programs.

Large comp anies with successful programs emphasize that commitment to control of w o r k -related injury and illness must begin with topmanagement. Despite that widely held opinion,

little attention is given to injury and illness pre-

vention in the education of business administra-

tion students. One attempt at building manager

awar eness, the NIOSH a nd OSHA Project Minerva,is sponsoring a series of meetings for bu siness edu-

cation teachers to introduce them to the concepts

of occupational health and safety and to find ways

of bringing those concepts into their courses.

The Nation’s engineering schools annually train

nearly 400,000 stud ents. The accrediting or ganiza-

tion for engineering schools requires, in theory,

that engineering design courses consider healthand safety. These courses, in which students learn

the fundamentals of designing plants and proc-

esses, would appear to be especially appropriatefor learning about the control of hazards. The

topic apparently receives little attention, however.

At one major engineering school, for example,

most faculty interviewed agreed that safety was

important, but few hours were devoted to teach-

ing it,

The engineering curriculum, which prepares

students for a professional license at the bac-

calaureate level, is acknowledged as one of themost course-laden programs at a university. Al-though adding instruction in health and safety isattractive, it is difficult to fit this instruction intothe existing engineering curriculum.

Educating physicians about occupational medi-cine falls into two categories: general educationabout occupational disease and injury, and spe-cialized training for practitioners of occupationalmedicine. Improvements can be made in bothareas. It is generally accepted that physicians in

general practice fail to recognize the impact of oc-

cupational factors on the health of their patients.This poor recognition stems from an orientation

toward occupational health that is minimal at best

and often nonexistent in U.S. medical schools. To

accommodate classes on occupational medicine

in the crowded medical curriculum would require

that other subjects be dropped, a difficult task.



Ch. 1—Summary and Options q 1 1

Postgraduate, specialty training in occupational

medicine has traditionally been subsumed under

preventive medicine, centered in schools of pub-lic health, and sometimes criticized for providing

too little clinical experience. The criticism is be-

ing muted by the requirement of clinical experi-

ence for board certification of physicians in oc-

cupational medicine.

Dissemination of Health andSafety Information

Much information about hazards and controls

is available from NIOSH, OSHA, health andsafety professionals’ associations, and the trade

literature. The volume and unorganized state of

this information impede its use. As a start in mak-

ing information more accessible, NIOSH and the

National Library of Medicine have established computerized data systems that provide useful in-

formation for evaluating workplace hazards.

OSHA has a consultation program that is de-signed to provide assistance in hazard identifica-tion and control to employers, especially thosewho run small businesses. It is a p otentially va l-

uable tool for the dissemination of information

and may be a way to improve job conditions that

is less adversarial than the enforcement of regu-

lations through inspections. In fiscal year 1983,OSHA funded consultations in more than 30,000

workplaces.To date, OSHA has not evaluated the effects

of the consultation program on injuries and ex-

posures. Although OSHA urges that employersshare the consultants’ information with employ-

ees, this step is not required, and it is probable

that workers are sometimes not informed. Some

observers have expressed concern that funding for

consultative visits diverts resources from OSHA

inspection activities.

Let t ing workers know about occupat ional

hazards is now facilitated and required by State

and local “right-to-know” laws and the recentlyissued OSHA rule concerning the labeling of con-

tainers of hazardous chemical substances. Such

information is valuable not only to workers but

also to owners and managers who p urchase chem-

icals for their businesses and to doctors and other

health professionals,

Incentives and Imperatives That Influence

the Decision to Control Hazards

Increased knowledge of hazards and improved controls provide the means for protecting healthand safety, but a decision to adopt the controls

is necessary for them to have any impact at all.

In fact, the first and most important act in work-

place health and safety may be the decision to con-

trol

th e

q

q

0

q

q

q

q

hazards. At least seven factors may motivatedecision to control:

employers’ enlightened self-interest,

information on hazards and controls,

financial and tax incentives,

workers’ compensation and insurance,tort liability,

employees’ rights and collective bargaining,

an d

regulation.

The first six factors can be viewed as incentives;

the last, regulation, is an imperative. OTA finds

that while each of these may motivate a decision

to control, the influence of all the incentives and

the imperative is limited.

Employers’ Enlightened Self-Interest

An important motivating factor behind volun-tary employer actions concerning health and safe-

ty is enlightened self-interest and concern for other

humans, Reinforcing such voluntary efforts arereductions in the costs of absenteeism, workers’

compensation, or medical care when the decisionto control hazards results in fewer injuries and ill-

nesses.

OSHA has recently instituted several programs

to encourage voluntary hazard control. In sev-

eral States, employers are exempt from programed

inspections if they receive an OSHA consultation

and thereafter correct all serious hazards. OSHA’sVoluntary Protection Program also encourages

voluntary actions.

Some employers also participate in cooperativeefforts to develop voluntary standards that draw

upon the collective information and expertise of

companies in a particular industry, trade associa-

tion, or standard-setting organization. Voluntarystandards are an important source of information

for employers, workers, and Government agen-



12 . preventing Illness and Injury in the Workplace —

cies, and they m ay mov e all companies that agreeto them to a common performance level.

However, voluntary standards are also criti-

cized for being insufficiently protective. Suggested

remedies include having additional input from la-

bor unions and the public when standards aredrafted. Yet unions and public interest organiza-

tions frequently lack the staff and other resources

to participate in voluntary standard-setting. Fur-

thermore, they often do not want to participate

because of a history of industry domination and

the unenforceable nature of voluntary standards

The pressures of the competitive marketplace

substantial ly l imit the abil i ty of individual

employers to improve employee health and safety

through voluntary actions. If a company devotesits resources to improving workplace conditions

but its competitors do not, the firm can find itself

at a disadvantage.

Information on Hazards and Controls

Timely and accurate data are necessary for

making decisions, and both Government and pri-

vate organizations provide information about

hazards and controls. Although necessary, infor-

mation alone may have little influence on deci-

sions to control.

Financial and Tax Incentives

Reducing the costs of purchasing needed equip-ment and technology can encourage employers

to improve health and safety. Four kinds of tax

and assistance programs might be useful for oc-cupational health and safety: investment tax

credits, accelerated depreciation allowances, di-

rect subsidies, and Government loan programs.

Funds from a Government loan program for small

businesses have been used for occupational health

and safety investments, but that program was

abolished in 1981. The other three mechanisms

have been used to encourage investments in equip-

ment for environmental protection, but not for

health and safety controls.

tion of injuries and illnesses is a secondary goal.Although workers’ compensation programs have

probably had a positive effect on injury experi-

ence, empirical evidence for this has been diffi-

cult to gather.

Four factors limit the incentives that workerscompensation can provide for control of hazards.

First, all insurance schemes spread losses; there-

fore, the insurance function of workers’ compen-

sation means that employers who cause injuries

do not bear their full costs, unless they are self-insured or pay premiums that are directly tied to

their injury and illness experience. Second, ben-

efit levels represent less than the full social costs

of injuries and illnesses. Third, some injuries and

most illnesses are not compensated because a

claim is never filed, or they are inadequately com-

pensated because the claim is delayed or denied.

To the extent that these factors reduce the frac-tion of the costs of injuries and illnesses that are

borne by employers, they reduce incentives forprevention. Changes in the system that lead to

a greater proportion of the costs of illnesses and

injuries being paid by employers would enhance

the prevention incentives of workers’ compen-

sation,

Tort Liability

The last decade has seen spectacular growth in

the number of cases in which workers sued firms

that manufactured machinery and other productspurchased by employers for workers’ use, Such

suits are generally filed against “third parties, ”

manufacturers and suppliers, because workers’

compensation programs bar suits against employers.

Tort liability has received special attention be-

cause of the number of th i rd-par ty lawsui ts

against suppliers of asbestos. If the number of

third-party suits increases, and if they are successful for hazards other than asbestos, they may be-come an important incentive for prevention. Even

so, the number of cases may be limited because

it is difficult to produce the degree of proof re-

quired by courts in cases of occupational disease.

W or ker s’ Com p en sa tion a nd In su ra nce Em ployees’ Righ ts an d Collective Bargain in g

The primary goal of workers’ compensation The OSH Act created opportunities for worker programs is to pay injured workers’ medical ex- participation in health and safety activities. The

penses and to compensate for lost wages. Preven- act provided that workers can:



—.

Ch. I—Summary and Options q 13

q

q

q

q

q

q

request OSHA inspections,

participate in the conduct of an OSHA in-

spection,participate in any of the stages of a pro-

ceeding before the Occupational Safety and

Health Review Commission,

contest the “reasonableness” of the abatementdate set by OSHA,participate in standard s development and the

issuance of variances, and

request a Health Hazard Evaluation from

NIOSH.

In addition, the act established a mechanism to

protect employees from job discrimination for

having exercised any of these rights. This provi-

sion prevents discrimination against employees

who refuse work that presents an imminent dan-

ger of injury, although it probably does not ex-

tend to employees who refuse work that theworker thinks presents a health hazard.

Collective bargaining is particularly useful for

establishment-specific implementation of controls

and for monitoring em ployer actions. It is severelylimited because only about 20 percent of the work

force is unionized and because not all unions have

sufficient staff expertise in industrial hygiene, in-

jury prevention, or occupational medicine. More-

over, health and safety provisions must competewith other bargaining issues for attention and re-

sources. Some people object to collective bargain-

ing for injury and illness prevention because theybelieve that health and safety on the job ought

to be an employee right, not subject to nego-

tiation.

At least 82 percent of union contracts containat least one clause related to health and safetyaccording to data collected by the Bureau of Na-tional Affairs, Unions can encourage members’

participation in health and safety activities, par-

ticipate in worker education in hazard recogni-

tion, provide or have access to technical exper-

tise, and es tabl ish mechanisms for d ispute

resolution between employer and union,

OSHA Regulation

Mandatory Federal regulations are an impera-

tive for the adop tion of controls. Labor represent-atives insist on mandatory standards and em-

ployer representatives, especially health and safety professionals, accept the need for them. Most of

the standards set by OSHA, however, have been

criticized by nearly all parties, but for different

reasons. Labor groups judge the standards as in-

sufficient to protect health. Business groups see

them as nit-picking, excessively stringent, unnec-essary, inflexible, and too costly. The criticismsfrom both sides in part reflect fundamental dif-

ferences concerning the desirable level and type

of Federal intervention in this area.

OSHA’s Standard-setting Criteria.–Since 1981,

OSHA has used four criteria for decisions on

health standards. First, it determines if the haz-

ard in question poses a “significant risk” and war-

rants regulatory intervention. Second, the agency

determines whether regulatory action can reduce

the risk. If so, OSHA develops a standard to re-

duce the risk “to the extent feasible, ” consideringboth technological and economic feasibility. Final-

ly, OSHA analyzes the cost effectiveness of vari-

ous options to determine which will achieve its

chosen goal most efficiently.

All OSHA regulatory actions are now reviewed

by the Office of Management and Budget (OMB)

under Executive Order 12291, which, to the ex-tent permitted by law, requires regulatory agen-

cies to demonstrate that their proposed and final

regulations pass a cost-benefit test. Generally

speaking, the results of the OMB review and

agency responses have not been made public,making it difficult to d etermine if OSHA d ecisions

have been altered by OMB’s cost-benefit review.

OSHA’s Record of Standard Setting.—Thereis dissatisfaction about the length of time OSHA

takes to develop, propose, and promulgate new

standards or revisions of existing standards. In its

first 13 years, through December 1984, OSHA

issued only 11 new or revised health standards

concerning 24 specific chemical substances and

one standard covering exposure to noise. Stand-ards for two of the substances and noise were

overturned by the courts. Twenty-six new or re-

vised safety standards were completed. In addi-

tion, broader regulations concerning employee ac-

cess to records, a “generic” policy concerning theregulation of carcinogens (under which no sub-

stance has been regulated), and the labeling stand-

ard were issued.




In part because of the slowness of OSHA stand-

ard writing, many OSHA standards seriously lagbehind recommendations and voluntary standardsissued by professional societies and voluntarystandards organizations.

Most current OSHA health standards are based on the exposure limits published by the Ameri-can Conference of Governmental Industrial Hy-gienists in 1968, and most safety standards relyon American National Standards Institute pub-lications of the 1960s. Those s tandards were

adopted in 1971 under a section of the OSH Actwhich gave OSHA authority to adopt established

Federal standards and national consensus stand-

ards. ACGIH annually updates its limits, in-

cluding standards for additional chemicals, andoften recommends stricter exposure limits. OSHA

often does not follow suit.

OTA finds that ACGIH exposure limits and

NIOSH recommendations, overall, are stricter

than the OSHA standards. In addition, the 1968ACGIH list covered nearly 400 substances. The

current ACGIH list covers over 600 substances,

but OSHA’S list—with a handful of additions—

remains essentially the same as ACGIH’s 1968 list.

A mechanism for timely and efficient OSHA con-

sideration of new ACGIH exposure limits and

NIOSH recommendations might prevent OSHA

from lagging behind professional recommen-

dations.

OSHA Inspection and Enforcement.—A regu-latory strategy will succeed only if the agency’senforcement efforts have adequate resources. For

most establishments the probability of a routine

OSHA inspection is very low (there are about

160,000 inspections annually in a total of 4,600,000

workplaces). Most inspections take place in man-

ufacturing or construction. But even in those in-

dustries, on average, a plant or site will be in-

spected only rarely. For example, the typical

manufacturing establishment can expect to be in-

spected once every 6 years. In addition, even if

an employer is found not to be in compliance, thefines issued by OSHA are small, especially when

compared with the costs of many types of con-

trols. For example, the average proposed penalty

for employer violations that threaten “death or

serious physical harm” is less than $200,

The current administration has implemented a

number of changes in inspection and enforcement.

A new type of inspection examines only the em-

ployer-maintained injury records if the firm’s

injury rate is below the national average for man-

ufacturing. In addition, the number and percent-

age of inspections with “serious” and “willful”violations has fallen, and the total dollar amount

of proposed penalties has been reduced substan-

tially.

Other new OSHA policies encourage area di-

rectors and employers to “settle” citations by re-

ducing or eliminating penalties in return for an

employer’s promise to abate the hazard and to

comply with OSHA regulations. These changesmay decrease the contentiousness of some OSHA

proceedings. On the other hand, they may have

further reduced an already weak regulatory effort.

OSHA’s Effects. —The imp act OSHA can have

on injury rates is constrained by the small size of

the OSHA regulatory effort, which can inspect

less than 4 percent of the Nation’s workplaces

annually. Most evaluations have searched for

OSHA’s effects on total injury rates, which could

be masking the success of the agency in prevent-

ing certain specific types of injuries as well as pos-

sible differences in the effectiveness of each area

office of OSHA and of the 25 jurisdictions oper-ating “State programs. ”

The research results are mixed. Several re-searchers have found favorable, but generallysmall, changes, implying that OSHA activitieshave reduced injury rates. Other researchers havenot found any significant correlation betweenOSHA activity and workplace injuries.

Currently, OSHA points to decreasing injuryrates for 1980 through 1983 as evidence that the

agency’s new regulatory approaches are paying

off. However, changes at OSHA could not fully

account for the declines, for they were not insti-

tuted until 1981, more than a year after the dropin rates began. Moreover, as indicated earlier, the

economic recession, including increased unem-

ployment and a shift away from “smokestack in-

dustries, ” is the most important factor behind this

decline.



Ch. l—Summary and Options q 1 5

There is some evidence that several OSHA reg-ulations have had a positive effect on exposuresto health hazards. The best known case is vinyl

chloride. Exposures d eclined dra matically after the

issuance of a more stringent OSHA standard.

Substantial declines have taken place in asbestos

exposure levels, perhaps due to OSHA efforts, butmore likely due to fears of tort liability suits.

A study commissioned for this assessment

found substantial decreases in lead levels in

workplace air and even more marked reductions

in lead levels in emp loyees’ blood in the years since

OSHA’s new lead standard was promulgated.

Another study commissioned by OTA found sub-

stantial decreases in exposures to cotton dust fol-

lowing the introduction of a new agency stand-

ard. The number of workers exposed to levels

above the new, tighter exposure limit for cotton

dust has been halved in the short time since thestandard came into effect. Several textile mills ap-

pear to be in complete compliance, while others

expect to be in the near future.

Measuring OSHA’s impact is difficult. To detect

the impact of a small Federal program on some-

thing as large as the Nation’s entire work force

might be asking too much, Regarding workplace-

related illnesses, even if the data were reliable, it

is too early to expect that OSHA regulations

would have much impact on occupational disease.

On the positive side, however, OSHA standards for vinyl chloride, cotton dust, and lead haveclearly reduced workplace exposures. Further-more, increased productivity accompanied com-

pliance with both the vinyl chloride and cottondust regulations.

Reindustrialization and WorkplaceHealth and Safety

Over the years, the process of industrial change

and renewal has led to improvements in occupa-

tional health and safety. Although quantitativeestimates are lacking, to some extent the reported declines in injury rates dating from early in thiscentury may be due to the installation of m o d -

ern, safer plants and equipment. A second factor may be general shifts in employment away from

industries and operations with greater hazards.Similarly, in some particular cases, exposures to

health hazards have declined because of increased

mechanization, but it is not clear whether ex-

posures to health hazards overall have decreased,

remained the same, or increased.

Thus, through the process of industrial change

health and safety can improve without anyone’s

explicitly “intending” it. In ad dition, some changes

in the workplace have taken place because of

employers’ desires to minimize the threat of fire

and explosion or to reduce the downtime of plant

or equipment. Some changes that lower the threatof property damage or “down time” also reduce

exposures to toxic agents or the risk of injury.

If this country is entering a period of reindus-

trialization, many opportunities will be available

to improve health and safety. As new plants are

built, employers may take advantage of oppor-

tunities to install controls as part of initial con-

struction, when they can be put in at lowest cost.

If the Government provides economic incentives

or financial assistance to firms as they modern-

ize, it can consider methods to encourage the in-stallation of controls. Some of the incentives

already mentioned—including tax breaks and di-

rect financial subsidies, as well as possibly tim-

ing new OSHA regulations to coincide with in-

dustrywide changes —might be useful during a

period of reindustrialization.




OPTIONS FOR CONTROLLING WORKPLACE HAZARDS

Data and Hazard Identification

Increasing the Usefulness of

Current Data Systems

Identifying workplace health and safety hazardsis the first step in reducing occupational morbid-

ity and mortality. Certain changes in Federal data

collection efforts can make epidemiologic investi-

gations.

Mortality Surveys.--One nationwide study of

death certificates to examine associations between

industry and occupation and mortality was done

in the 1950s. Since then, epidemiologists in the

States of Washington and Rhode Island have con-ducted statewide studies. These are valuable notonly for identifying high risks associated with

some types of work but also for indicating occupa-tions and industries that do not present high risks.

Yet statewide mortality analyses cannot be rep-

resentative of the Nation as a whole and lack the

statistical power that would be present in an anal-

ysis of data for the whole country. Nationwide

mortality analyses would provide important leads

for further study to pin down associations be-

tween work and various causes of death, as well

as valuable information about hazards in occupa-

tions that are scattered across the country, e.g.,

carpenters or butchers.

Currently, NIOSH and the National Center forHealth Statistics provide instruction and assist-

ance to a few States that are conducting mortal-

ity surveys. A collaborative effort between NCHS

and NIOSH would probably best accomplish the

task of carrying ou t nationwide mortality surveys.

Option I : Congress could provide funds and per-sonnel for an NCHS/NIOSH collaborative ef-

fort to produce accurate coding of industry and occupation information on death certificates.That information could then be used to pro-duce mortality analyses for occupations and in-

dustries either in:s the few States that are establishing mortal-ity surveys or

q nationally.

The National Death Index. -Information on

death certificates is essential to any epidemiologic

study investigating causes of death. When sup-plied with someone’s name and date of birth or

Social Security number, the National Death In-dex (NDI), a service of the NCHS, can tell epi-

demiologists whether that person has died and

where the death certificate is located. Until NDI

was established, epidemiologists had to contact

every department of vital statistics to locate the

death certificate. Quite simply, the NDI reduces

the number of such inquiries from more than so

to 1, although each certificate must still be ob-tained from the office of vital statistics that holdsit.

The NDI would be more useful if it supplied

all the information encoded upon death certifi-cates. Were it to be modified to do that, epide-

miologists could obtain all vital information for

mortality studies from a single inquiry. The ben-

efits of such a change wou ld be to speed up stud ies

and reduce their costs. Such a change would in-

crease the work load at NCHS associated with the

NDI and require some system whereby State de-

partments of vital statistics could still receive rev-

enue for supplying information.

Option 2: The National Death Index could bemodified so that all information collected ondeath certificates can be made available from it.

Addresses From Internal Revenue Service

Records.—Epidemiologic studies frequently re-

quire investigators to interview subjects of the

study or their families. One impediment to such

efforts is the difficulty of locating people. Inter-nal Revenue Service (IRS) records are a reason-

ably complete source of recent addresses, but only

NIOSH and some other Federal agency scientists

and persons working on contract to NIOSH can

obtain addresses from IRS.

There is some confusion about who can use this

“NIOSH window” and clarifications about thisare needed. In addition, it may be desirable to

allow a wider spectrum of researchers to obtain

addresses from IRS. Any expansion of the win-



Ch. l—Summary and Options 17

dow would require safeguards so that addresses

received this way are used only for epidemiologic

studies.

Option 3: Congress could direct the Federal agen-cies to define clearly who can obtain IRS-held

addresses and create procedures to allow awider spectrum of researchers to obtain ad-dresses from the IRS for use in locating persons

for epidemiologic studies.

Linking Federal Data Systems to Facilitate Epi-

demiologic Studies. –The records systems of the

Census Bureau, Social Security Administration,

Veterans’ Administration, OSHA, and NIOSH

could be linked together to provide information

about medical conditions, work history and ex-

posures, and the current address in a single file.

Such a link could improve epidemiologic studies;

but it increases also the possibility of invasion of a person’s privacy. The option suggested here is

intentionally vague because of the delicate bal-

ance between improving our capacity to under-

stand disease and protecting citizens’ privacy.

Although epidemiologists are convinced of thevalue of linking together data systems, few efforts

to do so have been approved. “On Occupational

Cancer Estimation, ” the recent report of the De-

partment of Health and Human Services’ Com-

mittee to Coordinate Environmental and Related

Programs, suggests some options for linking data

systems.

Option 4: Congress could encourage considera-tion of various proposals to link together Fed-eral data systems for use in epidemiology.

Injury Investigation

OSHA investigates 1,500 to 2,000 accidents in-

volving fatalities or five or more hospitalizations

each year. Unfortunately, little attention has been

paid to using the collected information to prevent

future accidents, and for many years it had only

gathered dust in OSHA’s files. The agency has

conducted some limited analyses of these inves-tigations, has initiated a small effort to distrib-

ute summaries of construction accidents to labor

unions, trade associations, and other organiza-

tions, and is developing a new data system to pro-

vide information collected during accident inves-

tigations. Complementing these activities, NIOSH

has begun detailed investigations of a small num-

ber of fatal injuries. In addition, the BLS has ob-

tained information on some types of nonfatal

injuries through questionnaires completed by in-

jured workers.

Option 5: Congress might direct OSHA, N1OSH,and BLS to devote additional resources to in-vestigating fatal and nonfatal injuries, with theobjective of developing information useful for

preventive efforts.

BLS Annual Survey

The BLS Annual Survey, which collects infor-

mation from employer-maintained logs of injuries

and illnesses, is the best source of information

about occupational fatalities and nonfatal injuries.

Since 1981, employer-maintained injury records

and the results of the BLS Annual Survey havebeen used to grant exemptions from OSHA in-

spections. Because of this reliance on the data,

assessing the reliability of the responses would be

prudent.

In the early 1970s, BLS conducted onsite evalu-

ations of a sample of employer responses to the

Annual Survey to verify their accuracy. This

“Qual i ty Assurance Program” has not been

repeated since 1976.

Option 6: Congress could direct OSHA and BLSto conduct a new “Quality Assurance Program”

to determine the accuracy of employer-main-tained injury records.

Toxicology

The Federal Government, especially through

the National Toxicology Program and the Na-

tional Center for Toxicological Research, is sup-

porting large-scale efforts to improve toxicology

so that results will be more predictive of human

effects and more readily accepted in the settingof standards. The Toxic Substances Control Act

mandates the submission to EPA of information

about “substantial risks” to human health that areidentified by companies. This section of the stat-

ute and the act’s requirement that companies no-

tify EPA of available toxicologic information

before new chemicals are introduced into com-

merce are important in protecting workers’ health.

This assessment suggests no particular options re-




garding toxicology, but it draws attention to the

importance of those programs.

Improved Control Technologies

NIOSH-Supported Research on Controls

Provided with sufficient resources, NIOSH,

through vigorous grant and contract programs,

could encourage the application of the techniques

of engineering, epidemiology, ergonomics (hu-man-factors engineering), industrial hygiene, and

other disciplines to the development of innovative

hazard control methods. Increasing NOSH’S re-

search in control technologies even five- or ten-

fold need not require a proportional increase in

NIOSH staff. Most of the research could be donein private sector and university laboratories.

Increased research and development of control

technologies would enable the Federal Govern-

ment to provide new information to improve

safety and health. It might also improve cooper-

ation between the Federal Government and occu-

pational health and safety professionals in the pri-

vate sector. Research in control technologies

represented only 12.8 percent or about $7.4 mil-

lion of the NIOSH budget in fiscal year 1983.

Three general research areas could benefit from

additional funding: engineering controls, personal

protective equipment, and new production tech-

niques.

Workplaces built some years ago with little at-tention to occupational health and safety often

incorporated few injury and illness controls when

they were constructed. Instead, controls—if they

are used at all—are added later as retrofits. Addi-

tional work is needed to d evelop general principles

for designing controls into plant and equipment

in order to increase effectiveness and minimize

interference with production. Another goal could

be improved control at reduced cost. Lower costs

might redu ce employer and manu facturer resistance

to the installation of controls and the burdens of

regulatory standard setting and enforcement.

Research on personal protective equipment

should develop reliable and comfortable devices

and methods to assess efficacy in “real-world”

conditions. Research on respirators is particularly

needed, but investigations of other kinds of per-

sonal protective equipment are also important.

A third priority area for research in workerhealth and safety is new technologies. The haz-

ard potential of new processes, procedures, equip

ment, and techniques needs to be evaluated, and

attention paid to the development of controls.

Early attention to hazards will provide health ben-

efits to workers; moreover, lower costs are asso-ciated with building hazard control into the tech-

nologies at first rather than having to retrofit later.

Option 7: Congress could expand support of NIOSH research and demonstrations in controltechnologies, using both NIOSH staff and re-sources as well as grants, cooperative agree-ments, and contracts. This expanded researchand demonstration effort could be directed at

four different areas:q fundamental engineering research, directed

q

at finding generalizable principles for health

and safety controls;applied research and demonstration projectsconcerning improved engineering controltechniques;research in improved personal protectiveequipment;efforts to track emerging industries and new

plants, evaluate hazards, and offer advice to firms engaged in new technologies,

Private Sector Research

Much research, especially that oriented towards

the development of controls for particular installa-tions, is conducted by employers, equipment man-

ufacturers, and the insurance industry. Their ef-

forts have produced successful solutions for many

occupational health and safety problems, To the

extent that they have the appropriate expertise,

employers and manufacturers should be eligible

for NIOSH research grants and contracts.

Certification and Regulation of

Personal Protective Equipment

All types of personal protective equipment pose

similar questions: What kinds of tests for effec-

tiveness should be required? When should the tests

be done—before or after marketing? Who should

condu ct the tests? How shou ld test results be used ?

Option 8: N1OSH could be given resources toestablish procedures to test and certify some or



—.


all types of personal protective equipment; theagency might:

Option 8A: establish a program of premarket testing that includes, at a minimum, appro-

priate laboratory evaluation of personal pro-tective equipment, and, as soon as possible,

testing and certification to reflect real workplace situations;

Option 8B: conduct postmarked surveillance tocollect reports of equipment failure and de-

fects, and to investigate those reports; or Option 8C: explore alternative arrangements

for both premarket testing and postmarked surveillance of persona! protective equipment.

These arrangements could include different combinations of self-testing and certification bymanufacturers, testing and certification by in-dependent parties, “spot-check” testing by

NIOSH, and full-scale testing by NIOSH.Although employers and employees rely on ef-

fectiveness labeling to select equipment, those

figures often overstate actual effectiveness. For ex-

ample, OSHA instructs its compliance officers to

assume that hearing protectors provide only so

percent of the laboratory-measured protection.

Option 9: Congress could provide OSHA and NIOSH with resources to develop, collect, and disseminate information on “real-world” effec-tiveness of currently available personal protec-tive equipment.

Education, Training, andInformation Dissemination

The Federal Government provides in-house

training to its own and other employees and grant

support for various education and training pro-

grams. One example of an in-house activity is the

OSHA Training Institute, which provides con-

tinuing education to Federal and State OSHA staff

(principally inspectors) and, to a limited extent,

to individuals from the private sector. Grant-sup-

ported activities are split: OSHA has concentratedon employee and employer training, whereas

NIOSH has general responsibility for the educa-

tion of professionals.

Workers and Supervisors

Since 1978, the OSHA New Directions Program

has awarded grants to labor unions, trade asso-

ciations, universities, and nonprofit institutions

for developing and conducting training and edu-cation programs. The focus has been worker train-

ing, although a number of New Directions grant-

ees have also trained supervisors and produced

educational materials useful to supervisors, man-

agers, and workers.

The New Directions Program, although not so

well evaluated as it could be, is seen as a success

by many health and safety professionals. Cur-

rently the grants that were supported by transfer

of money from the National Cancer Institute toOSHA are being evaluated, and other assessments

could be encouraged. The characteristics of good

and poor projects should be publicized and the

funding level of the New Directions Program,which has been decreased, could be reconsidered.

Aiding local or industry-centered organizations

to find solutions to local problems provides a di-

rect approach to health and safety problems,

Option 10: Congress might increase Federal support for occupational health and safety educa-tion and training, possibly through the New

Directions Program, by:q

q

involving unions, workers’ organizations,and trade and educational associations ineducation and training through the provision

of grants to develop informational and educational materials and to hire professionalhealth and safety staff;supporting education of supervisors and managers in occupational health and safetythrough programs directed at providingeducational materials to employees.

The Federal Mine Safety an d Health Act of 1977

requires mine operators to provide certain speci-

fied amounts of safety training to workers. SomeOSHA standards require employers to provide

worker training concerning specific hazards, but

there are no requirements for instruction or train-ing in most occupations. However, in the absence

of any requirement, some employers provide

health and safety training. Furthermore, some col-




lective bargaining agreements specify that all

workers receive some training and that advanced

instruction be provided to worker members of

health and safety committees.

Option 11: Employers might be required to pro-

vide a certain minimum level of health and safety training to their entire work force.

Health and Safety Professionals

NIOSH training grants to universities support

two activities: academic programs that train in-

dividuals in a single specialty, and Educational

Resource Centers, which provide complete pro-

grams. Many health and safety experts believe

that these funds have been well spent, increasing

the number of graduated professionals and en-

hancing the abilities of professionals through con-

tinuing education. On the other hand, there has

been only limited evaluation of these programsor the actual impact that the increased number

of professionals has had on worker health and

safety.

Funding for these programs has been reduced

in recent years and the current administration has

proposed complete elimination of the ERCs. Cut-

backs in Federal funding in this area are likely to

reduce the number of trained professionals.

Option 12: Congress could continue to fund train-ing of occupational health and safety specialists,

including the Educational Resource Centers,through the NIOSH training grants program.

Engineers, Physicians, and Managers

The disciplines of engineering and medicine

have a marked impact on occup ational health and

safety even though most practitioners in these

disciplines are not specialists in workplace health

and safety. Neither general-practice physicians

nor engineers receive significant instruction about

occupational hazards and controls. For physi-

cians, the prime need is training to recognize the

impact of occupational exposures on health. Engi-

neers need to understand the nature of occupa-

tional hazards and to learn the fund amental design

techniques useful for prevention of work-related

illness and injury. In addition, managers play an

impor tant cont inuing role in decis ionmaking

about health and safety.

Some starts have been made (and some aban-doned) to extend information about safety and

health to physicians, engineers, and business

administration educators and students. The De-

partment of Health and Human Services sup-

ported some efforts to educate physicians in envi-

ronmental and occupational health in severalmedical schools in the late 1970s, but funds are

no longer available. NIOSH has sponsored a series

of workshops on the topic of engineering educa-

tion concerning health and safety,

Option 13: Congress could provide support for and encourage:q

q

q

introducing occupational medicine in medi-cal school course work;introducing or expanding occupational safetyand health into engineering school curricula;introducing or expanding classes about oc-

cupational health and safety in businessadministration courses,

For example, grants through NIOSH or the Na-tional Science Foundation might be used to de-velop training modules for integration into ex-isting courses.

Expanded Information Services

The OSHA consultation program, which was

instituted to provide health and safety evaluations

to businesses, especially small firms, is a relatively

popular program. One possibility is to expand the

program to provide consultation to a greater num-ber of employers as well as to employees and

unions. This would require funding, as well as the

creation of p rocedures for p roviding these services.

Option 14: Congress could expand the OSHAconsultation program by:q

q

q

providing increased funding for OSHA con-sultation;directing OSHA to explore methods to en-courage employers to share this informationwith employees and their representatives;expanding the consultation program to pro-

vide this service to employees and unions.

Insurance Industry Research

Representatives of insurance companies visitmore plants than OSHA is able to inspect, and

many employers, especially small firms that lack



. .

full-time health and safety personnel, rely on the

advice of their insurers’ loss-control specialists.

The establishment of an institute similar to the

Insurance Institute for Highway Safety might fa-

cilitate the dissemination of industry-collected in-

formation on occupational health and safety. No

option is proposed because there would be no Fed-eral role in such an institute,

Computerized Information Systems

There are many useful collections of data. For

instance, NIOSH produces and collects informa-

tion about toxicity, assessment of control tech-

nologies, and product testing; OSHA collects in-

formation about hazards and controls during

inspections, consultations, and courses. Combin-

ing information from some or all of these sources

would produ ce a data system for use by d esigners,

engineers, workers, employers, and health and

safety specialists. Users could be charged for serv-

ices to defray expenses and possibly to make the

service self-supporting.

Option 15: The Federal Government could pro-vide grant or contract money to apply com-

puter technology to the collection and dissem-ination of occupational health and safetyinformation.

Incentives and Imperatives

Voluntary Implementation of ControlsVoluntary employer efforts to improve health

and safety are very important. OSHA has initi-ated a program to encourage such efforts, and

NIOSH has often persuaded employers to con-

trol hazards that are not currently subject to

OSHA regulations. Attempts to encourage “vol-

untary protection” must be kept in balance, how-

ever, with the standard-setting and enforcement

required by the OSH Act.

Option 16: Congress could direct OSHA and NIOSH to increase the attention devoted to en-

couraging voluntary efforts and to publicize the firms that have exemplar y programs in healthand safety,

Ch. l—Summary and Options q 2 1—

Workers’ Compensation Programs and

Tort Liability

Workers’ compensation programs, adminis-

tered by the States, have been credited with con-

tributing to th e pr evention of injuries and illnesses.

There is reason to believe that this may be true

for occupational injuries, although data to sup-port this conclusion are limited. For illnesses, data

are even more sparse, and the programs offer

fewer incentives for prevention of illness than for

injuries.

Most potential lawsuits by employees against

their employers for occupational injuries and ill-

nesses are barred by the statutes that created the

State workers’ compensation systems. It has beensuggested that this prohibition be eliminated in

some circumstances, but this would involve ma-

jor changes in workers’ compensation laws.

Congress is considering legislation to provide

compensation for the victims of asbestos-related

disease. This proposal is a response to perceived

problems in both the workers’ compensation and

tort liability systems.

Prevention should be considered in any changes

in compensation. In general, a compensation sys-tem should be designed to encourage prevention.

If Federal revenues are used to supplement oc-

cupational disease compensation funds, the Fed-

eral contribution might be accompanied by a re-quirement that companies take concrete steps to

prevent future cases of disease—a suggestion thatis admittedly hard to implement, Since OSHA

would almost certainly already be regulating any

hazard important enough to require a Federal con-

tribution to compensation, it is not clear what ad-

ditional requirements might be imposed on com-

panies that benefit from compensation legislation.

But it is also important to consider carefully any

changes in either compensation or tort liability

to guard against changes that might weaken in-

centives for prevention.

Labor-Management Committees

Labor-management health and safety commit-

tees exist in many U.S. workplaces, in both union




and nonunion shops. They offer an avenue for

sharing and conveying information about h azards

and controls. OSHA currently supports the for-

mation of joint committees in companies that

participate in the OSHA Voluntary Protection

Programs.

Option 17: Congress could encourage the forma-tion of labor-management committees by:q

q

directing that OSHA expand its VoluntaryProtection Program;increasing OSHA funding for training, con-sultation, and other technical assistance toworkplaces with labor-management com-mittees.

The Role of OSHA

Updating OSHA Regulations

It is well known that OSHA lags behind pro-fessional health and safety organizations and con-

sensus standards in responding to new informa-

tion about health hazards. The agency upgrades

its regulations through the same time-consuming

rulemaking procedure it uses to promulgate new

regulations, and changes are often opposed.

OSHA considers NIOSH recommendations

about exposure limits, but has taken few regula-

tory actions based on NIOSH criteria documents.

Requiring an OSHA response to NIOSH recom-

mendations would ensure that the regulatory

agency considered the research agency’s findings,

but making it mandatory for OSHA to regulate

on the basis of NIOSH recommendations might

not be useful. The Mine Safety and Health Ad-

ministration (MSHA) is currently required to re-

spond to certain NIOSH recommendations. How-

ever, NIOSH has sent no such recommendations

to MSHA, perhaps because of the direct tie be-

tween recommendation and regulation.

Option 18: Congress might direct OSHA to de-velop methods to respond to changes in na-tional consensus standards and other profes-sional recommendations.

Option 19: Congress might require OSHA to con-sider NIOSH recommendations for new or more stringent controls within a fixed period of time—say, 2 or 3 years. At the end of that time, OSHA could adopt, modify, or decide

against adopting the recommendations, but it would have to respond or be subject to suit.

Without changing the current system of stand-

ard setting, OSHA inspectors could provide in-

formation to both employers and workers con-

cerning professional recommendations. Although

it would not be legally binding, employers mighttake actions based on this information.

Option 20: OSHA inspectors could be directed to provide information (to employers and em-

ployees) on current NIOSH recommendations, professional organizations’ recommended exposure limits (such as ACGIH’s, which are up-dated annually), and voluntary standardswhenever these recommendations and stand-ards would affect the hazards found in particu-lar workplaces,

Standard Setting

Despite the fact that it did not succeed, a re-

cent effort to negotiate a standard for benzene

should provide much valuable information about

the feasibility of using negotiations in standard

setting.

Option 21: Congress might encourage OSHA tostudy possible procedures for negotiation dur-ing standards development and implementa-tion. These procedures will have to assure theadequate representation of all affected parties.

In the setting of health standards, OSHA hasgenerally moved substance-by-substance, Each

proposed health standard can be, and most have

been, opposed. OSHA has made three attempts

to establish “generic standards. ” The agency pro-mulgated a “cancer policy” in 1980 that defined

what data would be necessary and sufficient to

make a decision about a substance being a car-

cinogen and the nature of the standard that would

then be issued. The “access to records regu lation, ”

a generic standard applying to all employer-held

health and safety records, guaranteed workers the

right to inspect records and required that employ-

ers retain them. The recently promulgated label-ing, or “hazard communication” standard also has

generic aspects.

Generic standard s offer g reater efficiency in that

matters of a general nature can be settled once




rather than being renewed for every specific case.

There are, however, difficulties in issuing broad

regulations that are to apply in many situations.

Moreover, there is no guarantee that generic

standards will be used. For example, no carcino-

gens have been regulated under the agency’s “can-

cer policy. ”

Possible areas for generic standards include ex-

posure monitoring and employee training. It may

also be possible to issue standards that deal with

groups of, rather than single, substances.

Option 22: OSHA could be encouraged to issuegeneric standards to supplement substance or hazard-specific rules.

OSHA Enforcement Activity

No other OSHA activity stirs up so much emo-

tional fervor as its inspection and enforcementactivities. Many businesses object to inspections

as being nit-picking and unrelated to employee

health and safety, Employees and unions, on the

other hand, believe that inspections are essential

to worker protection and are concerned that

OSHA devotes insufficient resources to them and

that inspectors are not vigorous enough in enforc-

ing legal requirements.

Whatever the number of inspections, some vio-

lations are found and punished by fines, In most

cases, the fines levied by OSHA are less than the

costs of controll ing hazards. One possibil i ty

would be to increase fines to levels equal to the

actual costs of implementing controls. Or fines

might be based on a calculation of the amountnecessary to have a deterrent effect.

In some cases, fines equal to the costs of con-

trol would exceed the maximum levels established

in the OSH Act. Therefore, the law may have to

be changed to allow higher penalties. Of course,

higher p enalties will raise the nu mber of contested

OSHA actions and the general level of contro-

versy in this field.

Option 23: Congress could consider what theappropriate level of OSHA enforcement a c t i v -

ity should be; it could then either:q continue the current levels of personnel and

funding for inspection activity and the new policies concerning inspection targeting and citation settlement; or

q increase the number of inspectors, and thelevel of fines, and change the targeting and settlement policies to increase incentives for compliance.

Other Federal Actions Affecting Hazard Control

Various tax and financial assistance programs—

investment tax credits, accelerated depreciation,

government loan programs, and direct subsidi-

es—might encourage employers to install control

technologies. However, all these programs have

disadvantages. First, they would reduce Federal

tax revenues or increase budget outlays. Second,

depending on their design, tax-based incentives

can be relatively inefficient mechanisms because

firms that would have installed controls, even inthe absence of the program, would now receive

a tax subsidy, Third, there will be difficulties in

dividing the purchase price of equipment betweenfeatures that are health and safety controls and

those that are part of the equipment for purely

productive reasons.

Option 24: Congress might enact a tax and finan-cial assistance program to assist businesses inimproving occupational safety and health.

As the United States considers its economic and

industrial policies, it is unclear what balance is

to be struck between updating old-line industries

and focusing on new industries. In the future, the

Federal Government may play an active role inthe “reindustrialization” or “deindustrialization”

of America.

If explicit Federa l

include discussions

ested businesses,others, as well as

policies are created, they may

and agreements among inter-

unions, communities, andFederal loans and financial

assistance. Information could be developed con-

cerning the health, safety, investment, and pro-

ductivity needs of various industries. One possi-

bility would be to provide financial assistance for

health and safety, as well as for productivity in-

vestments.

The general disadvantages of these approaches

include the concern that health and safety will

“take second place” to the push for productivity.

In addition, many object to any Federal role in

coordinating or financing industrial investments.




Option 25: If the United States makes available funds or tax incentives for the building or re-building of industry:q

q

It

controls for health and safety hazards could be eligible for the same funds or tax breaksas other construction costs;

companies receiving reindustrialization as-sistance might be required to design healthand safety into their new plant and equipment,either to meet existing standards or to achievelower exposure levels or safer processes.

has been suggested that regulatory require-

ments have diverted resources from “productive”

uses and contributed to economic slowdowns.

However, in at least two cases (standards concern-

ing vinyl chloride and cotton dust), new produc-

tion processes were developed that both benefited

worker health and improved productivity. Fitting

regulatory activities to productivity concerns canbe achieved in two ways: either delaying regula-

tory requirements until they coincide with plannedmodernization or using health and safety regula-

tions to “spur” productivity improvements.

Option 26: Congress could direct OSHA to:q delay the required use of engineering con-

trols, so that the installation of these controlscoincides with modernization of an industry;

q use health and safety regulations to en-courage plant and equipment modernization.

Creation of an Occupational Safety andHealth Fund

OTA is aware of concern about recent large

swings in occupational safety and health policy.

Two areas—education and training programs,

and research on workplace controls—have had

funding reduced in the past few years. The crea-

tion of an Occupational Safety and Health Fund

might provide more stable and enhanced fund ing.

Recent U.S. research concerning the use of

“washed cotton” to control the hazards of cotton

dust also provides a model for cooperative re-search. This project was funded by Government

and industry, with oversight and direction pro-

vided by a group of labor, management, and

Government officials. Jointly administered re-

search efforts and training programs have also

emerged from collective bargaining.

A fund could be established with or without

a Government contribution. For example, inter-

ested citizens, employers, workers, foundations,

and other groups could make voluntary contri-

butions. Or Congress could create a fund. If it

becomes a Federal activity, financing could be

through a payroll tax on employers or, although

this would be more difficult, through a tax or sur-charge based on workers’ compensation premiums(with some adjustments for the presence of health

hazards in various industries). For example, a 0.1

percent employer tax on the total U.S. payroll of

$1.6 trillion (in 1982) would result in annualrevenues of about $1.6 billion; a 0.01 percent tax

would produce $160 million. A 1.0 percent sur-

charge on workers’ compensat ion premiums

(about $25 billion in 1980) would produce annualrevenues of $250 million. Another possibility

would be to allocate fines collected for violations

of OSHA standards to this fund. This would pro-

duce less money; in 1983, OH-IA’S proposed fines

totaled $6.4 million.

Several different administrative arrangements

for such a fund are available, Congress could fol-

low the model of the Work Environment Fund of

Sweden by creating a tripartite board of employ-

ers, employees, and Government representatives,

or it could delegate administrative responsibilities

to NIOSH, since this would be a research and in-

formation dissemination activity. The fund andits research and training projects could exist

alongside existing projects and arrangements at

OSHA and NIOSH, or Congress could consoli-

date existing research and training activities (in-

cluding NIOSH extramural research grants and

training grants, OSHA New Directions grants and

OSHA-funded consultations) under one umbrellagroup.

Although such a fund would enhance the com-

mitment to research and training, there are dis-

advantages to consider—primarily that this rep-

resents a new venture, with all the problems thatsuch undertakings incur. Moreover, a new tax or

surcharge, even though of modest size, runs against

the desire embodied in recent legislation to reduce

business taxes.



Ch. l—Summary and Options —

q 2 5

Option 27: Congress could create an OccupationalSafety and Health Fund to finance research incontrol technology, training and education, and information dissemination.

The Needs of Small Businesses

Loans for Compliance With OSHA Standards

Small businesses are often disproportionately

burdened by investments required for health and

safety protection. Congress recognized this when

it passed the OSH Act by also amending the Small

Business Act to allow the Small Business Admin-

istration (SBA) to make loans for OSHA com-

pliance. Between 1971 and 1981, when Congress

eliminated authorization for this program, SBA

processed 261 such loans. Now may be a good

time to study this program to learn what effect

these loans had and why so few were processed.

Following such a study, Congress could consider

reauthorizing the loan program.

Option 28: Congress might direct OSHA and/or SBA to study the results of SBA loans made

for compliance with OSHA standards.

Shared Resources

It is inefficient and impractical to require each

small business to provide a full range of health

and safety services. Instead, organizations and

programs to serve the needs of a number of small

businesses in a given area or industrial specialtymight be cost effective. Initial funding could comefrom OSHA or NIOSH, with the hope that these

programs would ultimately be self-supporting.

The most difficult part of this option is to de-

sign a method to sustain the program after the

startup period. Even though shared programs

should cost less than if a company were to pur-

chase the services entirely on its own, some small

businesses might find the price beyond their

means. It is unclear how to aid those companies.

Option 29: Congress might direct NIOSH and

OSHA to encourage the development of shared programs to provide industrial hygiene, safetyengineering, medical surveillance, and worker health and safety training for small businesses,

Changed Regulatory Approaches

Providing protection against occupational in-

juries an d illnesses in small business establishments

presents its own set of problems. It may be cost

effective to treat occupational health and safetyin such firms in a fashion similar to current regu-

lation of consumer products—by regulating ma-

ch ines and p roduc t s t ha t sm a l l bus inesses

purchase.

Of course, many products purchased by smallbusinesses are also used in larger businesses,

whose employees would also benefit from such

regulation. An important limitation of this ap-

proach is that some occupational hazards are cre-

ated in the improper installation, use, and main-t e n a n c e o f m a c h i n e s a n d p r o d u c t s . T h i s

regulatory approach would have only limited im-

pact on those hazards.

Option 30: Congress could take actions to improve the safety of products used by small busi-ness. This might include:• directing NIOSH to conduct tests of prod-

ucts used by small businesses and to publishthe results in a form easily available to suchestablishments;

q encouraging OSHA, Consumer Product Safety Commission, and EPA regulatory ac-tions concerning the products used by smallbusinesses.

Establishment of Occupational Medicine ClinicsIn the United States, most occupational medi-

cine is practiced in the workplace by physicians

employed by industry, especially by large com-

panies.

Changes are apparent, however, as small-and

medium-sized companies are making choices be-

tween contracting with hospital-based clinics for

medical care or maintaining a company medical

department. The clinics may grow to fill current

voids—servicing industries, regions, and employ-

ers where such services are unavailable or defi-

cient. Clinics might, because of a larger patientload and a staff that consequently sees more pa-

tients, be able to provide more-knowledgeable

care and improved physician training.




The staff of these clinics emphasize that they

will provide advice about prevention as well as

medical care. The combination of staff physicians,

industrial hygienists, and engineers could provide

a critical mass for a great deal of important activ-

ity in hazard identification and control.

Programs concerned with occupational medi-

cine and prevention should consider and stud y the

choices. They may alter industrial medical care

and responsibilities of industry and labor, as well

as the relationships between such clinics and the

private practice of medicine.

Assessing Health and Safety Programs

A key final component in improving occupa-

tional health and safety is evaluating which pro-

grams to identify hazards, develop control tech-

nologies, disseminate information, and implement

controls work and which programs can be im-proved. Assessing or evaluating efforts in occupa-

tional safety is difficult because of the many fac-

tors that influence injury rates over time. Some

of these may also stymie the evaluation of occupa-

tional health activities; more importantly, because

of latent periods and difficulties in recognition,

it is hard to measure improvements in occupa-

tional health.

Congress in the last few years has already in-

dicated a desire for more systematic assessment

of Government activities. The Regulatory Flex-

ibility Act of 1980, for example, requires that reg-

ulatory agencies, including OSHA, review over

a 10-year period all regulations that have a sig-

nificant impact on small businesses.

This principle of reviewing and analyzing ex-

isting programs might be extended to nonregula-

tory programs. For example, the OSHA New

Directions grants program, and the NIOSH train-

ing grants programs could be assessed. In addi-

tion, periodic assessment could be specified when

new programs are established. The principal dis-

advantage of such a requirement would be the

diversion of resources from other important areas,

such as hazard identification and research on con-trol techniques.

Option 31: Congress could require periodic assess-ment of all occupational safety and health pro-grams and provide funds to conduct suchassessments.



2.

Data on Occupational

Injuries and Illnesses



Contents

—



2Data on Occupation;Injuries and Illnesses

In this chapter, OTA presents a summary of ber of occupational injuries in U.S. workplaces.

the available statistical information concerning the For occupational illnesses, however, the data are

number and distribution of occupational injuries extremely limited. (A fuller discussion of these

and illnesses. In general, currently available data topics is found in Working Paper #l of this

describe, with reasonable accuracy, the total num- report. )

SOURCES OF INFORMATION

Prior to the passage of the Occupational Safety

and Health (OSH) Act in 1970, occupational in-

jury data collection efforts were limited. Onesource was a series of surveys by the Bureau of

Labor Statistics (BLS). This information was

limited by its dependence on voluntary reports

from employers, by the particular standard most

commonly used for recording occupational in-

juries, and by incomplete industry coverage bythe BLS surveys. One study of data from 1967

and 1968 indicated substantial underreporting of

injuries by employers (186), In addition, some

limited data were available from the National

Safety Council (NSC), state workers’ compensa-tion agencies, and employer records. In the OSHAct, Congress called for the creation of a new,

mandatory system of data collection.

The system created by the Occupational Safety

and Health Administration (OSHA) and BLS re-

quires employees to keep records using a speci-fied format. In addition, BLS conducts annual sur-

veys of a sample of employers. These survey

results are used to compute injury and, to a

limited extent, illness rates by industry, as well

as estimates of the total numbers of fatalities, lost-workday cases, and cases without lost worktime

but that involved medical treatment.

The BLS Annual Surveys (604,606-608) are the

best source of statistical information concernin g

work-related injuries. The published data are

based on large survey samples, and, within the

limitations of the survey methods, appear to be

reliable. These estimates, however, are subject to

several limitations:

q they are available only since 1972,q depending on the type of case, they cover

only two-thirds to three-fourths of the U.S.

work force,

q they are based on a survey that is adminis-

tered only once a year, and

q they provide very little detail concerning the

nature and causes of occupational injuries.

A possible fifth limitation is that these estimates

are ultimately based on employer records of injuries and illnesses. (The extent of this possiblebias is discussed below and in Working Paper #l. )

Nothing can now be done about the first limita-

tion. The second and third could be improved,

but these would involve changes in methods and

perhaps require greater resources. To address thefourth limitation, BLS has initiated two additional

data collection efforts. Since 1976, the Bureau has

compiled information provided by 26 to 36 state

workers’ compensation agencies, in a data base

known as the Supplementary Data System (SDS)

(397). And since 1978, BLS has conducted a series

of surveys of injured workers concerning specific

types of occupational injuries, published as Work Injur y Reports (599-601,603,605).

Two other Federal systems provide injury data.

The National Health Interview Survey (NHIS) of

29




the National Center for Health Statistics (NCHS) cy room admissions to produce information on

collects information during household interviews. occupational injuries. Finally, OSHA has pub-

A system recently developed by the National lished analyses of several different types of fatal

Institute for Occupational Safety and Health injuries using information collected during acci-

(NIOSH) uses information from hospital emergen- dent investigations.

OCCUPATIONAL INJURIES

Fatal Injuries

As discussed in Working Paper #l, for the last

five years, data from the BLS Annual Surveys in-

dicate that between 3,000 and 5,000 occupational

fatalities occurred each year in private sectorestablishments with 11 or more employees. About

1,000 deaths occur in private sector establishments

with fewer than 11 employees. The NSC figuresrange between 11,000 and 13,500 for the entire

workforce. Applying a variety of assumptions to

data derived from death certificates yields a range

of estimates from 5,500 to 11,000 for the entire

workforce for 1977. OSHA inspection data sug-

gest that at least 4,500 occupational fatalities

occurred in the private sector workforce in fiscal

year 1982.

The Annual Surveys conducted by BLS are the

best source of statistical information on occupa-

tional injuries. They u se a large survey sam ple that

is capable of directly measuring the occurrenceof injuries. However, because this sample covers

only private sector employment (the self-em-

ployed and public sector employees are excluded),

an adjustment must be made to generate an esti-mate for the entire workforce.

OTA used two similar methods, both based on

the BLS data, to develop its estimate of the num-

ber of occupational fatalities due to injuries. The

first estimate uses the five-year average of thenumber of fatalities in establishments with 11 or

more employees. For 1979 to 1983, this equals

about 4,180. Approximately 11 percent of theseare due to heart attacks. Subtracting these yields

a total of 3,720 deaths due to injury (see table 2-

1). To this should be added the five-year average

from the BLS Annual Survey of deaths in estab-

lishments with fewer than 11 employees. For 1979

to 1983, after adjusting for heart attacks, this was

930. Thus, the total from the BLS Annual Sur-

vey is 4,650.

To this should be added the deaths among the

self-employed and public employees. Applying

the death rates for private sector workers, ad-

justed for heart attacks, to these workers yieldsa five-year average of 1,640. Adding this to the4,650 generated directly by the Annual Survey

yields a total of about 6,300 deaths .

Table 2-1.—Annual Occupational Fatalities From Injuries,Summary of Estimates

Averageannual Source of

Universe Years total estimate or d ata

All employment . . . . . . . . . . . . . . . . . . . . . . . . . . 1979-83 12,200 NSCAll employment . . . . . . . . . . . . . . . . . . . . . . . . . . 1979-83 6,000 OTA

a

Private sector workplaces

with 11 + employees . . . . . . . . . . . . . . . . . . . . 1979-83 3,720 BLSPrivate sector workplaces

with 1-10 employees . . . . . . . . . . . . . . . . . . . . 1979-83 930C BL S

aEgtlmate ig b~~ cm BLS arid OSHA data and Is described in the text

bd,l~ minus I I percent of deaths reported es heart attacks (~).

c1 ,040 minus 11 percent of deaths reported as heari attacks. (110

NOTE: Because of differing methods and deflnltions, some of these estimates are, strictly speaking, not directly comparablewith each other.

SOURCE: Office of Technology Assessment.



——— —. . .

Ch. 2—Data on Occupational Injuries and Illnesses q 31

Alternatively, the BLS figures for establish-

ments with 11 or more employees for each indi-vidual year can be adjusted by applying the

private-sector death rate (for injuries in establish-

ments with 11 or more employees) to the work-

ers exclud ed comp letely (self-emp loyed and pu blic

employees) or for which annual estimates are notavailable (small, private sector establishments).

Using this method, the total ranges from 7,265

in 1979 to 4,600 in 1983, with an average of 6,180

deaths per year.

Round ing either of these estimates to th e nearest

thousand yields OTA’s estimate that about 6,000

deaths due to occupational injuries occur each

year. The National Safety Council average of 12,200 is considerably higher. It is difficult if not

impossible, to reconcile the estimates from the BLS

and the NSC. The published data from state vital

statistics are insufficient to do so (see Working

Paper #l). Moreover, the NSC estimates have

been criticized in the past for including duplicate

reports and deaths from previous years and for

not being based on the results of a probability sur-

vey. Instead they are developed using the results

of special studies in combination with a variety

of statistics from several sources. These methods

may not generate reliable estimates, either for a

particular year or over time.

OTA’s estimate of 6,000 injury deaths per yeartranslates into about 25 occupation] fatalities

each working day. Rarely, however, does thisdaily toll occur at the same time, in the same

workplace. Usually, occupational deaths occur

one or two at a time in widely scattered work-

places. Because of this, occupational fatalities only

rarely receive significant publicity.

Motor vehicles (30 t o 40 percent), off-the-road

industrial vehicles (10 percent), and falls (10 per-

cent) are associated with over half of the fatal oc-

cupational injuries. In addition, occupational fa-

talities are unevenly spread among industries.

Table 2-2 presents fatality rates for the major in-

dustry divisions in the private sector. Mining,with a fatality rate of 44.3 per 100,000 full-time

workers, is the most hazardous industry. Con-

struction; agriculture, forestry, and fishing; andthe transportation and public utility industries also

present above-average risks of deaths due to in-

Table 2.2.—Occupational Fatality Ratesa

By Industry for 1982

Industry division Rateb

Mining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.3Construction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.7Agriculture, forestry, and fishing . . . . . . . . . . . 28.4

Transportation and public utilities . . . . . . . . . . 21.9Average of private sector ., . . . . . . . . . . . . . . . . 7.4Manufacturing . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.5Wholesale and retail trade . . . . . . . . . . . . . . . . . 3.8Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5Finance, insurance, and real estate . . . . . . . . . 2.5aF~r ~~t~bllghrnentg with I 1 or more employees Includes fatal injuries and

reported deaths due to illness.bFatalit~eg p er 100,000 full-time workers

SOURCE: (608)

jury. Manufacturing has a death rate below the

average for the private sector, although it has a

nonfatal injury rate substantially above the aver-

age. Wholesale and retail trade; services; and fi-nance, insurance, and real estate are safer indus-

tries, with fatality rates between 2.5 and 3 .8deaths per 100,000 workers.

Nonfatal Injuries

Table 2-3 summarizes the estimates of the num-

bers of occupational injuries. These estimates vary

partly because of differences in the definitions of injuries, the population universes, and methods

of estimation.

NSC defines a disabling injury as one that in-volves one or more days away from work, some

form of permanent impairment, or death. For BLS

and OSHA, a lost-workday injury is one that in-

volves the employee either not working at all for

one or more days beyond the day of the injury

or reporting to work and being assigned to a

“lighter duty” job (restricted work activity).

Combining the BLS estimate of lost-workdayinjuries (2.1 million in both 1982 and 1983) in the

private sector with the estimates for Federal, State,

and local employees (0.1 and 0.3 million) yields

a total of 2.5 million lost-workday injuries. Thiscompares to the NSC estimate of 1.9 million “dis-

abling” injuries. Using the total of 2.5 million in-

juries, it appears that each working day results

in about 10,000 injuries that are serious enough

to lead to loss of worktime.




Table 2-3.—Annual Nonfatal Occupational Injuries,Summary of Estimates

Source ofEstimate estimate

Definition Universe Year (millions) or data

Lost-workday cases . . . . . . . . . . . . . . . . . . . .All private sector workplaces 1983 2.1 BLSLost-workday cases . . . . . . . . . . . . . . . . . . . . U.S. Government—civilian and personnel 1982

0.1OSHA

Lost-workday cases . . . . . . . . . . . . . . . . . . . .State and local government 1982 0.3 SDSa

“Disabling” . . . . . . . . . . . . . . . . . . . . . . . . . . .All employment 1983 1.9 NSCTotal “recordable” . . . . . . . . . . . . . . . . . . . . . All private sector workplaces 1983 4.7 BL STotal “recordable” . . . . . . . . . . . . . . . . . . . . . U.S. Government—civilian and personnel 1982 0.2 OSHATotal “recordable” . . . . . . . . . . . . . . . . . . . . . State and local government 1982 0.7 SDS a

Medically attended or activity restricted . .All employment 1981 11.3 NHISTreated in emergency rooms . . . . . . . . . . . .All employment 1982 3.2 NIOSH

%tlmato Is baeed on data from SDS and Annual Survey and Is described In Working Paper #1.NOTE: Because of differing methods and deflnltlons, some of these estimates are, strictly speaking, not directly comparable with each other

SOURCE’ Office of Technology Assessment

The BLS/ OSHA definition of “recordable” in-

jury includes all lost-workday injuries plus allthose that involve medical treatment beyond first

aid. The National Health Interview Survey in-cludes all injuries that are “medically attended”(which may involve only a consultation with a

doctor) or cause “restricted activity,” whether or

not that also involves lost worktime. Data devel-

oped by NIOSH through the National Electronic

Injury Surveillance System (NEISS) include allcases treated in hospital emergency rooms.

These various sources again yield differing esti-

mates. The sum of BLS data and the Federal,

State, and local government estimates is 5.7 mil-

lion recordable cases in 1982. The number of pri-

vate sector injuries went down slightly in 1983,Assuming that the number of public sector injuriesstayed the same (0.9 million), the sum of the BLS

and public sector estimates would be 5.6 million

in 1983. The NHIS estimates 11.3 million cases.

This translates into a range of between 22,000 and

45,000 injuries each working day. And the NIOSH

estimate of the number of emergency room cases,

based on the NIESS data, is 3.2 million cases or

about 12,000 cases per day.

The largest difference in these figures is between

the combined BLS and public sector estimate (5.6

million cases) and the National Health InterviewSurvey (11.3 million). Most of this difference re-

mains even when data from the same year are

used. The 1981 BLS and public sector estimate isa total of about 6 million cases.

The NHIS includes self-employed persons, but

it is unlikely that approximately 8.7 million self-

employed workers can account for the remain-

ing 5.3 million injuries. It could be that the slightlydifferent definitions of the BLS Annual Survey

and the NHIS contribute to this discrepancy. It

is also possible that employees and their families

are reporting to the NHIS injuries that are notrecorded by employers. A number of reasons

could account for employers not recording an in-

jury: an employee may not have reported it to

the employer; the employer judged the injury to

be a “’first aid only” case that is not required tobe recorded; or the employer’s records are not ac-

curate and comprehensive.

The NEISS estimate of emergency room casescould be consistent with either the BLS estimate

or the NHIS figure. The 3.2 million emergencyroom cases (in 1982) would constitute about 55

percent of the 5.7 million cases in the private and

public sectors from (the 1982) BLS and govern-

ment reports or about 30 percent of the 11.3 mil-

lion cases estimated by the NHIS. The figure of

30 percent is roughly consistent with a special

study of data from 1975, which estimated that

about 36 percent of all injuries occurring “at job

or business” were medically attended at emer-

gency rooms (388).

Table 2-4 summarizes various estimates of the

amount of time lost due to nonfatal occupational

injuries, including lost worktime, bed disability,

and restrictions on daily activity. The BLS esti-



Ch. 2—Data on Occupational Injuries and Illnesses q 3 3

Table 2-4.—Days Lost Annually From Occupational Injuries,Summary of Estimates

Source ofEstimate estimate

Definition Universe Year (millions) or data

Lost workdays. . . . . . . . . . . . . . . . . . . .All private sector workplaces 1983 36.4 BLS

Lost workdays. . . . . . . . . . . . . ... . . . . U.S. Government—civilian and personnel 1982 1,2 OSHALost workdays. ., . . . . . . . . . . . . . . . . . . . . . . All employment 1981 60-70’ OTABed disability days. . . . . . . . . ... . . . . . All employment 1981 44.0 NHISRestricted activity days . . . . . . . . . . . . . . . All employment 1981 214.9 NHIS%TA e s t i m a t e I S b a s e d o n data-f~om NHIS and Is–described I; Workln9-Paper #l

- - – -

.

NOTE Because of dlfferlng methods and deflnltlons, some of these estimates are, strictly speaking, not directly comparable w!th each other

SOURCE Off Ice of Techno logy Assessment

mat e of days away from work and of restricted

work activity (“light duty”) equals 36.4 million

days—the equivalent of over 140,000 people

working full-time for a year. Time lost by Fed-

eral civilian employees adds about 1.2 million

days to this total. No estimates for State and local

employees or for the self-employed are directlyavailable.

A higher total of about 60-70 million “’lost

workdays” can be indirectly estimated using the

results of a special NCHS analysis of injuries. Part

of the reason for the higher figure is that this esti-

mate should cover the entire work force. In

addition, the varying definitions and survey meth-

ods between the BLS and the NHIS may contrib-

ute to the difference. The NHIS also provides data

on bed disability (44 million days) and of days

of restricted daily activity (close to 215 million

days).

The BLS figures imply that about 1 in 13 U.S.

workers suffered an occupational injury in 1982.Nearly half of these were serious enough to re-

sult in the employee missing one or more days

of work beyond the day of the injury, On aver-

age each lost-workday injury results in 17 days

lost from work. The NSC has estimated that the

direct and indirect costs of work injuries totaled

$30.2 billion in 1980 (324),

Trends in Injury Rates

It is probable that occupational injury rates

have fallen since the turn of this century. The data

published by the NSC support this, but these data

may not be accurate or reliable. In particular, re-

cent trends in the NSC data are inconsistent with

data collected from other sources. However, ac-

counts of working conditions earlier in this cen-

tury reveal many instances of job hazards that are

considered appalling by today’s standards. Many

of these have been improved, and injury rateshave fallen. (Of course, this decline in injury rates

may not apply to occupational illness rates. )

Trends over the last two decades have not been

constant from year to year and measures of dif-ferent types of injuries sometimes go in different

directions. During the 1960s, the BLS surveys of

manufacturing showed rising injury rates. The

BLS Annual Surveys from the 1970s show a rela-

tively large drop in non-lost-workday injuriesfrom 1972 to 1975, and then a continuing decline

from 1975 to 1983. The BLS lost-workday caserate rose during most of the 1970s, falling only

between 1974 and 1975 and for the three years

after 1979 (fig. 2-1). The BLS total case rate, wh ichcombines the non-lost-workday and lost-workday

cases, shows a slight rise from 1972 to 1973, and

then a decline from 1973 to 1975. This rate then

began a slight rising trend until its peak in 1979.

By 1982, the total case rate had declined to 7.7

per 100 workers. This decline continued in 1983,

when the total case rate was 7.6 per 100 work-

ers. This is the lowest level reported since 1972,

wh en these d ata w ere first collected. Fatality rates

calculated from the BLS estimates show a general

decline through the 1970s. Injury rates calculated

from the National Health Interview Study showno readily apparent trend from 1962 to 1981, pos-

sibly because of the relatively larger sampling

error for this survey.

Injury and fatality rates are affected by a num-

ber of factors. These include the effects of the busi-




Figure 2.1.- Occupational Injury Rates, 1972.83

21- Lost-workday cases

I

1972 1974 1976 1978

Year

ness cycle, various changes in

of workers’ compensation, the

1980 1983

the administration

practice of occupa-

tional medicine, ‘and other socioeconomic factors.In addition, OSHA and NIOSH and other safety

and health programs may have contributed to

changes in rates. But the effects of OSHA activi-

ties, in particular, may be difficult to discern innational injury trends because of the low prob-

abilities of OSHA inspections, the relatively low

penalties for violations of standards, and the pos-

sibility of differential effects on various types of

hazards. There may also be variations in the ef-

fectiveness among the 24 separate State programs

and Federal OSHA operations, which cannot be

detected using national data.

Injury Rate Trends, the Business Cycle, and

OSHA Policies

The lack of any dramatic improvements in injury rates during the 1970s has been cited to sup-port the belief that OSHA has been ineffective.

More recently, it has been claimed that the recent

declines in the injury rates resulted from the cur-rent administration’s “cooperative, non-adversary

approach to job safety and health” (643,644,650).

Although it is possible that some of the decline

can be explained by these changes, several otherfeatures must also be considered.

First, as figure 2-1 shows, the decline in injury

rates started in 1980—before the changes in

OSHA policies that w ere instituted in 1981. More-over, the installation of controls, changes in em-

ployee training, etc., often take place over sev-eral years. Thus it is possible that the observed

changes from 1979 to 1983 represent the effectsof some combination of the policies of the “old”

and the “’new” OSHA. Second, the new policy

that targets inspections on the basis of injury

records may influence employer recordkeeping

toward undercounting. Independent verification

of employer injury records is necessary to assess

the possible impact on changes in employer rec-

ordkeeping. Third, as mentioned above, a num-

ber of factors besides the effectiveness of OSHAcan influence injury-rate trends.

Foremost among the factors influencing injury

statistics is the business cycle. Since the 1930s re-

searchers have noted that, other things being

equal, increased business activity leads to higher

injury rates while decreased activity lowers rates.

The general explanation for this phenomenon is

that as business picks up, employers hire more

young and inexperienced workers. Both youngerworkers and inexperienced workers of all ages

tend to have higher injury rates than older, more

experienced workers. Moreover, as production ex-pand s, businesses open new plants and bring new

machinery on-line. For both of these cases theremay be a period of adjustment as management

and workers learn how to use the machinery safe-

ly. In addition, during a business upturn there will

be increases in the pace of production, increases

in the amount of overtime worked, less downtime, and less time devoted to repair and main-

tenance, all of which lead to increases in accidents.

During business downturns, all of these elements

are reversed-younger and less experienced work-

ers are laid off while older and more experienced

employees are retained, plant operations slowdown, and more effort is devoted to repair and

maintenance (254,444).

OTA has compared injury rates with several

measures of the business cycle. Figure 2-2 shows

data for the BLS total recordable injury rate and



Ch. 2—Data on Occupational Injuries and Illnesses q 35

Figure 2.2.—lnjury Rates and Unemployment—Private Sector: 1972.83

— I n j u r y r a t e ---- Unemployment rate

the unemployment rate for 1972 to 1983. The total

recordable injury rate declined from 1973 to 1975

and again from 1979 to 1982, simultaneously with

rising unemployment rates. In addition, the ris-ing injury rates from 1975 to 1979 coincided with

declining unemployment rates. From 1982 to

1983, the total injury rate and unemployment

went down slightly, while the lost workday rate

stayed the same.

In figure 2-3, these two variables have been

plotted against each other, with the unemploy-

ment rate on the horizontal (or x-axis) and the

injury rate on the vertical (or y-axis). Examina-

tion of this figure reveals an ap paren t inverse rela-tionship between injury rates and unemployment.

That is, as unemployment rises in a recession, in-

jury rates decline.

Another possible measure of the business cy-

cle is to examine the level of employment, as op-

posed to the unemployment rate. This must be

done carefully because in the last few years, the

changes in the level of employment have not been

the same in all industries. In fact, from 1979 to

1982, employment in the more hazardous manu-facturing and construction industries declined,

while employment in the other major private sec-

tor industry groups has stayed the same or in-

creased. Figures 2-4 an d 2-5 show the relationship

between employment and lost-workday injury

Figure 2-3.– Injury Rates and Unemployment-Private Sector: 1972-83

Unemployment rate (percent)

Figure 2.4.—Lost-Workday Rate and Employment—Construction: 1972.83

0.0 ‘ ‘ 2.0 4.0 6.0

Employment (millions)

rates in construction and manufacturing alone.

Again there appears to be a close relationship. As

employment rises, so do injury rates.

OSHA has suggested to OTA that the recent

injury rate declines are not the result of the cur-rent recession because “BLS has estimated that

only 16 percent of the decline in injury rates in1982 can be attributed to a disproportionate drop

in hours worked in high-risk industries” (34). BLS,

however, noted that the procedure they used forthis calculation, “does not take into account . . .

other factors which may also affect the rate, but




Figure 2.5. -Lost. Workday Rate and Employment—

0.0 ‘ ‘

which have not. .

8.0 12.0 16.0 20.0 24.0

Employment (millions)

been measured, such as the dem-

ographic composition of the workforce, worker

education, improved safety measures, the role of State and Federal agency compliance programs,

technological change, etc” (607).

But the “demographic composition of the work-

force” and “technological change” are two

variables that are p articularly affected b y the bu si-

ness cycle. In addition, the amount of overtime

worked, the pace of production, and the rate of

new hires are affected by the business cycle. The

BLS procedure for calculating the effects of the

decline in hours worked may not fully capture the

effects of these other variables on injury rates.

Additional analysis using variables that directly

measure the new hire rate, the number of over-

time hours, the rate of production, and capacity

utilization in specific industries may clarify thisrelationship further. (Examination of the influence

of new hires is, however, made more difficult be-

cause BLS no longer publishes statistics on labor

turnover, which included the new hire rate. ) But

at present, it appears that the effect of the recentrecession, especially in construction and manu-

facturing, is the most important factor behind theinjury rate declines from 1979 to 1983. In addi-

tion, it appears that national injury rates since

1972 have been largely related to the level of busi-

ness activity.

When the OSH Act was enacted in 1970, Con-

gress placed the legal responsibility for prevent-

ing occupational injuries and i l lnesses with

employers and created several agencies, includingNIOSH and OSHA, to conduct research and ad-

minister regulations. Employees, of course, also

have a personal stake in preventing disease andinjury in the workplace. Some detailed studies on

the effectiveness of OSHA in improving the ef-forts of employers and employees have found a

favorable but small impact, while other studies

have not found any effect (see ch, 13 for a sum-

mary). Even the favorable effects detected in sev-

eral studies may not be large enough to be dis-cerned in national injury statistics, while shifts in

the nature of the injury rate-business cycle rela-

tionship may be difficult to detect. However, it

is clear that if any improvements have been made

they have not been large.

Accuracy of Occupation Injury Estimates

Questions raised about the accuracy of esti-

mates based on employer-mainta ined in jury

records have intensified with the current admin-

istration’s inspection targeting system. OTA has

conducted a limited comparison of data from the

BLS Annu al Surv ey and from th e BLS Sup plemen-

tary Data System (SDS) to see if they are con-

sistent. Data were available only for years before

the implementation of the new inspection target-

ing system and the conclusions of this analysis,

therefore, apply just to that period.

Some States participating in the SDS reportonly lost-workday cases while others report all

cases involving either lost workdays or medical

treatment. OTA found that for States reporting

only lost-workday cases to the SDS, the numbers

of cases were not consistently higher or lower

from either SDS or the Annual Survey, after ad-

justing for the minimum waiting periods (as

defined by State workers’ compensation). Al-

though there were some differences between these

two data sources, these differences were not con-

sistent from one State to the next. In States thatreport all cases involving either lost workdays or

medical treatment to the SDS, consistently more

cases were reported to the SDS than would be ex-

pected from the Annual Survey data.



Ch. 2—Data on Occupational Injuries and Illnesses q 3 7

In another analysis, OTA compared BLS An-

nu al Surv ey injury rates with rates calculated from

the estimates of th e N HIS. This analysis comp ared

information derived from employer records (BLS)with that from workers and their families (NHIS).

This comparison showed that, in recent years,

overall injury rates based on the NHIS are about

one-third higher than those from the BLS Annual

Survey.

Differences among the various sources couldarise from different methodologies and, as such,

O C C U P A T I O N A L I L L N E S S E S

There is substantially less quantitative informa-tion on occupational illnesses than on injuries. Al-

though employers are required to include occupa-tional illnesses in their records, it is well accepted

that employer records and the BLS Annual Sur-

vey estimates, which are based on employer

records, underestimate the magnitude of the oc-

cupational disease problem. This is because many

occupational diseases are indistinguishable from

non-occupational diseases, because they often be-

come manifest only after a latent period, and be-

cause of a general lack of recognition of the oc-

cupational causes of many diseases. For 1983, the

BLS Annual Survey estimate is about 106,000 oc-

cupational illnesses, but that is almost certainly

an underestimate.

The most commonly quoted estimates are that

up to 100,000 deaths due to illness and 390,000illness cases occur each year as a result of work-

place cond itions. Although the estimate of 390,000cases was cited during the Congressional debates

about the Occupational Safety and Health Act,

OTA has not been able to determine the exact

methods for deriving this estimate.

The estimate of 100,000 deaths was derived first

by a crude technique using the results of three epi-

demiologic studies and later by an analysis of in-formation in a 1951 British death registry. As a

result, the 100, 000-deaths figure can only be con-

sidered an estimate, but it is unclear to what ex-

tent the figure is biased. Peter Barth and Allen

Hunt (46) have reported other estimates that range

may not be worrisome. Or it could be that em-

ployers do not report certain types of injuries to

the BLS Annual Survey even though they do sub-

mit reports to workers’ compensation. As dis-

cussed above, the differences between the BLS An-

nual Survey and the NHIS may also stem from

employers labeling some injuries as cases involv-

ing only first-aid treatment, even though employ-

ees and other family members consider them seri-ous enough to report to the NHIS.

from 10,000 deaths to 210,000 deaths. More ac-

curate estimates are difficult because of a general

lack of information on both historical and cur-rent worker exposures, incomplete knowledge of

the d eleterious effects of workp lace exposur es, and

the general problems of assigning single “causes”

to diseases created by multiple factors.

Although it is well accepted that employer

records understate the magnitude of the occupa-tional illness problem, it is very difficult to quan-

tify the extent of this understatement. One pilot

study, conducted by David Discher and colleagues

(143), explored the usefulness of medical exami-nations and industrial hygiene surveys for iden-

tifying the extent of occupational illness in sev-eral industries. The researchers administered

medical exams to workers in four industries, con-

ducted industrial hygiene surveys, and classified

a total of 451 medical conditions among the sur-veyed workers as probably linked to occupational

exposures. Eighty-nine percent of these 451 con-

ditions were not noted in either the workers’ com-

pensation claims or the employers’ logs. Although

this percentage of non-reporting may not be appli-cable to all workplaces, this study did reveal a

large number of cases that were not being recog-

nized by employers and were thus not recorded.

It is also interesting to note that the BLS Sup-

plementary Data System reported only 234 work-ers’ compensation cases for all cancers in 1980.

This can be compared to the range of estimates

for occupational cancer caused by asbestos alone,




which is between 4,000 and 12,000 cases annually.

Even if the SDS total is adjusted for all the statesthat do not currently report to the SDS, there ap-

pears to be substantial underreporting of cancer

cases to workers’ compensation programs.

The absence of an accurate accounting of theoccupational disease toll highlights the need for

accurate and comprehensive information on em-

ployee exposures, both to provide a basis for more

accurate disease estimates and to measure the ef-

fectiveness of current occupational health efforts.

C O N C L U S I O N

OTA estimates that about 6,000 U.S. workers

die each year from occupational injuries, or about

25 each working day. In addition, each workingday there are at least 10,000 injuries that result

in lost worktime, and about 45,000 that result in

restricted activity or that require medical atten-

tion. Estimates of the number of nonfatal injuries

vary partly because of differences in the defini-

tions of injuries, the population universes, and

methods of estimation. Some discrepancies may

also be due to differences in how employers and

employees interpret the severity of an injury.

Injury and fatality rates are affected by a num-ber of factors. These include the effects of the busi-

ness cycle, and various changes in the adminis-tration of workers’ compensation, the practice of

occupational medicine, and other socioeconomic

factors, as well as the possible effectiveness of

OSHA in reducing injury frequency and severity.

The NIOSH National Occupational Hazard Sur-vey (564,565,566) and National Occupational Ex-

posure Survey can provide information on the

number of employees potentially exposed to haz-

ardous substances, but they do not provide any

information on the level of exposure and only

limited information on the duration of exposure.

Although it may be possible to use the data col-

lected by OSHA during inspections to develop

estimates of worker exposures, such analysis de-

pends on further research.

.

OTA finds that the effect of the recent reces-

sion, especially in construction and manufactur-

ing, is the most important factor behind the injury rate declines from 1979 to 1983, In addition,it appears that most of the changes in national

injury rates since 1972 are associated with changes

in business activity.

Compared with occupational injuries, there is

substantially less quantitative information on oc-

cupational illnesses, Although employers are re-

quired to include occupational illnesses in their

records, it is well accepted that employer records

underestimate the magnitude of the occupational

disease problem. However, it is difficult to quan-

tify the extent of this understatement.



3.

Health Hazard Identification









. —

Ch. 3—Health Hazard Identification q 43———

as has the perception of work-relatedness. Society

is less willing to accept adverse effects of any kind.

Because so much disease is known to be pre-

ventable, poor health is no longer taken as a con-

comitant of certain occupations. Our increasing

ability to detect subtle effects allows us to broaden

our efforts in prevention.

There is something seductive about new risks,

and a tendency to focus on new hazards. Al-though in one sense occupational health is deal-

ing with new and ever-subtler effects, the old dis-

eases are still around, in greater numbers than is

generally perceived. In 1979, an estimated 84,000active workers suffered from acute byssinosis and

at least 35,000 employed or retired workers were

disabled from cotton d ust-related d isease. In 1978,

an estimated 59,000 workers were thought to suf-

fer from silicosis. Even as new and perhaps scien-

tifically and medically more intriguing conditionsbecome issues in occupational health, the old

problems require continued vigilance.

To guide its research priorities, the National In-

stitute for Occup ational Safety and Health (NIOSH)

has developed a list of 10 groups of occupational

diseases (table 3-1). Although termed the “Ten

Leading” work-related diseases, the list includes

nearly all categories of health effects that have

ever been linked to workplace conditions.

Six of the categories of diseases listed by NIOSH

are discussed in this chapter. Traumatic injuries

are the subject of the next chapter, and noise-indu ced hearing loss is discussed in chap ter 8. The

reader is referred to the recent textbooks by Levy

and Wegman (269) and Rem, et al. (396), for de-tails of disease and hazard identification.

Respiratory Disorders

The lungs and other parts of the respiratory

tract come in contact with all manner of airborne

materials in the workplace. Gases, vapors, fumes,

fibers, and particles all may be inhaled, Of all

health effects, occupationally related cancers of the respiratory tract receive the greatest attention,

but they are not the only serious respiratory con-

ditions associated with the workplace, and cer-

tainly not the most widespread. Other responses

of the respiratory system may be acute irritation,

immunologic or allergic reactions, or chronic

changes in the tissues that line the respiratory

Table 3.1 .—The Ten Leading Work-Related Diseases and Injuries:United States, 19828

-.Type of disorder/inju”~ Exam Dies

1

2

3,

4.

5.

6

7,

8,9.

10,

.—

Occupational lung diseases

Musculosketal injuries

Occupational cancers (other

Amputations, fractures, eyelacerations, and traumatic

Cardiovascular diseases

Disorders of reproduction

Neurotoxic disorders

asbestos is, byssinosis, silicosis, coalworkers’ pneumoconiosis, lung cancer,occupational asthma

disorders of the back, trunk, upperextremity, neck, lower extremity;traumatically induced Raynaud’sphenomenon

than lung) leukemia, mesothelioma; cancers of thebladder, nose, and liver

oss, —

deathshypertension, coronary artery disease,

acute myocardial infarctioninfertility, spontaneous abortion,

teratogenesisperipheral neuropathy, toxic encephalitis,

psychoses, extreme personality changes

(exposure-related)Notse-induced loss of hearing —

Dermatologic conditions dermatosis, burns (scaldings), chemicalburns, contusions (abrasions)

Psychologic disorders neuroses, personality disorders,alcoholism, drug dependency — —

‘The condlt!ons I Isted u rider each category are to be v!ewed as sdwfed examples, not cornprehenswe defl n It Ions of the category

SOURCE (563)




tract. Some conditions that begin as acute prob-

lems progress to chronic states, perhaps the best

known being byssinosis–or “brown lung” disease.

NIOSH has made formal recommendations for

maximum exposure levels to 60 substances, based

on their effects on the respiratory system. Thatnumber is greater than the substances cited for

any other organ system.

Chronic Conditions

The most serious conditions are pneumoco-

nioses, chronic conditions occurring generally

after years of exposure to very fine dusts. The

tissue reacts by thickening, producing a condition

called “pulmonary fibrosis. ” The best known

pneumoconioses are asbestosis, silicosis, and coalworkers’ pneu moconiosis (“black lun g”), but simi-

lar conditions may be produced by a number of

different materials, such as talc and kaolin.Pneumoconioses are characterized by coughing

and shortness of breath, which grow worse over

time, followed in the later stages by signs of heart

failure and eventually ending in death.

Chronic bronchitis can be caused by a number

of occupational hazards but, as the commonest

chronic response of the respiratory tract, is also

brought on by nonoccupational causes. It may

also be multicausal, as many diseases are, with

nonoccupational factors (particularly cigarette

smoking) interacting with occupational exposures

to cause disease.

Emphysema is another chronic condition in re-

sponse to many different stimuli. Though there

are undoubtedly cases of occupational origin, fewconvincing, direct correlations between workplace

exposures and this disease are known.

Beryllium disease (berylliosis) is an example of

granuloma format ion in response to fore ign

bodies in the lungs. Granulomas form when body

cells responding to an “inciting agent” become sur-

rounded by bundles of collagen (a type of con-nective tissue).

Acute Conditions

Inflammations and irritations of the tissues lin-

ing the respiratory tract occur in response to many

inhaled substances. The upper respiratory tract—

the nose, throat, and larynx-is the most frequent

site of irritation, It is susceptible to highly solu-

ble irritants, such as ammonia, hydrogen chloride,

and hydrogen fluoride-gases commonly encoun-

tered in industry.

Irritants that are less soluble tend to travel far-

ther down the respiratory tract before they areabsorbed entirely, causing irritation in the mid-

dle as well as the upper respiratory tract. Chlo-

rine, fluorine, and sulfur dioxide, all commonly

used chemicals, have such properties, The major

effect on the lungs is bronchoconstriction.

Irritants of low volubility may cause only mi-

nor upper respiratory tract problems, but their

delayed reaction deep in the lungs, which may oc-cur as much as a day later, can be very serious.

Ozone, oxides of nitrogen, and phosgene—again,

commonly encountered in workplaces—are the

most important hazards in this class.

Asthma and “hypersensitivity p neumonitis” are

two manifestations of immunologic or allergic

type reactions. Bronchial asthma, a conditionaffecting perhaps 4 percent of the U.S. popula-

tion, is also prevalent among certain occupational

groups. Asthma is a generalized obstruction of the

airways in an allergic type of response to some

substance. Causes can be of bacterial or animal

(e.g., animal dander, small insects, bee toxin) orplant (e.g., flour, grain dust, fungi, cotton, flax,

tea fluff, wood dusts) or chemical (e.g., formal-

dehyde, certain pesticides, some metals, someacids) origin. Often the condition develops only

after a period of sensitization, and for some

agents, very high p ercentages of those exposed be-come sensitized. It has been reported that nearly

all workers in power plants along the Mississippi

River become sensitized to river flies (396).

The causes of hypersensitivity pneumonitis in-

clude a variety of organic materials, commonl y

fungi or bacteria. Beginning with coughing, but

without the wheezing associated with asthma,

these disorders can become chronic and disabl-

ing. Such conditions as “farmer’s lung, ” “mush-room picker’s lung, “ “cheese washer’s lun g, ” and

“paprika splitter’s lung” fall into this category.

Byssinosis deserves particular recognition. (For

further discussion of this disease, see ch. 5.)

Though it has been known in some sense as a dis-



—

Ch. 3—Health Hazard Identification q 4 5

ease associated w ith cotton an d other textile fibers

for hundreds of years, it was ignored as an occu-

pational disease in this country unti l fair ly

recently. The disease begins with tightness in the

chest and a decrease in lung capacity upon ex-

posure. The condition is most severe on Monday

mornings. Over a period of years, chronic ob-

structive lung disease may develop, partially or

totally disabling the worker. The earlier stages of

the disease are thought to be reversible, but the

later stages are not. The exact etiologic agent of

byssinosis is not known, but various chemicals

and organic substances have been suggested.

Musculoskeletal Disorders

Low back pain is responsible for more lost

work-time than any other medical condition ex-

cept upper respiratory tract ailments. In terms of

treatment and workers’ compensation, low back

pain is the costliest occupational ailment. More

than half of all workers will experience low back

pain of some kind sometime in their working lives,

but the percentage of those cases associated withthe workplace is unclear.

Low back pain may develop progressively and

insidiously, or it may come on with immediacy.

Pain may be dull and aching, with fatigue and

stiffness, or sharp and crippling. Surprisingly lit-

tle is known about the physiologic and physicalcauses underlying back pain. Circumstantial evi-

dence implicates intervertebral discs in manycases. (Discs are cartilaginous structures separat-ing the vertebrae of the spine. ) In extreme cases,

a disc may rupture, but physical signs that would

explain the pain are usually absent. Episodes of

pain, which last usually from a few days to a few

weeks, generally resolve with rest. Months or

years may pass without another attack.

Muscles, tendons, ligaments, and bones can

also be damaged by traumatic events or by re-

peated strains over a long period. Although mus-

cle pulls and tears have been recognized for years,

the “repetitive motion disorders"—those causedb y repeated, often forceful motions, mainly of

parts of the arm —have come to attention more

recently (see “Carpal Tunnel Syndrome, ” ch. 7),

Much assembly-line work and food processing,

for exam ple , i s cha racte r ized by r epe ti ti ve,

strenuous, awkward tasks. The prevalence of

repetitive motion disorders is unknown, but more

and more industries are recognizing that they have

such problems.

CancerTable 3-2 is a list of recognized occupational

cancer hazards. In most cases, there is convinc-

ing or very strong evidence that the listed sub-

stances have caused cancer in humans. Inspection

of the table shows that many of these substances

cause common cancers, for instance, of the lung

and skin. Except for a few specific and infrequent

cancers, there is no way to tell, from examining

a cancer patient, what agent(s), exposure(s), or

behavior(s) caused the tumor.

The most detailed information about an occu-

pational cancer hazard involves asbestos. The un-

folding of that story illustrates the time necessaryfor association to be accepted and some contro-

versies about occupational illness. Individual case

studies and reviews of case series relating expo-

sures to asbestos with cancer began to appear in

the literature in the 1930s (161). According to

Selikoff (430), however, the establishment of an

association between occupational exposure to as-

bestos and lun g cancer dep ended on a classic stud y

by Doll in 1955 (147).

Although asbestos was positively identified as

a cause of lung cancer in the 1950s, and exposureto it was known to be widespread, no published

estimate of its impact on nationwide mortality

was a vailable un til 1978, when tw o estimates were

made. Selikoff (555) estimated that the annual

number of asbestos-related cancer deaths was

about 50,000. His estimate elicited little public at-

tention.

The other 1978 estimate (555), entitled “Esti-

mates of the Fraction of Cancer in the United

States Related to Occupational Factors, ” was pre-

pared by the National Cancer Institute, the Na-

tional Institute for Environmental Health Sciences,and NIOSH. Ten employees of those institutionswere listed as contributors to the “estimates pa-

per, ” which was placed in an Occupational Safety

and Health Administration (OSHA) hearing rec-

ord about that agency’s proposed generic cancer




Table 3=2.—Some Occupational Cancer Hazards

Agent Cancer site or type Type of workers exposed

Acrylonitrile . . . . . . . . . . . . . .

4-aminobiphenyl . . . . . . . . . . .Arsenic and certain arsenic

compounds . . . . . . . . . . . . .

Asbestos . . . . . . . . . . . . . . . . .

Auramine and themanufacture ofauramine . . . . . . . . . . . . . . .

Benzene. . . . . . . . . . . . ... , . .

Benzidine. . . . . . . . . . . . . . . . .Beryllium and certain

beryllium compounds . . . .

Bis(chloromethy l)ether(BCME) . . . . . . . . . . . . . . . . .

Cadmium and certaincadmium compounds . . . .

Carbon tetrachloride . . . . . . .Chloromethyl methyl ether

(CMME) . . . . . . . . . . . . . . . . .

Chromium and certainchromium compounds. . . .

Coal tar pitch volatiles . . . . .

Coke oven emissions . . . . . .Dimethyl sulphate . . . . . . . . .Epichlorohydrin . . . . . . . . ., .Ethylene oxide . . . . . . . . . . . .

Hematite and undergroundhematite mining . . . . . . . . .

Isopropyl oils and themanufacture of isopropyloils . . . . . . . . . . . . . . . . . . . .

Mustard gas . . . . . . . . . . . . . .2-naphthyiamine . . . . . . . . . . .

Nickel (certain compounds)and nickel refining . . . . . . .Polychlorinated biphenyls

(PCBs) . . . . . . . . . . . . . . . . .

Lung, colon

Bladder

Lung, skin, scrotum,lymphatic system,hemangiosarcoma of theliver

Lung, larynx, GI tract,pleural and peritonealmesothelioma

Bladder

Leukemia

Bladder, pancreas

Lung

Lung

Lung,

Liver

Lung

Lung,

Lung,

Lung,LungLung,

prostate

nasal sinuses

scrotum

kidney, prostate

leukemiaLeukemia, stomach

Lung

Paranasal sinusesRespiratory tractBladder, pancreas

Nasal cavity, lung,

Melanoma

larynx

Manufacturers of apparel, carpeting, blankets, draperies,synthetic furs and wigs

Chemical workers

Workers in the metallurgical industries, sheep-dip workers,pesticide production workers, copper smelter workers,vineyard workers, insecticide makers and sprayers,tanners, miners (gold miners)

Asbestos factory workers, textile workers, rubber-tiremanufacturing industry workers, miners, insulationworkers, shipyard workers

Dyestuffs manufacturers, rubber workers, textile dyers, paintmanufacturers

Rubber-tire manufacturing industry workers, painters, shoemanufacturing workers, rubber cement workers, glue andvarnish workers, distillers, shoemakers, plastics workers,chemical workers

Dyeworkers, chemical workers

Beryllium workers, electronics workers, missile partsproducers

Workers in plants producing anion-exchange resins(chemical workers)

Cadmium production workers, metallurgical workers,electroplating industry workers, chemical workers, jewelryworkers, nuclear workers, pigment workers, batteryworkers

Plastic workers, dry cleaners

Chemical workers, workers in plants producing ion-exchange resin

Chromate-producing industry workers, acetylene and anilineworkers, bleachers, glass, pottery, pigment, and linoleum

workersSteel industry workers, aluminum potroom workers, foundryworkers

Steel industry workers, coke plant workersChemical workers, drug makers, dyemakersChemical workersHospital workers, research lab workers, beekeepers,

fumigators

Miners

isopropyl oil workersProduction workersDyeworkers, rubber-tire manufacturing industry workers,

chemical workers, manufacturers of coal gas, nickelrefiners, copper smelters, electrolysis workers

Nickel refiners

PCBS workers



Ch. 3—Health Hazard Identification . 47

Table 3-2.—continued

Agent Cancer site or type Type of workers exposed

Radiation, ionizing . . . . . . . . .

Radiation, ultraviolet . . . . . . .Soots, tars, mineral oils . . . .

Thorium dioxide . . . . . . . . . . .

Vinyl chloride . . . . . . . . . . . . .

Agent(s) not identified . . . . .

SOURCE (542)

Skin, pancreas, brain,stomach, breast, salivaryglands, thyroid, GI tract,bronchus, Iymphoid

tissue, leukemia,multiple myeloma

SkinSkin, lung, bladder, GI

tractLiver, kidney, larynx,

leukemia

Liver, brain, lung,hematolymphopoieticsystem, breast

PancreasStomachBrain, stomachHematolymphopoietic

systemBladder

Eye, kidney, lungLeukemia, brainColon, brainEsophagus, stomach, lung

Uranium miners, radiologists, radiographers, luminous dialpainters

Farmers, sailors, arc weldersConstruction workers, roofers, chimney sweeps, machinists

Chemical workers, steelworkers, ceramic makers,incandescent lamp makers, nuclear reactor workers, gasmantle makers, metal refiners, vacuum tube makers

Plastics factory workers, vinyl chloride polymerization plantworkers

ChemistsCoal minersPetrochemical industryRubber industry workers

Printing pressmen

Chemical workersFarmersPattern and model makersOil refinerv workers

Photo credit OSHA, Office of Inforrnation and Consumer Affalrs

Shipbuilding operations present a variety of both safety and health hazards. During World War 11,many workers were exposed to asbestos in naval shipyards



48 q preventing Illness and Injury in the Workplace

policy (the “estimates paper” is available as an appendix in Peto and Schneiderman (371)).

Had the paper been only deposited in the hear-

ing record it might have passed largely unnoticed.

Its findings, however, were widely publicized

when then-Secretary of Health, Education, andWelfare Joseph Califano cited them in a speech.

Based on the “estimates paper, ” he stated that

workplace exposures caused at least 20 percent

of all cancer in this country-with exposure to

asbestos alone responsible for 13 to 18 percent.

These projections were controversial as soon as

they were publicized, and they attracted many

critics. They also resulted in a spate of articles pre-

senting other estimates of the cancer risk associ-

ated with occupational exposure to asbestos.

The subsequent p apers can be divided into twogeneral groups. One group used methods similar

to the “estimates pap er” to project nu mbers of can-

cer deaths based on estimates of workers exposed,

exposure rates, and mortality observed among in-

sulation workers highly exposed to asbestos. A

second type of paper measured the number of

deaths from mesotheliomas, which are closely

associated with asbestos exposure, and thenmultiplied that number by some factor to estimate

all asbestos-caused cancer deaths.

Methods similar to those employed in the 1978

paper generated three estimates of total asbestos

cancer mortality. Those estimates, lower than the

13 percent figure in the “estimates paper, ” were1 percent (162), 2 percent (216) and 3 percent

(331). The different numbers reflect the authors’different estimates about the numbers of heavily

exposed workers—estimates that can be criticized

because they were not made on the basis of ac-

tual measurements. As that sort of information

does not exist, however, documented assumptions

are the best that can be provided.

In the case of asbestos, scientists interested in

extrapolating from study-generated data to esti-mates of national cancer mortality are aided by

the fact that asbestos causes asbestosis and meso-theliomas. Both those diseases are reasonably rare

and reasonably diagnostic for asbestos exposure.

Although both are subject to undercounting that

limits the accuracy of estimates based on them,

the estimates from them are congruent with those

based on the method used originally in the “esti-

mates paper. ” Calculations based on numbers of

mesotheliomas and asbestosis produced estimates

of between 1 and 2 percent of all cancer deaths

being due to asbestos (148,212,294,370).

The consistency of the projections that asbestoscauses between 1 and 3 percent of current cancer

deaths (190) has a pronounced effect on estimates

of total occupationally related cancers. Most, but

not all, participants at an international conference

about occupational cancer agreed that workplace

exposures cause less than 5 percent (20,000 an-

nual deaths) of U.S. cancer mortality (371).

Although this number is not as frightening as

saying asbestos causes 13 percent of cancer and

that workplace exposures cause at least 20 per-cent, and p erhap s twice that figure, it is still a large

number of deaths. Furthermore, as representatives

from all sides—academe, labor, and manage-

ment—agree, those cancers are preventable.

The amount of cancer that is associated with

workplace exposures is a significant part of the

current debate about the relative importance of

various factors in cancer causation (see (18), the

exchange of facts and opinions in ‘letters” Science

224:659 et seq., especially (154) and (19)).

Reproductive Disorders

The possibility that people’s occupations areleading to problems for an unborn generation is

frightening. It is increasingly a concern amongworkers, and attention to reproductive disorders

on the part of scientists is intensifying. Few facts

are available to either support or quell the fears

that a great many reproductive hazards are pres-

ent in the workplace. Relatively few instances of harm are known when compared with the known

effects of workplace hazards on workers them-

selves.

Initial concerns about reproductive health fo-

cused almost exclusively on women. Exposure to

the high levels of lead common at the beginning

of this century were known to cause menstrual

disorders, sterility, miscarriages, and stillbirths.

Much more recently, concern has been extended

to males. One episode provided the catalyst. In



Ch. 3—Health Hazard Identification q 49

the late 1970s, a number of men working in the

manufacture of dibromochloropropane (DBCP),

a pesticide, were unable to father children, In-

vestigation revealed severely depressed sperm pro-

duction.

Damage can occur in males and females in anumber of ways. In men, successful reproduction

depends on proper functioning of the prostate, on

libido, and on erection and ejaculation. The pro-

duction and viability of sperm can be affected by

damage to the sperm-producing cells or to the

sperm as they develop.

In women, damage can occur in the reproduc-

tive cells, the oviducts, the endometrium, or to

ovarian function. During fetal development in the

uterus, humans are most vulnerable to environ-

mental insults . Death, irreversible structural

changes (teratogenesis), and growth retardation

are the main classes of effects. More difficult to

measure or prove are subtle deficits in intellec-

tual capacity and functioning.

The effects of lead have been mentioned. At

least one form of another heavy metal, mercury,

is a known teratogen. Certain pesticides—DBCP

and Kepone for instance-affect sperm produc-

tion. Ionizing radiation has a variety of effects,

particularly on fetuses—causing growth retarda-

tion, for instance, or microcephaly, or having

latent effects, such as leukemias that develop dur-

ing childhood. A few organic solvents and phar-

maceuticals also are known to affect reproduc-tive health. In all, relatively little is known about

the extent of workplace-induced reproductive

damage, but efforts to find out more are underway. A current OTA assessment scheduled forcompletion in 1985, “Reproductive Health Haz-

ards in the Workplace, ” addresses this issue.

Necrologic Disorders

A wide variety of metals and organic com-

pounds act on the nervous system to cause phys-

ical and behavioral problems. Since many bodily

functions require the participation of nerves,nerve impairment affects not only sensory abili-

ties, but motor (muscular) ability as well as the

functioning of organs.

Lead is the best-known neurotoxin in the work-

place. More than a million American workers are

exposed currently. Mercury, manganese, andother metals, as well as organic solvents and

organophosphate insecticides, also pose neuro-

toxic risks. Table 3-3 lists some known neurotox-

ins and their effects.

Neurotoxins can damage the myelin sheath sur-rounding the nerve fiber or the nerve cell itself.

Toxins can also interfere with the production and

functioning of “neurotransmitters,” chemicals pro-

duced in the body that are necessary for proper

functioning of the nerves. ’some necrologic im-

pairment is reversible, but damaged nerve cells

have limited capacity for regeneration and repair.

Neurotoxins affect the parts of the nervous sys-

tem to different degrees. The most commonly

affected are peripheral nerves-those of the ex-

tremities. Hands and feet are often the f irst

symptomatic zones, and numbness and tingling

the first signs. Weakness in the hands and feet fol-

lows, and then difficulty walking and an inability

to grasp heavy objects. Other symptoms includeimpaired vibratory sense, loss of touch percep-

tion, and tremors of the hand and other parts of

the body.

A host of behavioral changes can also result

from necrologic insults: Slow response time, im-

paired hand-eye coordination, irritability, lack of

concentration, continual emotional instability,

and impairment of recent memory area few suchsigns. (Lewis Carroll’s “Mad Hatter” may have

been a victim of the necrologic effects of mercuryused in making felt hats. )

Most neurotoxins act through common path-

ways, though some have more specific effects:

Carbon disulfide, for instance, acts at all levels

on the central nervous system, but also causesconditions as extreme as acute psychosis.

Skin Disorders

The skin, the largest organ of the body, pro-vides the first line of defense between workers an d

their env ironment. Because it is read ily observable,

recognition of a problem is relatively easy. For




Table 3-3.—Neurologic Effects of Occupational Toxins

Peripheral Effects

Effect Toxin Comments

Motor neuropathy . . . . . . . . . . . . . . . . Lead

Mixed sensorimotor neuropathy . . . . Acrylamide

Arsenic

Carbon disulfide

Carbon monoxideDDTN-hexane and methyl

n-butyl ketone (MBK)

Mercury

Primarily wrist extensors; wrist drop and ankle drop rare

Ataxia common; desquamation of hands and soles;sweating of palms

Distal parethesias earliest symptom; painful limbs,especially in calves; hyperpathia of feet; weaknessprominent in legs

Peripheral neuropathy rather mild; CNS effects moreimportant

Seen only after severe intoxicationOnly seen with ingestions

Distal paresthesia and motor weakness; weight loss,fatigue, and muscle cramps common

Predominantly distal sensory involvement

Other Manifestatlons

Manifestation Agent Manifestation Agent

Ataxic gait , . . . . . . . . . . . . .AcrylamideChlordaneChlordecone (Kepone)

DDTN-hexaneManganeseMercury (especially with

methyl mercury)Methyl n-butyl ketone (MBK)Methyl chlorideToluene

Bladder neuropathy. . . . . . . Dimethylaminopro pionit ri te(DMAPN)

Constricted visual fields . . Mercury

Cranial neuropathy . . . . . . Carbon disulfideTrichloroethylene

Headache . . . . . . . . . . . . . . . LeadNickel

Impaired visual acuity ... , N-hexaneMercuryMethanol

Increased intracranialpressure . . . . . . . . . . . . . . Lead

Organotin compounds

Myoclonus . . . . . . . . . . . . . . Benzene hexachlorideMercuryNystagmus . . . . . . . . . . . . . . MercuryOpsoclonus . . . . . . . . . . . . . Chlordecone (Kepone)Paraplegia. . . . . . . . . . . . . . . Organotin compoundsParkinsonism . . . . . . . . . . . . Carbon disulfide

Carbon monoxideManganese

Seizures . . . . . . . . . . . . . . . . LeadOrganic mercurialOrganochlorine insecticidesOrganotin compounds

Tremor. . . . . . . . . . . . . . . . . . Carbon disulfideChlordecone (Kepone)DDTManganeseMercury

NOTE: This table Includes most, but not all, of the neurotoxic substances associated with Ilsted conditions.

SOURCE: (39a)

both these reasons, skin disorders account fornearly half of all reported occupationally relatedillnesses in the United States. NIOSH has recom-

mended maximum exposure levels for about 40agents based on their effects on the skin (see table

3-4).

Chemical, physical, and biological agents, me-chanical factors, and plant and wood substances

are known to cause occupationally related skindisorders (see table 3-5). There is probably no in-

dustry without some potential for exposure to one

or more of these agents. The industries with thehighest risk for skin disorders are listed in table

3-6. Although caused by a large nu mber of agents,

both biological and chemical, skin diseases aremanifested in a relatively limited number of clin-

ical symptoms: contact dermatitis, infection, pilo-sebaceous follicle abnormalities, pigment dis-

orders, and cancers.

Contact dermatitis accounts for 90 percent of

all occupational skin disorders. The most com-

mon manifestations of contact dermatitis are red-ness and swelling, and vesiculation (e.g., a poison

ivy rash) in more severe cases. Contact dermatitismay be an allergic reaction or simply due to an

irritant.

Bacterial, fungal, and viral infections may becontracted from customers or clients by such pro-




Table 3-4.—Substances for WhichNIOSH Has Recommended Exposure

Limits to Prevent Skin Disorders

AcrylamideAlkanes:

Pentane

HexaneHeptaneOctane

Arsenic, inorganic compoundsBenzoyl peroxideBenzyl chlorideCarbon blackChromium (Vi)Coal tar productsCresolEpichlorohydrinEthylene dibromideFibrous glass (dust)Glycidyl ethers:

Allylglycidyl ether (AGE)n-Butyl glycidyl ether (BGE)Di-2-,3-epoxypropyl ether (DGE)

Isopropyl glycidyl ether (lGE)Phenyl glycidyl ether (PGE)Hydrazines:

Hydrazine1,1-dimethyl hydrazinePhenyl hydrazineMethyl hydrazine

Hydrogen fluorideHydroquinoneNickel, inorganic and compoundsPhenolPolychlorinated biphenyls:

Chlorodiphenyl (42°/0)Chlorodiphenyl (54°/0)

Refined petroleum solventThiols:

Butyl mercaptan (1-butanethiol)Methyl mercaptan (1-methanethiol)Ethyl mercaptan (1-ethanethiol)

Tin, organic compoundsTungsten:

insoluble compoundssoluble compounds

Vanadium

SOURCE Adapted from (12Sa)

fessionals as barbers and hairdressers and by hos-

pital workers. Staphylococcus and streptococcus

bacteria may cause a range of skin conditions

from superficial to those of deep skin layers. More

serious bacterial infections, such as anthrax in

sheep handlers and animal hide workers, arerarer.

Fungal infections often arise in moist, warm

environments. Ringworm and Candida albicansinfections are common examples. Candida infec-

Table 3-5.—Workpiace Agents Thatinduce Skin Disorders

Chemical agentsRhus oleoresin (poison ivy and oak)AcidsAlkalisSolventsoilsSoaps and detergentsPlasticsResinsParaphenylenediamineChromatesAcrylatesNickel compoundsRubber chemicalsPetroleum products not used as solventsGlass dust

Plant and Wood Substances Pink rot celeryCitrus fruit

Physical Agents Ionizing and nonionizing radiation

WindSunlightTemperature extremesHumidity

Biological Agents BacteriaVirusesFungiEctoparasites (mites, ticks, fleas, etc.)Biting animals

Mechanical factors PressureFrictionVibration

SOURCE: (23a).

tion is common in workers, such as dishwashers,who are frequently exposed to water, because

moist conditions favor the fungus’ growth. Viral

infections are acquired by contact with other peo-ple and are a particular hazard for workers ex-

posed intimately to other individuals in the course

of their work, such as health care workers.

Pilosebaceous follicle abnormalities, generally

acne-like lesions, occur after exposures to heavyoils and certain chemicals, particularly chlorinated

aromatic hydrocarbons. The example currently

most discussed is chloracne after exposure to

chlorinated dioxins, either in the manufacturingprocess, or, most dramatically, after industrial ac-cidents involving the generation and release of

large amounts of the chemical. Chloracne may

persist for 10 yearn or more after exposure ceases.




Table 3-6.—industries at Highest Risk for Occupational Skin Diseases

Annual reportedincidence rate Target population Incidence of lost

(per 1,000 (rounded to workdays perIndustry workers) x nearest 1 ,000) x Severity

ax Durationb = industry per year

P o u l t r y d r e s s i n g p l a n t s 16,4 89,800 030 10.04,405Meat packing plants 72 164,300 0.31 4,3 1,561

Fabricated rubber products 55 103,200 0.22 11,5 1,424Leather tanning and finishing 21,2 22,900 0.34 8.3 1,392Ophthalmic goods 8.5 38,000 0.52 8.3 1,390Plating and polishing 8.3 61,400 0.28 9.0 1,270Frozen fruits and vegetables 7,2 43,200 0.31 12,1 1,153Internal combustion engines 5.5 75,700 027 8.8 999Canned and cured seafoods 5.6 19,700 0,36 23,7 934Carburetors, pistons, rings, valves 70 29,400 024 17.9 895C h e m i c a l p r e p a r a t i o n s 8.3 36,700 0.23 12.3 855Boat building and repairing 11.1 48,000 0.22 7,4 854aseverlty ,s defined by number Of lost-workday cases dwlded by fOtd Wnbw Of Cases HI that IndustrybDura[lon IS [he number of lost workdays per IOSt workday case

SOURCE (23a)

Pigment d isorders occur when melanin p roduc- versible or not, depending on the causative agenttion is either increased or decreased through ex- and on the severity of the insult. Other changes

posures to chemicals or from a traumatic event—a in skin color are due to staining of various layers

burn, for instance. Loss of pigment may be re- by such substances as heavy metals.

K N O W N A N D U N K N O W N H E A L T H H A Z A R D S

Health hazards are agents that can cause dis-

ease in people exposed to them. In terms of oc-

cupational health, there are three kinds:

q

q

q

identified hazards known to be present in theworkplace;

hazards that are present in the workplace but

that have not been identified as causes of dis-

ease; and

new substances or processes not yet introducedinto the workplace, that will be hazardous to

human health.

This section reviews the findings that led to

some associations being made between particu-

lar diseases and workplace hazards, as well as the

methods currently employed to identify hazards.

Identified Hazards

Diseases associated with mining and metal-

working have been recognized for many years,

to some extent because of the antiquity of those

trades. Some industrial chemicals are known to

cause a variety of diseases, and energy from all

parts of the electromagnetic spectrum is a hazard

under particular circumstances. As the following

examples show, associations between agents and

diseases have been made by people from all sec-tors of society based on laboratory information

as well as observations of human illness.

Physical Agents

Sources of ionizing radiation are increasingly

common in the workplace. X-ray apparatus and

radioisotopes are widely used, and nuclear power-

plants and scientific research also involve poten-

tial exposures to ionizing radiation. Very high

doses of radiation can kill workers within a few

days, but of greater concern, because the events

are more likely, is low-level exposures, which maylast for several years and may cause cancer. The

deleterious effects of radiation were discovered

from observations of disease among early work-

ers in the field and confirmed by analyses of the

survivors of Nagasaki and Hiroshima.



Ch. 3—Health Hazard Identification 53 —

Nonionizing radiations include ultraviolet, in-

frared, microwave, and laser. All present hazards

for workers’ eyes, and there is continued interest

in and study about other effects from microwave

radiation. Ultraviolet and infrared radiation as

well as intense visible light are generated in weld-

ing, and w elders’ goggles and h elmets are designedto protect against such hazards.

Also in the category of physical agents is noise,

which, especially if it is loud and continuous,

causes progressive hearing loss. The impact of oc-

cupational noise is difficult to separate from theeffects of aging, but many studies have shown

workplace noise is a hazard to hearing. (See ch.

8 for a discussion of the role of personal protec-

tive equipment in preventing hearing loss. )

Vibration, often experienced as a result of the

use of handtools, causes a number of musculo-

skeletal disorders (see ch. 7).

Heat, cold, and pressure encountered in under-

water work are also hazards. These have been

associated with particular jobs for a very longtime, and many of their effects are visible during

or soon after exposure.

Metals

Hunter (218) divides hazardous metals into

three groups. Those known since ancient times,such as lead and mercury, were long ago associ-

ated with disease. According to Hamilton (1922,

quoted in 218), the first legislation directed against

an occupational hazard was drafted in 1665 in

Idria, now part of Yugoslavia. The workday for

cinnebar (mercury ore) miners was restricted to

6 hours as a preventive measure to reduce the

occurrence of tremors. Mercury continues to

cause concern today as an environmental con-taminant, and it is especially dangerous in the

organic (methylmercury) form.

Hunter’s second group, the “other metals, ” are

arsenic, phosphorus, and zinc. He points out that

the grouping is arbitrary in that arsenic is a

metalloid and phosphorus a nonmetal. Thesethree elements have been in common industrial

use for a few centuries, and all have caused ill-

ness and death. The recognition of phosphorusas the cause of “phossy jaw” among matchmakers

(see box A) led to the substitution of a safe form

Box A.—’‘Phossy Jaw”

Phossy jaw was a disease that resulted frominhaling yellow or white phosph orus fumes thatpenetrated any d efective tooth an d killed cellsin the jaw and surrounding tissues. Invasion of

the dead areas by germs from the mouth led tosuppurating infection, swelling, and intense pain.Death could result from blood p oisoning; surgi-cal treatment, wh ich o f ten included removal of the jaw, was incapacitating and disfiguring. Thedisease was first diagnosed in w orkers in Euro-pean match factories in the m idd le of the 19thcentury.

Up t hrou gh 1908, there w as no recognition of ph ossy jaw as an occup ational health problemin the Un ited States. A Bureau of Labor stu dythat year of the wages of women and childrenin the match industry revealed 150 cases of phossy jaw. Two years later, the Bureau issued“Phosph orus Poisoning in the Match Ind ustry inthe Un ited States.”

One of the surest forms of controlling expo-sures to hazardous substances is to substitute aless hazardou s chemical. Phossy jaw was con-quered by substituting a d ifferent form of ph os-phorus for the “w hite phosphorus” commonlyused in matches. The Diamond Match Co.,which held the American patent for the safe form(sesquisulphide), waived its patent rights andmad e the safe substitute available to the entireindustry (199). In 1912, Congress passed the“Esch Act,” which levied a tax on w hite phos-

phorus matches, driving them from the market.

of phosphorus in matches. These three metals still

occupy important places in industry and in agri-

cultural products.

The third group of metals are those recently in-troduced into commerce, including some impor-

tant in advanced metallurgic technologies and the

nuclear industry. Toxic effects are definitely asso-

ciated with some—beryllium, cadmium, chro-

mium, manganese, nickel, osmium, platinum, ra-dium, ruthenium, selenium, tellurium, thallium,

thorium, uranium, and vanadium. In some meas-

ure, because these substances were introduced into

the workplace when industrial hygiene measures

were more common, exposure to many of them




has been well controlled (218). Also important to

controlling exposures to some of these metals is

their great expense; uncontrolled losses through

spills or into the atmosphere as vapors, fumes,

or dusts entail financial losses as well as healthhazards.

Many metals are worked in industry with noreported toxic effects. Cesium, cerium, colum-

bium, gallium, germanium, hafnium, iridium,

lanthanum, molybdenum, rhenium, rhodium,rubidium, strontium, tantalum, titanium, tung-

sten, and zirconium, for example, have not been

associated with illness in workers (218). Exposures

to many such metals are controlled by standardindu strial hygiene p ractices, and the fact that someof these metals are very expensive also encourages

reduced exposures.

Hunter (218) is a good source of historical in-

formation abou t the u ses and effects of the various

metals and about British approaches to control-ling exposures. Rem, et al. (396), discusses clini-

cal symptoms and treatments as well as U.S. ap-proaches to control, and Levy and Wegman (269)provide a lively introduction to the occupational

health and industrial hygiene problems associatedwith the metals, with less emphasis on clinical

detail than Rem. Tyrer and Lee (483) summarize

information about acute and chronic health ef-

fects of the metals and list recommended and reg-

ulatory limits to exposure.

Dusts and Fibers

The hazards of mineral dusts have been known

since mining began. Both silica dust and coal dust

cause lung diseases. The widespread use of silica

as an abrasive for “sand blasting” and otherpolishing results in many thousands of American

workers being exposed to mineral dusts that are

associated with lung diseases. In addition, cotton

dust and asbestos are important as causes of bys-sinosis and asbestosis, respectively.

Chemicals

Because of the explosion of organic chemistry(chemistry that involves carbon) in the last 100

years, thousands of new chemical substances have

been introduced into the workplace. Currentlythere are more than 55,000 chemicals listed in the

Environmental Protection Agency’s (EPA) inven-tory of Chemical Substances, which is a compila-

tion of chemicals in commerce. About 100 new

chemicals are introdu ced to commerce each m onth

(547a). Many of these substances–pesticides of various kinds and drugs-are designed to alter

normal biological functions, and it is no surprise

that some have been found to cause cancer andother diseases, and that these substances are of

special concern (542).

Some of the now-known hazards, such as vinyl

chloride monomer, have been discovered as a re-

sult of workers who have become sick. (See ch.

5 for a fuller discussion. ) Several years before analert physician noted an excess of rare liver tumorsin vinyl chloride workers, the results of an ani-mal test of the same chemical were announced at

a scientific meeting. The animal tests also showed

the chemical to be a liver carcinogen. It can be

argued that had the animal results been taken seri-ously, exposure to vinyl chloride would have been

reduced sooner. As it happened, the existence of

the animal studies may have been a factor in therapid regulatory process that led to significant re-ductions in vinyl chloride exposures.

Acrylonitrile is a commonly used plastic that,

like vinyl chloride, presents little hazard after it

is polymerized. However, animal studies showed

that acrylonitrile monomers are carcinogenic, anda follow-on epidemiologic study showed an ex-

cess of cancer among acrylonitrile production

workers. Regulations restricting exposures to the

substance were drafted by OSHA; unlike most

other OSHA health regulations, the final stand-ard for acrylonitrile was not challenged in court.

There must have been a number of reasons for

that success, and included in them were probably

the congruence between the results of the animal

and human studies and the fact that the methodsdeveloped to control vinyl chloride exposures

were directly applicable to the control of acrylo-nitrile.

Methods for Detection of Present,

Unidentified HazardsEpidemiology, toxicology, and occupational

medicine provide the means for identifying the

causes of occupational illnesses. In the traditional,



Ch. 3—Health Hazard Identification 55

idealized view of the process, physicians gener-

ate hypotheses about possible associations be-tween workplace exposures and subsequent dis-

ease. Hypotheses are tested in epidemiologic

studies so that the associations can be character-ized in statements of statistical probability.

The traditional role of toxicology has been to

provide information about the mechanisms of dis-

ease causation, the end results of which are

detected by physicians and studied by epidemiol-

ogists. Toxicology today is generally thought of

in different terms. Since the late 1960s and par-

ticularly through the 1970s, toxicology has been

seen as a way to identify chemical hazards before

their effects appear in humans. The most visibletoxicologic activities are the testing of chemicals

for carcinogenic properties in laboratory animals,

mainly rats and mice (542). The Federal Govern-

ment, through the National Toxicology Program,spent $31.6 million in 1983 on bioassays for thatpurpose.

There is also a certain amount of research now

going on in development of short-term tests (so

named because they require significantly less than

the 2 to 5 years for an animal bioassay) as even-tual replacements for and supplements to bioassays,

One of the most powerful methods of identify-ing associations between workplaces and diseases

is through workers themselves. For instance, the

pesticide dibromochloropropane was identified as

a cause of m ale sterility by w orkers talking to eachother. A possible relationship between office work

involving video display terminals and fetal mal-

formations that is now being actively investigated

similarly derives from workers’ observations. In

many cases, workers’ comments to their physi-

cians lead to epidemiologic and toxicologic in-

vestigations and to medical surveys to decide

whether a suspected association is real.

Toxicology

Toxicology is the testing of chemicals in ani-

mals, plants, or lower forms of life to detectbiological effects. In addition to questioning what

kinds of effects are produced and under what ex-posure conditions, toxicologists also investigate

the mechanisms by which substances cause dam-

age. That information is especially important in

efforts to predict the likely toxic effects of sub-

s t ances that h ave not yet been tested. Toxicologycan be subdivided in a number of ways. Here,

testing for acute toxicities is discussed first, fol-

lowed by a section on methods for investigating

chronic toxicities—carcinogenesis, mutagenesis,

and teratogenesis.

Acute Toxicity Testin g. —Chemical burns an d

immediate difficulty in breathing as a result of in-

halation of a su bstance are examp les of acute toxic

effects. Animal testing of chemicals for toxicity

has produced a voluminous data set.

Increasing concern about animal welfare is

causing reconsideration of animal testing meth-

ods. For instance, one of the most venerable acute

toxicity tests is the LD 50 test. Designed in the

1920s, the test involves the use of 50 to 100 ani-

mals to decide what amount of substance will

cause the death of 50 percent of the animals. Thismethod is coming under increased attack, how-

ever, as being imprecise and causing more ani-

mal suffering than is necessary. OTA is studyingthe use of alternatives to animals in research and

testing. The report from that project, expected in

1985, will discuss the pros and cons of various

animal tests and alternatives to animal tests.

NIOSH’s 1980 Registry of Toxic Effects of

Chemical Substances lists 45,156 substances. In-

cluded for most of the substances is the LD 50 esti-

mate of the amount that will kill half of a popula-

tion of test animals. In addition, informationabout the toxic effects of the substance on ani-mal skin and eyes is also commonly reported.

Dosages of ingested or injected substances nec-

essary to cause effects in animals are expressed

as the weight of the substance administered

divided by the animal’s body weight, i.e., milli-grams of substance/ bod y weight in grams or

kilograms. When the substance is inhaled, the

dangerous concentrations are expressed as parts

per million in air or as the weight of the substance

per cubic meter of air. These values provide data

for making estimates of the biological effects of the substance in humans. Almost always, safety

factors of 10 or 100 are used in setting acceptable

limits for workers. That is, if 100 parts per mil-

lion of a substance causes breathing difficulties

in animals, a prudent policy would be to limit

worker exposures to 10 or 1 part per million.




Chronic Toxicity Testing.—Structural activity

relationship (SAR) analysis, chronic animal bio-

assays, and short-term tests are the main tools of toxicology (see table 3-7) as it relates to car-

cinogens, and, in general, chronic health hazard

identification (542,547a). Finding a toxic effect in

humans is far more convincing evidence about theseriousness of a hazard than detecting a toxic ef-fect in animals, which, in turn, is more convinc-

ing than results from short-term tests. The w eakest

evidence is that derived from projections from

structural activity relationships. Although the

Federal effort devoted to chronic toxicities-muta-

genicity and teratogenicity as well as carcino-

genicity—is largely directed toward identifying

carcinogens, there are some minor stirrings of ef-fort to broaden beyond cancer (595).

Carcinogenicity has received the lion’s share of OSHA’s attention to health hazards. Of the fewer

than tw o dozen chemicals regulated through new,

permanent OSHA standards, all but two—lead

and cotton dust—have been carcinogens.

Extrapolation problems—that is, how knowl-

edge of effects in animals are projected to make

predictions for people and how exposure levels

in test animals are related to human exposure

levels–bedevil the use of animal test data. OTA

(542) has already discussed those problems andvarious approaches to reconciling them.

1) Structural activity relationship analysis, SARuses known information about the properties of

a substance to gain insight into the possible and

probable effects of the substance on human be-

ings. It is a new and still uncertain technique. Sub-

stances whose molecular structures resemble those

of known toxic substances come und er greater sus-picion than those whose structures do not. No

firm conclusions can be made based on these anal-yses except in the rare cases where all previously

known members of an entire class of chemicals

are known to be hazardous. In general, positive

results are taken to indicate a need for further

testing,

SAR has found most use in making estimates

of the toxicity of “new” chemicals, when no testdata are available. However, even there the scien-

tific und erpinnings of SAR are considered by some

to be very weak, and the conclusions based onit are hotly argued (547a).

2) Short-term tests. Short-term tests encompass

a large collection of methods for measuring tox-

icity in lower life forms-viruses, bacteria, and

lower plants and animals, such as fruit flies-incultured cells, or, in a few cases, in specific organ

systems of laboratory rodents (542). Since their

introduction about 15 years ago, they have been

characterized as holding great promise for tox-

icology. A cynic might say that they always will.

Table 3-7.–General Classification of Tests Available to Determine Properties Related to Carcinogenicity

Method System Time required Basis for test

Structural activityrelationship(SAR)

analysis ‘Paper chemistry”

Basic laboratory tests

Short-term tests Bacteria, yeast, culturedcells, intact animals

Bioassay Intact animals (rats,mice)

Epidemiology Humans

Days Chemicals with Iikestructures interact

Weeks similarly with DNA

Generally few weeks Chemical interaction with

(range 1 day to 8 DNA can be measured

months) m biological systems

2 to 5 years Chemicals that cause

tumors m animals

may cause tumors in

humans

Months to Iifetimes Chemicals that cause

cancer can be

detected m studies of

human populations

Structure resembles(positive) or does notresemble (negative)structure of knowncarcinogen

Chemical causes(positive) or does notcause (negative) aresponse known to becaused by carcinogens

Chemical causes(positive) or does notcause (negative)

Increased incidence oftumors

Chemical IS associated(positive) or is notassociated (negative)with an increasedincidence of cancer

Chemical may behazardous; thatdetermination requiresfurther testing

Chemical IS a potentialcarcinogen

Chemical IS recognizedas a carcinogen inthat species and as a

potential humancarcinogen

Chemical IS recognizedas a humancarcinogen

SOURCE Adapted from (542)



Ch. 3—Health Hazard Identification 57

Running counter to that lack of enthusiasm, re-

cent spectacular advances in molecular biology

suggest that short-term tests will grow in impor-

tance. As more and more insight into the molecu-

lar basis of carcinogenesis accumulates, along withrapid advances in methods to manipulate DNA

and other cellular components (542,548), im -proved short-term tests should follow. The limita-

tions and uncertainties of testing substances in

whole-animal bioassays are built into the methoditself. No such limits bound potential short-term

tests for discerning interactions between chemi-cal and cellular components. Of course, it will

always be possible to argue that the short-termtest system is not sufficiently parallel to humanbiology to serve as a guide to human risk esti-

mation.

The critical issue for development of short-termtests is defining their current and ultimate value

in policymaking. The first step is to find out howwell the results of a test represent the “truth,” a

process referred to as validation. Truth is usuallyrelative, and in the case of the carcinogenic po-

tential of chemicals, the convenient measuring

stick for truth is the bioassay, with its attendantlimitations (542). The acceptability of bioassay

results as a guide to making d ecisions about health

hazards appears, sometimes at least, to be tied to

the financial interest or disinterest of individuals

and organizations in the substances identified ascarcinogens.

There is little hope that a single short-term testwill ever suffice as a reliable predictor of toxicityin human beings, and hope is pinned on the de-

velopment of a battery of tests. Years of discus-

sion and argument will undoubtedly precede the

acceptance by scientists and regulators of any set

of tests. And even then, a “generally accepted”

test battery will be challenged in specifics, much

as evidence from bioassays currently is.

The development of reliable short-term tests

may actually enhance the value of bioassays,

which will always find a place in toxicologic

testing. Short-term tests can increase the knowl-edge base for deciding which chemicals should betested in animals, and can shed light on the prob-

able mechanisms of action of each chemical.

3) Bioassays. The bioassay is the mainstay of toxicology today. For some questions, answers

involving the biology of whole animals are essen-tial. The technique involves exposing a popula-

tion of laboratory animals, usually rats and mice,

to a suspect toxic agent. After an appropriate

time, about 2 years for carcinogenicity, the dis-ease incidence in the the treated population is

compared with the disease incidence in a popula-

tion of untreated controls. The premise underlying

the mammoth effort in bioassays is that evidence

of disease in animals is applicable to predictions

for people; in fact, substances known to be car-cinogens in humans also cause cancer in animals.

An entire branch of risk assessment has grown

up around the quantitative predictions of effects

in human beings based on animal evidence, In the

combination of bioassay and risk assessment has

lain the hope of perfectly protecting workers andthe public from chemical carcinogenesis before ef-

fects appear. On general principles, this appeal-

ingly simple system may still hold promise for set-t ing and defending regulatory goals, but i tssystematic failure to guide regulatory efforts in

specific instances has led to disillusionment.

The technical problems encountered in conduct-ing bioassays--including questions about high

doses, and the impossibility of knowing which ex-trapolation model is most appropriate—plaguerisk assessment. Equally or more important are

the assumptions involved. For instance, appar-ently endless arguments have gone on about

whether liver tumors in mice mean anything in

terms of human risk; the argument has not been

settled by experimentation but is silenced by con-vention (542).

Formaldehyde is a case in point. There is gen-

eral agreement that formaldehyde is an animalcarcinogen. The bioassay was carried out by in-

dustry’s own toxicology laboratory. But in the

final analysis, industry objected to regulating for-

maldehyde on the basis of the bioassay, and as-

sessments produced by different organizationsvaried in the amounts of human risk they pre-

dicted.




Epidemiology

The importance accorded epidemiology reflects

a trend toward more systematic, scientific study

of disease. The desire to base conclusions about

causality on something more than individual ob-

servation and intuition-the two most valuable

tools of the clinician—calls for describing asso-ciations quantitatively, both in terms of strength

of association and in terms of the probability that

the association is not simply one of chance. Care-

ful epidemiologic investigations have confirmed

important suspicions about work-related illnesses.

The now universally acknowledged case against

asbestos is built on epidemiologic studies.

The strengths of ep idemiology st il l remain tobe exploited. A great deal n eeds to b e learnedabout diseases and syndromes that are widespreadin the population. Certain chronic conditions

(cancers in particular) and heart disease are knownto be associated with various occupations. The

means exists, through the Surveillance, Epidemi-

ology, and End Results Program of the National

Cancer Institute (542,683), to enter about one-

tenth of all U.S. cancer cases on tumor registries

as they are diagnosed. This system provides the

ability to set up large case-control studies with

relative ease. (See box B.)

Cohort studies of large industrial populations—

which can be assembled by corporations and / or

unions and facilitated by workplace surveillance

systems that have been installed by many com-panies to track and store various sorts of data—also yield valuable information. (These surveil-

lance systems are discussed further in the “Oc-

cupational Medicine” section. )

G overnment Records. —An important and frus-trating feature of epidemiology in the United

States is the difficulty of locating and tracking

people. In a cohort study, it is critical that the

maximum number of cohort members be located.

If the cohort contains workers employed at a par-

ticular site S, 10, or 20 years ago, many will have

moved. In a case-control study, members of ei-ther population may be identified through hos-

pital records, and the recorded addresses may no

longer be current. In either type of study, the

epidemiologist often needs to locate people for in-terview and examination.

There are standard methods for locating peo-

ple in this mobile society. Asking at places of em-

ployment and using telephone and city directories

are common. Mail sent to the last known address

frequently reaches the person. In difficult cases,

the epidemiologists can hire private detectives or

credit bureaus to locate persons. The so-calledNIOSH-window facilitates some occupational epi-

demiology studies. Investigators who are allowed

to use it can supply a name and some other iden-

tifying information (such as the Social Security

number) to the Internal Revenue Service, and the

agency provides the person’s current address.

Members of the OTA Advisory Panel for this as-

sessment reported that there is some confusion

about who can and cannot use the NIOSH win-

dow and under what conditions.

The Federal Government collects information

about places of employment and about whathazards or substances are present in them. Such

records have obvious usefulness for epidemiology,

providing a quick method for identifying persons

who m ay have been exposed to a substance. How-

ever, all the record systems have flaws that re-strict their usefulness (542,557). The recommen-

dations made by the Committee to Coordinate

Environmental and Related Programs (CCERP)

of the Department of Health and Human Serv-

ices provide an excellent grounding for questions

about the current systems and suggestions for

changes.

The National Death Index (NDI) can tell epi-

demiologists that a person is dead and which State

(or other) department of vital statistics holds thedeath certificate. This speeds up the retrieval of

information for studies, but the NDI does not ac-

tually provide information on the cause of death

and underlying causes.

Section 8(e) of the Toxic Substances ControlAct (TSCA) requires that manufacturers report

to EPA on chemical substances that pose signifi-

cant risks to human health or the environment.

Some companies voluntarily report these resultsto NIOSH and OSHA. In practice, this reportingrequirement means that an employer that carries

out a short-term test, a bioassay, or an epidemi-

ologic study that shows a health risk must report

it to the EPA. EPA prepares a report on each 8(e)




Case-Control Studies.

In a case-control study, persons with the disease under study (cases) are compared with individualswithout the disease (controls) with respect to risk factors that are judged relevant. Some authors labelthis study design “retrospective” because the presence or absence of the predisposing risk factor is deter-mined for a time in th e past. However, in some cases the presence of the factor and the disease are ascer-tained simultaneously.

The choice of appropriate controls is rarely without problems. Often, for practical reasons, con-trols are chosen from hospital records. But th ey may not be rep resentative of the general pop ulation,

and they th erefore may introd uct “selection bias” (2$2).

General Considerations

In case-control an d cohort studies, the groups selected should be comparable in all characteristicsexcept the factor under investigation. In case-control studies, the groups should resemble each other ex-cept for the presence of the disease; in cohort studies, the study and comparison groups should be simi-lar except for exposure to the suspect factor. Since this rarely is possible in practice, comparability be-tween groups can be improved by either matching individual cases an d controls (in case-control studies)or by standard statistical adjustmen t procedures (in either case-control or cohort stud ies). Demograp hicvariables such as age, sex, race, or socioeconomic status are most commonly used for adjustment ormatching.

There are advantages and disadvantages in both types of study (see table 3-8). Case-control studiestend to be less expensive to condu ct, require relatively fewer ind ividuals, and often have been especially

Table 3-8.-Advantages and Disadvantages of Case-Control and Cohort Studies

Type of study Advantages DisadvantagesCase-control . . . . . . . Relatively inexpensive Complete information about past exposures

often unavailableSmaller number of subjects Biased recallRelatively quick results Problems of selecting control group and

matching variablesSuitable for rare diseaes Only relative risk is yielded

Cohort . . . . . . . . . . . .Lack of bias in ascertainment of risk Possible bias in ascertainment of diseasefactor status

incidence rates as well as relative risk ar e Large numbers of subjects requiredyieided

Associations with other diseases as by- Long follow-up period

product can be discovered Problem of attritionChanges over time in criteria and methodsVery costlyDifficulties in assigning people to correct

cohortSOURCE: (542).



60 q Preventing Illness and injury in the Workplace

notification and circulates it within the Agency

and to other Federal agencies, including OSHAand NIOSH. In addition, periodically the reports

received over a period of time are bound together

for distribution to libraries. The 8(e) activities,

therefore, provide a way to disseminate health

hazard information rapidly.

Occupational Medicine

The field of occupational medicine has gone

through a series of changes during this century.Not long ago, the clinician not only tended the

sick but also filled a number of other roles, in-

vestigating possible disease relationships and

fostering changes in the workplace. To a certain

extent, the role of the occupational physician w asaltered by the rise of epidemiology and toxicology

as separate professions.

Epidemiology and toxicology have not been the

panacea for solving workplace health problems

that some envisioned. Toxicology is limited to

testing under conditions that cannot mimic com-

plex human exposures and behaviors. Epidemiol-

ogy cannot begin until it finds subjects for study,

and it relies on outside input—in particular, clin-

ical observations of possible associations between

exposures or behaviors and disease—for hypoth-

esis generation. It has limitations in the kinds and

magnitudes of effects it can detect. The limitations

of both toxicology and epidemiology argue for

a continuing role for occupational medicine in

hazard recognition as well as in treating workers.

Better use of physicians’ experience and insights

will depend on education. There are two catego-ries: general education of physicians about oc-

cupational disease and injury, and specializededucation and training for practitioners of occu-

pational medicine. An orientation toward occupa-

tional health is minimal at best, in most U.S. med-

ical schools. Levy (269a) reports that only 5 0percent of U.S. medical schools provided someclass time to occupational health during the 1977-

78 academic year. This has risen to 66 percent in

the 1982-83 academic year. However, the median

number of required class hours devoted to occupa-

tional health remained at 4 hours. Postgraduate,specialty training in this country has traditionally

been subsumed under preventive medicine, and

centered in schools of public health. Recently in-creased emphasis has been placed on clinical ex-

perience in medical schools. The location of the

specialty courses is less important than making

sure the programs are well-taught and attractive

and that they provide clinical experience. The

NIOSH-supported Educational Resource Centers

(discussed in ch. 10) provide postgraduate edu-cation for physicians.

In the United States, the occupational medical

services are usually provided by physicians who

are directly employed by or under contract to

employers. Large companies frequently have on-

site medical departments, staffed by physicians

and nurses. Medium-sized companies might have

the full-time services of an occupational health

nurse, and possibly, the part-time services of a

local physician. Small companies have only rarely

provided occupational medical services.

An alternative organizational model is foundin occupational medicine clinics, which have been

growing in the last few years. These clinics are

usually associated with a hospital or university

and provide examinations and treatment to work-

ers. Clinics might, because of a larger patient load

and a staff that consequently sees more patients,be able to to provide more knowledgeable care,

as well as improved physician training. In somecases, the clinics’ staffs include not only doctors

and nurses, but also industrial hygienists and

safety engineers. The combination of staff from



Ch. 3—Healfh Hazard Identification q 61

different d isciplines can p rovide a critical mass for

a great deal of important activity in hazard iden-tification and control.

These clinics also provide advantages to em-

ployers, especially small to medium-sized com-

panies, that previously were not able to provideoccupational medical services to their workers.In the words of the director of an occupational

health department at one hospital:

The larger corporations will und oubted ly con-tinue to hav e in-plant occup ational health serv-ices. But m edium and smaller comp anies will beforced to m ake an economic decision on wh etherit is more advantageous to do it themselves orfarm the occupational health service to others

(Daniel Conrad, quoted in 338a).

Some hospitals are apparently establishing these

clinics in order to develop new sources of reve-nue. The staff of these clinics expect to be able

to conduct some research, as well as to provide

advice about prevention and medical care to em-

ployees (338a).

Medical Surveillance Systems. —Computerized

information systems have made it possible to store

massive amounts of data. Information about ex-

posures in the workplace and the health records

of workers can form the basis for surveillance sys-tems that aim to identify health hazards. Surveil-lance is defined as the “collection, collation, and

analysis of data and its dissemination to thosewho need to know” (474). Public health surveil-

lance techniques were developed in the last cen-tury to identify foci of pestilential diseases such

as cholera, smallpox, plague, and yellow fever,

so that appropriate control measures could be in-

stituted. In the workplace, the value of surveil-

lance is to alert workers and employers to unusualpatterns of morbidity or mortality.

Concerns today center on chronic rather than

acute diseases; the technical problems of linking

cause and effect are heightened by the remoteness

of disease from exposure. Computerized informa-tion systems in industry, including their use for

medical and exposure records, have enabled mas-

sive amounts of information to be stored and cor-relations to be produced.

In the occupational setting, the necessary com-

ponents of surveillance are:

q

q

q

exposure information of some type;

records of health outcomes, which may in-

clude causes of death; and

background information about characteris-tics of each individual that might influence

susceptibility to disease.

Variations in epidemiologic surveillance sys-

tems have to do mainly with the quantity and typ eof data in each category. “Exposure” can be quite

basic: for instance, knowing the plant within a

company, or the department within a plant, in

which a worker is employed, and updating it per-

haps yearly. At the more comprehensive end of

the spectrum, exposure might contain continuous

records of personal and area monitors measuring

chemicals and other agents in the industrial envi-

ronment.

Health outcomes may be ascertained from in-dustrial health and accident insurance reports,

which record only the most serious events, These

can be supplemented by information gathered in

preemployment examinations and nonroutine

visits to physicians, as an intermediate approach.

At the extreme, to the above information could

be added the results of periodic medical screen-

ing for many diseases or other abnormalities. Ba-

sically, the simp ler systems are considered passive,

using data collected for other purposes (person-

nel records, insurance data); systems can be pro-gressively more active in seeking data expressly

for health surveillance (312).

Routine analyses of data collected in surveil-

lance systems are seldom sufficiently rigorous toevaluate possible instances of occupational dis-

ease. Their broad, sweeping monitoring of health

events is more of a hypothesis-generating device.

It provides the means to make epidemiologic

studies as targeted and as timely as possible.

A sign of growing interest and activity in oc-

cupational health surveillance, and medical infor-

mation systems in general, was a meeting of the

American Occupational Medical Association’sMedical Information Systems Committee in 1981.Papers presented at that meeting, which described




19 such systems, were published as a supplement

in the October 1982 issue of the Journal of Oc-

cupational Medicine (238).

In the same issue of that journal, computer soft-ware companies advertised their ready-made pro-

grams for instituting surveillance systems. The

literature packets behind those systems, which ap-peared to be directed at smaller companies, de-

scribe convenient ways to classify and store large

amounts of information about workplace expo-

sures and employee health, What is missing, atleast in the prospecti, are discussions about the

ultimate value and potential contribution of suchinformation to detecting problems in the work-place. Although the systems may facilitate rec-

ord keeping that already goes on, they may failto have a serious impact on safety and health, as

they are promoted to do.

Occupational health surveillance remains asource of both great promise and great con-

troversy. If it could be used just to identify the

causes of occupational illness, setting the stage forpreventing further illness, there would be little to

say against the idea. As a purely scientific con-cept, it is unassailable. In practice, from the pointof view of companies, the collection and particu-

larly the analysis of data about exposures and

health outcomes raises legal issues of responsibility

and liability. From the employees’ point of view,there is a fear that surveillance will be adopted

as an alternative to installation of controls.

There is anecdotal evidence that some com-panies that had maintained surveillance systems

have now dismantled them. Although the samedata may still be collected for administrative rea-

sons, they are not being assembled in a form for

analysis of possible relationships between expo-

sures and disease. This step may at least in partstem from the unknown consequences of findingthe suggestion of a health problem—for instance,

a slight excess of some particular cancer. Further

study would certainly be necessary to confirm the

association, yet the liability associated with even

suspecting that a problem exists cannot be known

at this time.

Some employers are concerned that discover-

ing a possible association may make them liablein tort actions. In addition, section 8(e) of TSCA

requires reporting of such findings, making thempublic and available to potential litigants. On the

other hand, some companies expect that acting

responsibly w ill provide some d efense against tort

action. The problem of deciding how to use suspi-cions that may be generated by routine match-ing of health and surveillance information is a

very real one.

A second policy issue in this field concerns the

proliferation of data collection systems for health

and exposure information that are accompanyingthe microcomputer age. There appears to be little

thought given to the ultimate value of these sys-

tems in improving workplace safety and health.

Certainly for small companies, the targets of much

advertising, the number of workers will be toosmall ever to detect all but the most obvious ex-

cesses of disease. There may be scope for using

computer networks to pool data, but these activ-

ities bring their own problems. (See ch. 10. )

Another pertinent issue is the substitution of surveillance for prevention, particularly preven-tion in the form of controls on workplace ex-

posures. Union officials and many health profes-sionals fear that the creation of surveil lance

systems will lead to the impression that “some-thing is being done” to improve health, resulting

in less emphasis on controls and paralyzing ac-

tion against hazards until large numbers of peo-

ple become sick or die.

New Hazards

In some m easure, “familiarity breeds contempt”-

even when the subject is hazards-and there may

be a human tendency to fear new hazards morethan old ones. The emphasis placed on identify-

ing and understanding “new” hazards grows

partly from that psychology and partly from the

realization that it is easier to control hazards

before they become established in commerce andeconomically important.

Epidemiologic studies and occupational medi-

cine are of no value in learning whether a newagent is hazardous before people are exposed to

it. The introduction of a new substance or proc-

ess into the workplace that is subsequently shown

to be a hazard must be regarded as a failure of



.

— —-

preventive health measures. Analysis of the chem-

ical structure of a new substance can be used to

estimate what toxic properties are associated withit, but many people consider that technique to be

unreliable. Toxicologic techniques can be used to

learn about the hazards of new substances, but

the associated costs place some restrictions ontheir use.

Toxicology costs money, and manufacturers

will not spend great sums on testing a newly de-

veloped chemical before they know there is a mar-

ket for it. Some manufacturers argued during the

debate when the Toxic Substances Control Actwas passed that they did enough toxicologic

testing to be assured that new chemicals would

not pose unreasonable risks. TSCA set up two

programs to gather informat ion about new

chemicals.

The Premanufacture Notification Program

The Toxic Substances Control Act requires that

manufacturers prepare a Premanufacture Notice(PMN) and submi t it to EPA at least 90 days

before starting manufacture of a chemical sub-

stance for use in commerce. The PMN is to con-

tain any information available to the manufac-

turer about the toxicity of the chemical, Some

PMNs contain many items of information bear-

ing on the properties of the new chemical, whileothers contain none or only a few, and there are

disputes about how useful the reporting has beento date (547a).

It is clear from EPA’s experience with the PMN

program that a common plain for potentially haz-

ardous exposures to newly introduced substances

is in their manufacture. EPA has used formal and

informal regulatory procedures to reduce occupa-

S U M M A R Y

Preventing workplace-related disease requires

that associations between activities and exposuresand diseases be identified. The known health

hazards-extremes of heat and cold, radiation of

various kinds, noise, and some dusts, fumes, and


tional exposures to chemicals described on PMNs

(547a), and it has established informal communi-cations with OSHA and NIOSH staff about con-

trols. For instance, EPA has required the use of

respirators in the manufacture of some new chem-

icals described on PMNs. According to EPA offi-

cials, the Agency consulted with NIOSH aboutappropriate respirators.

The PMN program provides an important op-

portunity to identify hazards before they become

established in the workplace. Although EPA reg-

ulated pesticides under a licensing law beforeTSCA, its regulatory concern about other chem-

icals was restricted to those that became pollut-

ants. Under the PMN program, it has authority

to regulate chemical substances before they get

into the workplace.

Significant New Uses

TSCA anticipated that the uses of a chemical

described on the PMN might not be associated

with an unreasonable risk, but that a different use,

called a “significant new use, ” might. TSCAdirects EPA to write a significant new use order

about new chemicals that fall into this category.

In practice, EPA has restricted some chemicals to

particular uses and required submission of more

data about the chemical before it could be morewidely u sed. One examp le of this process concerns

a surfactant for cleaning. Concerned about pos-

sible dermatologic effects, EPA did not object toits use by professional cleaners, because those

workers could be instructed in the proper use.

However, if the surfactant is considered for use

in consumer products-a significant new use—

more information must be provided to EPA.

vapors from manufactured and naturally occur-

ring substances—illustrate the diversity of ex-posures. In addition to identified hazards, present

but so-far-unidentified hazards are also a concern.

Finally, increasing attention is being focused o n



64 q Preventing Illness and Injury in the Workplace — .

assessing the possible hazards of new substances

and processes before they are introduced into the

workplace.

Some health hazards that have been known for

centuries were obvious because of the particularnature of the diseases; for instance, lead poison-

ing symptoms were sufficiently distinctive to makethe association between exposure to lead and dis-

ease apparent. Three disciplines—occupationalmedicine, epidemiology, and toxicology—havebeen important in describing associations. All

three are currently used in investigations of cur-

rent exposures that may be hazardous. Toxicology

is especially important to learning about “new, ”

possibly hazardous substances before they areintroduced into the workplace.

Some of the most successful efforts at preven-

tion, such as the marked reductions in exposure

to vinyl chloride, began with a physician notingan unusual cluster of diseases. The importance of this source of information draws attention to med-

ical school teaching about the role of work in

health and disease. Unless medical students learnthe value of taking an occupational history as part

of the medical examination, associations may bemissed. Occupational physicians, familiar withworking conditions and exposures and often inter-

acting with industrial hygienists and safety engi-

neers, can be especially important in hazard iden-

t i f ica t ion. Workers’ own observat ions andcomplaints, brought to the physician, are often

the first indication of a hazard.Epidemiology is important less in initial iden-

tification of hazards than in providing evidence

for or against an association. In making decisionsabou t w hich haza rds a re “ rea l , ” pos i t i ve

epidemiologic studies are the most convincing evi-

dence, but there are often protracted arguments

about the appropriateness of study methods and

the conclusions drawn. Companies, trade asso-ciations, unions, and government agencies all

commission epidemiologic studies and comment

on studies done by others. Government records,which contain information about vital statistics

and locations, are especially useful in epidemi-ologic studies.

Toxicology provides information about the po-

tential hazards of substances by testing them in

animals or other systems. With the passage of the

Toxic Substances Control Act, which requires that

companies notify the Environmental ProtectionAgency of their intention to manufacture new

chemicals, the government is in a position to ob-

tain information about chemicals before they enter

commerce. Although there are conflicts abouthow much information EPA needs to protect

human health, it is clear that workplace exposures

are being identified as concerns in the case of somenew chemicals. Toxicology plays the central role

in identifying hazards from new chemicals.

TSCA also requires that companies notify EPA

about substances present in commerce that are

substantial risks, and the Agency then dissemi-

nates that information. All three disciplines—

occupational medicine, epidemiology, and toxi-

cology—have contributed to the identification of

substantial risks. The N IOSH Health H azard Eval-

uation program investigates possible associationsbetween exposures and illness at the request of

employers or employees or on its own initiative

(see ch. 10). It, too, relies on all three disciplines.

Hazard identification is not a smooth path;

arguments and conflicts abound. Evidence that

convinces some people leaves others unmoved.

The methods that were used in the past, improved

by better training and techniques, continue to beof value today. More attention during the edu-

cation of physicians and other medical personnel

to the influence of work on health, better use of

Federal records, where appropriate, to facilitateepidemiology, and continual research to make

toxicology more predictive all offer opportunities

to improve hazard identification. However, as is

made clear in other parts of this assessment, haz-

ard identification alone is not sufficient. Makinga decision to control a hazard requires that the

hazard be identified, but identification, by itself,

is not sufficient for control.



4.

Safety Hazard Identification



LIST OF TABLESTable No.

. .

,.



4Safety Hazard Identification;

Many safety hazards are obvious: a punch press

ram that descends every five seconds, a wet floor,

an unstable ladder. This is true at least for the

causes of acute injuries, though it is not neces-

sarily true for cumulative injuries. In either case,

what is often unclear is the complex of events

through which the potential of the hazard is real-

ized and an injury occurs. During this century the

theory of the cause of injuries has evolved, and

is still evolving, from attributing most injuries to

“unsafe acts” of workers, to identifying conditions

that increase the probability of an injury occur-

ring. Under the first approach, the preventive

remedy is to install perfect workers in jobs. Underthe second—by identifying all possible contrib-

uting factors—preventive strategies can be ap-plied, or at least considered, in different ways.

The causes of work-related injuries can be ex-

amined at two levels. The “macro” approach uses

aggregate statistics, such as those produced in the

Bureau of Labor Statistics’ Annual Survey, to ex-

amine the distribution of various types of injuries

according to several variables: industry, occupa-

tion, size of establishment, sex of worker, andothers (see ch. 2, Working Paper #l). These dis-

tributions provide general clues to injury causes.

The “’micro” level identifies specific injury causes.

An ep idemiological app roach analyzes sets of sim-

ilar injury-related incidents to find common cir-

cumstances contributing to their cause. At the

most specific level, individual injury-related in-

cidents are examined to determine cause; severalmethods have been developed at this level.

The nearly 4,100 work-related fatalities (includ-

ing heart attacks) that occurred in private sector

workplaces with 11 or more employees during

1982 were not even ly distribu ted over all indu s-tries (see table 4-1). Mining, accounting for 2 per-cent of employment, had 11 percent of the fatali-

ties, Construction, 5 percent of employment,accounted for 18 percent of reported on-the-jobdeaths. The wholesale and retail trades represent

25 percent of employment, but recorded only 12

percent of the fatalities. Finance, insurance, and

real estate, along with the service industries, ac-

counted for 31 percent of employment, but only

12 percent of fatalities.

A further breakdown reveals the injuries that

resulted in death by industry categories, both by

the distribution of causes within an industry cat-

egory (see table 4-2), and by the distribution of each cause across all categories (see table 4-3).Overall, motor vehicle accidents account for 27

Table 4.1.–On-the-Job Fatalities by Industry Division, in Private-Sector Units with11 Employees or More, 1982

Annual averageemployment Fatalities

Industry division Number Percent Number Percent

Private sector (total) . . . . . . . . . . . 62,629,000 100 4,090 100

Agriculture, forestry,and fishing . . . . . . . . . . . . . . . . . 729,000 1 180 4

Mining . . . . . . . . . . . . . . . . . . . . . . . 1,070,000 2 440 11Construction . . . . . . . . . . . . . . . . . . 2,898,000 5 720 18Manufacturing. . . . . . . . . . . . . . . . . 18,267,000 29 770 19

Transportation andpublic utilities. . . . . . . . . . . . . . . 4,629,000 7 970 24Wholesale and retail trade . . . . . . 15,603,000 25 490 12Finance, insurance, and

real estate . . . . . . . . . . . . 4,252,000 7 100 2Services . . . . . . . . . . . . . . . . . . . . . . 15,181,000 24 420 10NOTE Because of rounding, components may not add to totals

SOURCE (608)

67




Table 4-2.—Causes of On-the-Job Fatalities in Private-Sector Units with 11 Employees or More, byIndustry Division, with Distribution by Industry, 1981 and 1982 a

I

II

Causeb

Total—all causes . . . ....,-.., . . . . . . . . . .-

Over-the-road motor vehicles . . . . . . . . . , . . .Falls . . . . . . . . . . . . . . . . . . . . . . . . . ... . . .Heart attacks . . . . . . . . . . . . . . . . . . . . . . .Industrial vehicles or equipment . . . . . . . . . . .Nonaccidental injuries . . . . . . . . . . . . . . . . .Struck by objects other than vehicles

or equipment . . . . . . . . . . . . . . . . . . . , . . .Electrocutions . . . . . . ... . . . . . . . . . . , . .Caught in, under, or between objects other

than vehicles or equipment. . . . . . . . . . . . . .Aircraft crashes. . . . . . . . . . . . . . . . .Fires ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Plant machinery operation ... . . . . . . . . . . .

Explosions . . . . . . . . . . . . . . . . . . . . . . . . . . . .Gas inhalations . . . . . . . . . . . . . . . . . . . . . . . . . .Another . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10018126

273

1

100

2698

21<1

100

52

6

6

3

2

100 100 100

35 299 10

23 16

0 9

8 15

0 20 5

17 27 71 <10 <1

0 10 1

<1 3

27121010

7

1531

817

<1

201010

9

2

205

124

30

66

94

511

1

1685

6433

223

1

281

01

4

3571

233

4

1

1

2

21

3

the industry division level sampling errors are large Therefore, the results are for both Years

rather than a comparison between them.as the object or event associated with the fatality.

and nonmetal mining, and railroads for data are available‘ExcludesNOTE: Because of rounding, percentages may not 100

SOURCE (608)

Table 4-3.—Causes of On-the-Job Fatalities in Private-Sector Units with 11 Employees or More, by

industry Division, with Distribution by Cause, 1981 and 1982” -

I

Over-the-road motor vehicles . . . . . . . . . . . .Falls . . . . . . . . . . . . . . ,, . .,,..,.,,Heart attacks. ..., . . ..., ..., . . . . . . .,Industrial vehicles or equipment . . . . . . . . . . .Nonaccidental injuries . . . . . . . ..., ..., ...,Struck by objects other than

vehicles or equipment .,,,. . . . . . . . . . . . .Electrocutions . . . . . . . . ., . . . . . . .Caught in, under, or between objects other

than vehicles or equipment. . . . . . . .Aircraft crashes. . . . . . . . . . . . . . . ,.Fires .. ...,,. . . . . . . . . . . . . . . . . . . . . . . . . . .Plant machinery operations ..., . . . . ,...

Explosions . . ,. ....., . . . . . . . . . . . . .Gas inhalations . . . . . . . . . . . . ., . . . . . . . . .All other ., . . . . . . . . . . . . . . . . . . . . . . . . . . .

100

100100

100

100

34

312

2

6 10 18 37 11 44 47 20 8 6 25 16 24 11 18 7

14 32 23 5 6 0<1 <1 6 5 63 3

11

8169

20

38

319

2<1

658

100

100

10 16 33 8 31 04 34 21 18 3 0

<1

12

100

100

100

100

100100

100

1

212

1

026

4 12 21 30 20 99 6 22 32 6 5

15 8 46 14 1 22 11 78 2 7 0

5 14 47 20 8 09 10 48 14 12 05 18 33 13 16 1

is changes precisely the division level sampling errors are large Therefore, the are for both Years

rather than a comparison between themIs defined as the object or event associated the

and nonmetal mining, and railroads for which data are availa ble

‘Excludes railroadsNOTE rounding, percentages may not 100.

SOURCE (608)



— ..——

percent of fatalities, but in transportation and

public utilities the figure is 52 percent. In construc-

tion, falls were responsible for a greater propor-

tion of deaths (31 percent) than were over-the-

road motor vehicles (15 percent), although indus-trial vehicles and equipment were associated with

17 percent of deaths.

Nearly half of all fatalities (47 percent) resulting

from falls occurred in the construction industry(see table 4-3). Most fire- and explosion-related

Ch. 4—Safety Hazard /identification 69 ————- —

deaths in the work force (46 percent) and deaths

from plant machinery (78 percent) occur in man-

ufacturing. Add itional sources of aggregate injurystatistics are described in Working Paper #l.

Aggregate statistics can guide injury prevention

by highlighting general hazard categories in spe-cific industries. Immediate or underlying condi-

tions related to an individual injury can only be

determined through case study.

BASIC THEORIES OF INJURY CAUSATION

Traditional Approach—UnsafeConditions or Unsafe Acts

In the 1920s, Heinrich proposed a theory of in-

jury causation that many safety professionals have

followed ever since. Simplified, the theory states

a domino sequence:

• Injuries are caused by acciden ts.

• Accidents are caused by u nsafe acts of per-sons or by exposure to unsafe mechanical

conditions.

• Unsafe acts and conditions are caused by

faults of persons.q Faults of persons are created by the environ-

ment or acquired through inheritance.

Using this approach, Heinrich analyzed 12,000

cases of injury from insurance claim records plus

63,000 cases from the records of plant owners,

for a total of 75,000 cases. Seventy-three percent

of the injuries were classified as due to “unsafe

acts” by workers. Heinrich noted that 25 percent

of the cases examined would, according to the

usual methods employed at the time, have been

charged to defective or dangerous physical or me-

chanical conditions. However, he concluded that

man y cases in this group of 25 percent were caused

either wholly or chiefly by worker failure, and

only partly by physical or mechanical conditions.He decided to classify as “unsafe conditions” only

those cases that were wholly caused by physical

or mechanical failure. The injuries not wholly due

to ph ysical or mechanical failure (15 percent) w ere

grouped with the 73 percent of cases that involved

only “’unsafe acts. ” Thus he produ ced a w ell-

known and often cited figure that 88 percent of

injuries are due to “unsafe acts” by workers (380).Heinrich attributed only 10 percent of injuries to

unsafe conditions and considered the remaining

2 percent of injuries to be unpreventable (207).

Critique of Traditional Approach

Arndt (24) has noted that, although there has

been little research pu blished to sup port Heinrich’s

theory of injury causation, Heinrich’s ratio of 88

percent unsafe acts to 10 percent unsafe condi-tions is commonly cited. In fact, the published re-

search on this topic uniformly refutes Heinrich’s

theory.

Heinrich himself pointed out two other studies.

The first, by the National Safety Council (NSC),

concluded that unsafe acts contributed to 87 per-

cent of the cases examined, while mechanical

causes contributed to 78 percent. The total of 165

percent is due to NSC’s considering multiple

causes of accidents. An analysis in 1940 by the

State of Pennsylvania showed that an “equal num-ber” of injuries resulted from unsafe acts and me-

chanical causes. Heinrich recognizes the discrep-

ancy, which he attributed largely to the fact thatthe NSC and Pennsylvania studies allowed both

an unsafe act and an unsafe condition to contrib-

ute to a single injury. Heinrich’s methodology did

not permit such multiple assignment of cause

(207),




Table 4-4 presents a summary of other research

aimed at apportioning injury causes between un-

safe acts and unsafe conditions. Heinrich’s study

is the only one to attribute more than 35 percent

of injuries primarily to unsafe acts by workers.

The other research has generally categorized most

injuries as resulting from a combination of un-

safe acts and unsafe conditions.

Arndt (24) examined nearly 1,000 injuries asso-

ciated with mechanical punch presses. He devel-

oped eight mutually exclusive categories to de-

scribe the circumstances of the injury. These

included operator timing errors, inadvertent trip-

ping of the press, other operator errors, tripping

of the press by a second person, and machine

malfunctions. He found that 53 percent of the in-

juries resulted from something other than machine

malfunctions. All of that 53 percent would be at-

tributed to “unsafe acts” in a dichotomous sys-tem, like Heinrich’s, for recording causes of ac-

cidents. The machine malfunctions, including

broken parts and accidental recycling of the press,

which would generally be labeled “unsafe condi-

tions, ” amounted to 18 percent of cases. Arndt

was unable to classify 29 percent of the cases be-

cause of a lack of information.

Thus, under the traditional breakdown between

unsafe acts and unsafe conditions, about threetimes as many injuries in Arndt’s study would be

classified as due to unsafe acts rather than unsafe

conditions. But Arndt observes that a very largenumber of those classified as “unsafe acts” oc-

curred on presses activated by a foot pedal, by

a one-hand control , or automatically. These

presses allow operators to insert their hands in-

side the “point of operation” of the press. It is not

surprising, then, that someday someone places a

hand or arm inside such a press to adjust the piece

being worked on or to clear a jam, and then is

unable to remove it quickly enough. For exam-

ple, if a press operator produces 5,000 pieces aday, then the operator’s hands are placed in front

of the press ram every 5 seconds, which means

about 25,000 times per week or 1.2 million times

a year (24). It may be only a matter of time before

an operator commits an “error” and loses a fin-

ger in the press.

There are, however, machine designs that can

reduce and nearly eliminate this particular haz-

ard. Machines can be designed to operate withtwo-handed controls, so that the operator must

have both hands on the controls. In Arndt’s anal-

ysis, 60 to 70 percent of the injuries from pressesactivated by foot pedals, by one-handed controls,

or au tomatically were r elated to “u nsafe acts, ” and

only 10 to 20 percent related to “unsafe condi-

tions. ” For presses with two-handed controls, the

fraction due to “unsafe acts” was only 35 percent.

“Unsafe conditions” were cited in about 54 per-cent of these cases. Arndt’s paper does not pre-

sent any information on the injury rates associ-

ated with the various kinds of presses because data

on the total numbers of each control type are not

available. But it is clear that the design of the press

has a dramatic affect on the number and percent-

age of cases attributed to “unsafe acts. ”

The traditional partition between unsafe acts

and unsafe conditions unfortunately often draws

Table 4-4.—Estimated Percentages of Accidents Due toUnsafe Acts versus Unsafe Conditions

. .——Percent due to Percent due to Percent due to ‘Percent -

—.

Study unsafe acts unsafe conditions combination unknown

Furniss . . .:. . . . . . . ~. . . . . . . — – 16 84- —

Pennsylvania Department ofLabor. . . . . . . . . . . . . . . . . . . . 2 3 95 —

National Safety Council. . . . . . 19 18 63Mintz and Blum . . . . . . . . . . . . .

—

21 — 79Hagglund a . . . . . . . . . . . . . . .

—26 58 2 13

Hagglund b . . . . . . . . . . . . . . . . . 35 54 4 7

Henrich c . . . . . . . . . . . . . . . . . . . 88 10 — ——— — —

alnvestigations of reported fatalities.bRandom sample of accident reportscHenrlc h classified 2 percent as ‘unpreventable ‘‘

SOURCES (30,37,207,316)



Ch. 4—Safety Hazard Identification 71

attention away from the job or equipment rede-

signs that can remove or minimize hazards. In the

1959 edition of his textbook, Heinrich himself cau-

tioned safety professionals not to neglect work-

place conditions. He expressed confidence that

safety professionals would not “ignore the veryfirst common-sense step. . . of safeguarding [the]

mechanical environment” (quoted in 462).

The catchall category of “unsafe act” or “h um an

error” has greatly restricted advances in injury re-

search and the application of control techniques

in workplaces (380). The label “unsafe act” has,

unfortunately, often led to a failure to recognize

how the design of workplace equipment can m in-

imize the occurence of “unsafe acts” or reduce the

probability and severity of human injury.

The seriousness of this limitation is clear from

one commonly used system for recording infor-mation about injuries. The American National

Standards Insti tute (ANSI) Standard Z16.2, Method of Recording Basic Facts Relating to the Nature and Occurrence of Work Injuries, used

widely for employer injury investigation and rec-

ordkeeping. ANSI itself sees inadequacies in its

method, as the text of Z16.2 indicates:

It is recognized that the occurrence of an injuryfrequently is the culmination of a sequence of related events, and that a v ariety of cond itionsor circumstances may contribute to the occurrenceof a single accident. A record of all these items

unquestionably would be useful to the accidentpreventionist.

Any attempt to include all subsidiary or relatedfacts abou t each accident in the statistical record,however, would comp licate the p rocedure to the

point of impracticability. The procedu re, there-fore, provides for recording of one pertinent fact about each accident in each of the specific cate-gories or classifications. To insure un iform ity inthe selection of items to be recorded in each cate-gory, the items are specifically d efined in terms

wh ich eliminate an y necessity for decision as tothe relative impor tance of multiple items fallingin the same category (emphasis added).

Instead of collecting information on all the cir-

cumstances leading to the accident, the ANSI

Standard Z16 allows “only one pertinent fact” to

be recorded concerning the nature of the injury,

the source of the injury, the type of accident, the

hazardous condition present, and any unsafe act.

This standard facilitates the administration of in-

jury data collection because of its simplicity, but

it is inadequate for research on causation. Unfor-

tunately, the most common entry under this sys-tem is simply to attribute the injury to “worker

error. ”

According to Purswell and Stephens (380), at-

tributing responsibility for accidents to human er-

ror, with no significant information as to why the

error was committed, is not limited to the ANSI

system. It is found in other workplace-injury datacollection systems as well as those for collecting

data on non-workplace injuries. For example, re-

searchers in the field of highw ay safety have n oted

that there is no place on standard police formsto record many items that relate to features of thevehicle or the road that contributed to the injury.

For the most part, these forms are oriented around

recording information on the driver (41).

OTHER MODELS OF INJURY CAUSATION

Purswell and Stephens (380) describe a num-

ber of other models of injury causation and in-

vestigation. These include behavioral models,

management models, epidemiological models, andergonomic or human factors models .

Behavioral Models

The underlying concept of behavioral models

is that of the “accident proneness” of individuals.

Some safety specialists believe that a dispropor-

tionate number of injuries are incurred by a hand-

ful of individuals who are especially prone to ac-

cidents. Accident proneness has been, at one timeor another, ascribed to recent immigrants to the

United States, to certain ethnic/ racial group s, or

to certain personality traits (380). Thus efforts

were made to identify these workers and either

fire them or not hire them in the first place. Later

researchers have been unable to find similar traits




that will reliably predict which workers will beinjured. Unfortunately, the belief that there are“injury-prone” workers is still commonly held.According to a Bureau of National Affairs (78)

report, 65 percent of th e bu sinesses surveyed

stated that their safety programs attempted toidentify “accident-prone” individuals.

Other behavioral models have considered mo-

tivational factors, the rewards of working safely,

and the level of satisfaction received from work-

ing safely (368). It has been observed that many

workers perceive l i t t le posit ive reward for

working safely.

Management Models

Bird (58) revised H einrich’s dom ino th eory toemphasize management’s responsibility for injury

causation. His revised domino theory is:q

q

q

q

Injuries are caused by accidents.For each accident there are immediate causes

that are symptomatic of problems in the

overall system.

There are basic causes in the overall manage-

ment of the system that produce the imme-

diate causes of the accident.

The lack of management control permits the

basic causes of accidents to exist in the

system.

Bird’s approach therefore shifted the emphasis

from the worker as the cause of injuries to the

management system in which the worker exists.

Zabetakis (684) of the Mine Safety and Health

Administration Academy added the idea that in-

juries are due to an unplanned release or flow of

energy, again following the approach of the domi-

no theory. Energy release is considered in the

general sense—mechanical, electrical, chemical,

thermal, or ionizing radiation. Since unwanted

energy flow is a fundamental source of injuries,

Zabetakis claimed, a system maybe evaluated and

improved by studying:

the sources of energy existing in a system,

the means available to reduce the energy

levels,

the means of controlling the flow of the

energy, and

the methods available for absorbing the

energy should loss of control or improperflow occur.

The next major outgrowth of the domino the-

ory was based on the idea that multiple factors

can combine in a random manner to produce ac-

cidents and injuries. Such causation models focusnot only on unsafe acts of the injured person, but

also on unsafe acts of coworkers and unsafe con-

ditions that existed at the time. Attention is

ultimately drawn to failures in management sys-

tems that permit the multiple factors to converge

and produce an injury.

One of the best known management-oriented

approaches to accident causation is called the

Management Oversight and Risk Tree (MORT),developed by Johnson (235) for use in the analy-

sis of complex systems related to atomic energy.

It could also be called a systems mod el (discussedlater in this section). MORT employs a large sche-

matic to ind uctively trace events of a work-relatedinjury back in time, to identify the sequence of

unwanted energy flow, and to evaluate the ade-

quacy of barriers to unwanted energy transfer to

persons or equipment. Along the route, hazards

arising from specific accident circumstances, from

risks acknowledged or assumed by management,

and from general management systems and pol-

icy weaknesses are identified.

Still, several difficulties exist in adopting MORT

to general injury investigation or applying it to

most industrial workplaces. Its use as an indus-

trial injury investigation procedure is limited byits complexity. The method is more suitable for

investigating large-scale incidents, especially sit-

uations holding the potential for public disaster,

such as nuclear powerplants. While it is an excel-

lent approach for these situations, in its present

form it is much less useful for explaining most

work-related injuries. But it may be useful as a

blueprint for the optimal allocation of resources

for building a safety program (380).

Epidemiologic ModelsEpidemiology has been described as the search

for causal association between diseases or otherbiologic processes and specific environm ental ex-periences or exposures. The epidemiologic modelapplied to injury research seeks to explain the



occurrence of injuries within the system of host

(injured victim), agent (means of injury), and the

environment (physical, psychological, and socialfactors related to the event).

Using such a model, it should be possible to

identify features common to a set of injuries oraccidents, and either identify causes directly or

find clues to causation. This approach has advan-

tages over investigating each incident separately,

Looking at a group of off-the-road industrial vehi-

cle accidents, for instance, it might become appar-

ent that one company’s products are involved ina disproportionate number of incidents (40).

Gordon (187) and McFarland (295) were two

early proponents of epidemiologic models of in-

jury causation. Haddon (197) was successful in

implementing an epidemiologic approach to trans-

portation accidents while directing the NationalHighway Traffic Safety Administration. Baker

and her coworkers (40) have successfully used ep i-

demiologic techniques to describe work-related

deaths in Maryland.

The epidemiologic method requires the collec-

tion and study of far more information about the

host, the environment, and their interactions than

the behavioral and management models do. This

approach, which recognizes the interactive nature

of the injury process, is a significant advance overearlier models. In fact, it has provided a frame-work for the application of many systems ap-

proaches that incorporate human operator vari-

ables, environmental factors, and task demands.

The National Institute for Occupational Safety

and Health is currently conducting two epidemio-

logic studies to evaluate the role of personal,

managerial, and work environment factors in the

etiologies of fall-from-ladder accidents and ac-

cidents that result in fatal injuries. Both are case-

comparison studies that should produce a scien-

tific assessment of these causal factors.

Systems Models

The emergence of systems engineering as a dis-

cipline in th e 1960s gave rise to m any new app lica-

tions of systems theory, including systems safety.

The various models that have been used include

“failure mod e and effects analysis” an d “criticality

analysis.” Both these are largely oriented towards

Ch. 4—Safety Hazard Identification q73

assessing the reliability of hardware and equip-

ment. Another systems model, “fault tree analy-

sis,“ involves building a logical “tree” of events

that can lead to undesirable outcomes. The ana- q

lyst examines component failures, which can in-

clude both hardware and human errors, and at-

tempts to learn what might cause these failures

and what effects on system safety they might

have.

The systems-safety models have been applied

most extensively in military and aerospace en-

deavors with the focus on potential failure points

in system hardware. Few quantitative data exist

about human error rates, so including the human

component of this system is frequently precluded.

Ergonomic/Human Factors Models

The injury causation models developed by

human-factors engineers or ergonomists attempt

to provide insights into the problems of “unsafeacts” or human error that are lacking in other in-

jury causation models.

Ergonomists generally analyze the interactionsbetween workers and their machines for the

sources of injury causation. The limits of human

beings to perform consistently and without errors

are important issues to the ergonomists. Rather

than viewing operators’ errors as merely “unsafe

acts” that can only be addressed through train-ing and motivation, the ergonomic approachlooks to see if various features of the machine or

the design of the work might themselves be in-

ducing worker errors. These features can include

the presentation of information to workers

through displays, the design of machine controls,

and the relationships between displays and con-

trols. In addition, ergonomists analyze the phys-ical capacit ies of workers, such as l if t ing or

reaching ability, to determine whether the task

places undue stress on specified parts of the body

or leads to excessive fatigue.

Because of the importance of this discipline for

the prevention of both acute trauma and cumu-

lative trauma, as well as its potential usefulness

in the field of general workplace and equipment

design, ergonomics is discussed in greater detail

in chapter 7.




CRITIQUE OF INJURY CAUSATION THEORIES AND MODELS

The inherent simplicity of Heinrich’s domino

theory and its historical availability no doubt ac-

count for its widespread acceptance. A minimum

amount of training is required to understand its

application and it does provide an answer to thequestion of “cause,” even if it is a superficial one.

Since most injuries are classified as resulting from

“unsafe acts, “ it unfortunately allows more fun-

damental features of workplace design that leadto injuries to be ignored.

Behavioral models initially contributed to our

understanding of the human component of injury

causation, although approaches based on study-

ing “accident proneness” have contributed little

or no useful information for prevention. It is un-

fortunate that many firms still expend resources

trying to identify “accident-prone” individuals,rather than pinpointing features of workplace de-

sign that lead to injuries.

The adaptations of Heinrich’s theory that place

the responsibility for unsafe acts and unsafe con-

ditions on the management system of the enter-

prise represent a major step forward in prevent-

ing occupational injuries, The causal explanations

are still too simplistic, although these approachesdo provide a limited ability to predict the occur-

rence of hazards in the workplace.

The chain-of-events or multiple events models

(MORT is an example) recognize that many fac-tors influence injury causation and thus represent

progress over single-event models. However, the

current models do not have a sufficiently simple

organizing structure to make them useful across

a wide range of industries.

The epidemiologic model has value as an orga-

nizing framework for the systematic study of the

factors related to various types of injuries. It is

limited in that, in general, it cannot adequately

explain why injuries happen or how corrective

measures can be identified and applied.

The systems models have been developed pri-

marily to evaluate system, subsystem, and com-

ponent failures. The primary focus has been on

nonhuman or hardware failures. Although the po-

tential exists for incorporating human error rates

into these analyses, the data to do so are currently

very limited.

The hu man factors/ ergonomics mod els focus

on the human/ machine interface and thus pro-

vide a much-needed emphasis on understanding

the interaction of worker and machine in order

to achieve a safe working environment. The thrustof the p ractice of ergonomics is designing the work tusk, rather than merely installing machinery and

letting the worker find a way to adapt. Thus in-

jury prevention can bean integral part of job de-

sign. The principal shortcoming of this model isthe absence of any analysis of hardware failures

beyond the hu man/ machine interface. However,

compared with the injuries that occur at that in-

terface, hardware failures are relatively rare.

Purswell and Stephens (380) conclude that no

single model provides a wholly satisfactory ap-

proach to explaining the various facets of injury

causation. They suggest that, for the present, theepidemiologic model is useful for identifying ma-

jor categories of causal factors in the workplace,

and that these major categories should be stud-

ied in-depth using the hum an factors/ ergonomics

model.

The quest for causal models should not be the

sole object of research on injury prevention. What

is even more important is the design of interven-

tions to eliminate or reduce the injury hazards

faced by workers. In fact, one distinguished re-

searcher has concluded that the search for causal

models for injuries may ultimately be fruitless.Singleton has recently stated that “there can never

be a theory which will predict an accident and

even accident rates are subject to too many

variables for prediction to be meaningful. ” But

he adds:

It does not follow that w e must aband on hopeof controlling accidents. The same problem oc-curs in other complex practical situations. Theph ysician, for examp le, is often faced with a pa -tient with a disease which he cannot readily iden-tify. . . However, this does not mean that nothingcan be don e, The p hysician h as certain generalprinciples; the temperature must not be allowedto get too high, the body must not get dehydratedand so on. He can take action on the basis of theseprinciples without waiting to identify the causeof the symp toms. Similarly in acciden t pr even-tion we can take action to increase safety w ith-out waiting for a theory of accident causation(442).



Technologies for ControllingWork-Related Illness

.



ContentsPage

Control Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

Control at the Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Controlling Dispersion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

Control at the Worker.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Integration of Health Hazard Controls into Workplace Management . . . . . . . 85Case Study: Controlling Worker Exposure to Cotton Dust . . . . . . . . . . . . . . . . . . 85

Byssinosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85The OSHA Cotton Dust Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Changes in Cotton Dust Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86Costs of Compliance with the Cotton Dust Standard . . . . . . . . . . . . . . . . . . . . . 88

Case Study: Controlling Worker Exposure to Silica Dust. . . . . . . . . . . . . . . . . . . . 89

R,gulatory Activities for Silicosis Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90Control Techn ologies: Engineerin g M eth ods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Control Technologies: Personal Protection and Administrative Controls . . . . 91Strategies for Silica Dust Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Case Study: Controlling Worker Exposure to Lead . . . . . . . . . . . . . . . . . . . . . . . . . 92

Some Features of the OSHA Lead Standard .......,. . . . . . . . . . . . . . . . . . . . 9 2

Control Methods: Engineering and Respirators. . . . . . . . . . . . . . . . . . . . . . . . . . . 93Medical Removal Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Changes in Air Lead Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94Changes in Blood Lead Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Summary of Improvements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Extent of Control Technology Usage in the United States . . . . . . . . . . . . . . . . . . . 97Information About Controls and Areas for Research . . . . . . . . . . . . . . . . . . . . 97

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

LIST OF TABLESTable No. Page

5-1,5-2,

5-3.5-4.

5-5.

5-6.5-7.

5-8.

5-9.

5-10.

5-11.

Principles of Controlling the Occupational Environment . . . . . . . . . . . . . . . 80Benefits of N ew Technologies for Controllin g Worker Exposu re to

Vinyl Chloride Monomer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Suggested and Recommended Levels for Cotton Dust Exposure . . . . . . . . . 88Cotton Dust Measurements Before Promulgation of the OSHACotton Dust Standard and Percentage of Companies Claiming Compliancewith the Standard in North Carolina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88Estimated and Realized Costs of Comp liance with th e OSHACotton Dust Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89Measures To Reduce Air Lead and Blood Lead Levels . . . . . . . . . . . . . . . . . 93Blood Lead Levels That Trigger Med ical Removal From an d Return toLead-Contaminated Atmospheres. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93Med ical Removal Protection Transfers in a Sample of Lead Industry Plants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94Reductions in Average Air Lead Levels, 1977-78 and 1981-82. . . . . . . . . . . 95

Average Blood Levels Before and After Promulgation of the O SHALead Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95Projected In du stry-Wide Ann ual Costs of Comp liance With Air LeadLevels of 50 to 150 micrograms/m3 . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . 96 ,

LIST OF FIGURESFigure No. Page

5-1. G en era lize d O ccup atio n al Exp osu re . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 775-2. G en eraliz ed M od el for C on trol of W ork p lace H azar d s . . . . . . . . . . . . . . . . . . 78S-3. Vin yl C h lor id e R eacto r S yste m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81



5.Technologies for Controlling

Work-Related Illness

This chapter describes the principles and tech-

nologies for controlling workplace health haz-

ards—toxic substances and harmful physical

agents found in the workplace. For clarity and

since the control principles are similar for bothtoxic substances and harmful physical agents, dis-

cussion focuses on control of the former. Empha-sis is given to technologies proven to be the most

effective for protecting workers’ health—thosethat prevent hazard generation or that prevent

worker contact with the hazard. Three case stud-

ies commissioned by OTA illustrate these prin-ciples and technologies as applied in controllingwork-related exposure to cotton dust, silica, and

lead. In addition, the extent of the use of controltechnologies in United States workplaces is dis-

cussed.

Health hazards, as defined by public health sci-

ence, cause disease by an agent (hazard source)

transmitted through the environment by a vec-

tor (transmission of hazard) to a host or a recep-

tor (worker) who is affected. This model includesworkplace hazards to which workers are exposed

(see fig. 5-1). For workplace hazards, the source–the point at which the hazard is generated—may

be a gas, a liquid, or a solid if it is a substance,

or a form of energy if it is a physical agent. Trans-

mission or dispersion of the toxic substance or

harmful physical agent is generally through work-place air or by direct contact. The worker at risk

may receive (absorb) the hazard through inges-

tion, the skin, or by inhalation (see fig. 5-2).

A control technology system can includ e hazard

control at any or all of these three points—source,

transmission, or worker. Hazard controls applied

at the source, such as isolation of a process, or

in the transmission or dispersion path, such aslocal exhaust ventilation, are generally called

“engineering controls. ” Those worn by the work-

Figure 5-1 .—Generalized Occupational Exposure

~

Source Workplace Worker

Generation Transfer Exposure

—Gas — Respiratory — Liquid — Dermal —Solid — Ingestion — Energy

er, such as protective clothing or a respirator, are

generally called “personal protective equipment.“

A hierarchy of control methods is commonlyused. The first choice is control at the source,which can be done by design or modification of

a process or equipment or by substitution of less

hazardous materials. If the source is unalterable

through design or substitution, the next choice is

to control or contain the dispersion of the con-

taminant by isolation of the source, preventing

the toxic substance from becoming airborne, or

by removing the contaminant through local ex-

haust or general dilution ventilation. Finally, con-

trol at the worker may include administrative con-

trols, personal protective equipment, and work

practices. (Personal protective equipment is dis-cussed in ch. 8, and the hierarchy of controls is

discussed in ch. 9.)

77




Figure 5-2.—Generalized Model for Control of Workplace Hazards

Zone Isource

Production process

CONTROL SYSTEMS

There have been many attempts to define con-trol technology. Brandt (71) described it as a sys-tem designed to control contaminant emission and

dispersion along the pathway to the worker.Bloomfield (61) cited ventilation to reduce levelsof airborne contaminants as the primary means

of engineering control. The International Labour

Office (229) includes several techniques in con-

trol technology: ventilation; process changes; sub-

stitution of process, equipment, or material; isola-

tion of stored material, equipment, process, and

workers; and education of management, e ng i -neers, supervisors, and workers. Caplan (96)

defined engineering controls for indu strial hygienepurposes as “installation of equipment, or otherphysical facilities, including if necessary selection

and arrangement of process equipment, that sig-nificantly reduces personal exposure to occupa-tional hazards.” Smith (450) defined control tech-nology as substituting less dangerous substances,equip ment, or p rocesses; limiting releases or p re-venting buildu p of environmental contamination;

Zone Illreceptor

Photo credit: NIOSH

This electrostatic precipitator is used to remove oilmists from the atmosphere of a machine shop

limiting contacts between worker and toxic mate-rials by personal protective equipm ent; and in-troducing administrative changes.



Ch. 5—Technologies for Controlling Work-Related Illness q 79

For this assessment, a hazard control system in-

cludes:

1. control at the emission source by substitu-

tion of materials, change of pr ocess or equ ip-

ment, or other engineering means,

2. control of the transmission or dispersion of the contaminant by isolation, enclosure, ven-tilation, or other engineering means, and

3. control at the worker by personal protectiveequipment, work practices, administrative

control, training, or other means.

The controls in No, 1 and No. 2 are commonly

called “engineering controls. ”

Training workers, supervisors, managers, engi-

neers, and other concerned persons about a haz-

ard and its control underlies the effectiveness of

control solutions. Hazard-free operation requires

rigorous maintenance of controls, and good

housekeeping is essential to control secondarysources of contamination. Work practices (e.g.,

instructions that liquids should be poured away

from the worker) and administrative procedures

(e.g., that workers spend limited time in the pres-ence of hazards) are also important parts of a con-trol system. Table 5-1 is a compilation of hazard

control principles and includes examples of con-

trol measures.

One tenet of effective hazard control is that asystem should be designed in a way that the con-

trols are automated or inherent in the operationof the system. Thus, hazard controls should func-

tion even in the absence of continuous worker and

manager attention. For instance, enclosing a proc-

ess to prevent emission of toxic substances to

workplace air is a more reliable, and likely less

expensive, control than respirators, where effec-

tiveness is difficult to measure, protective fit is

difficult to achieve. Although systematic design

will consider a variety of control methods and

combinations, engineering solutions are preferred

because they depend less on routine human in-volvement for effectiveness. For example, groun d-

ing home electrical appliances provides greaterprotection against electrical shock than instruc-

tions to remember not to simultaneously touch

an ungrounded appliance and a metal surface.

Photo credif: OSHA, Office O f Informatlon and Consumer Affairs

Engineering controls include the enclosure ofoperations and using remote controls. This photoillustrates equipment designed to handle very toxic

radioactive materials

Because of the continuing need for human in-tervention and attention in the use of personal

protective equipment, practicing industrial hy-gienists employed by business, government, and

unions have long recognized that such equipment

should be turned to only after other means of pro-

tection have been exhausted (see ch. 9). Occupa-

tional Safety and Health Administration (OSHA)

standards require the use of engineering and work

practice controls except for the time period nec-

essary to install such controls, when engineering

and work practice controls are infeasible (in-

cluding many repair and maintenance activities),




Table 5=1 .–Principles of Controlling theOccupational Environment

Point of application ofthe control measure Control measure

At or near the hazardzone. . . . . . . . . . . . . . . . . .

To the general workplaceenvironment . . . . . . . . . . .

At or near the worker . . . . .

Adjuncts to the abovecontrols . . . . . . . . . . . . . . .

Substitution of

nonhazardous or lesshazardous material

Process modificationEquipment modificationIsolation of the sourceLocal exhaust ventilationWork practices

(housekeeping)

General dilution ventilationLocal room air cleaning

deviceWork practices

(housekeeping)

Work practices(housekeeping)

Isolation of workersPersonal protectiveequipment

Process monitoringsystems

Workplace monitoringsystems

Education of workers andmanagement

Surveillance andmaintenance of controls

Effective process-peopleinteraction and feedback

SOURCE (576)

when they are insufficient, and in emergencies (seech. 9). For instance, engineerin g solu tions to re-du ce airborne lead concentrations to the O SHAstandard are difficult to apply in lead smelters,and OSHA allows respirator programs while thesolutions are engineered.

Of course, the nature of some jobs requires reli-ance on personal protective equipment. For in-stance, firefighters depend on self-containedbreathing apparatus when fighting fires.

Control at the Source

Control at the source can be achieved by de-sign of n ew or m odification of existing processesor equipment, or by the substitution of less haz-ardous materials-all done, preferably, before theprocess or equipm ent is instal led and operated.

The industrial hygiene literature repeatedly pointsto source control as the m ost effective mean s of preventing work-related illness.

Designing Controls

Designing equipment to eliminate contact be-tween hazard and worker is the most effective wayto control exposure (71). The control of vinylchloride m onomer (VCM) provides an exampleof successful design eliminating a health hazard(see also box N in ch. 12). In the 1960s, beforeVCM w as recognized as a carcinogen, it was iden-tified as a cause of acro-osteolysis (bone deteriora-tion, especially in the finger tips). This finding ledthe American Conference of Governmental Indus-trial Hygienists (ACGIH) to revise the ThresholdLimit Value (TLV) exposure limit from 500 partsper million (pp m) to 200 pp m in 1970 (5).

Revision of the exposure limit meant that the

firms that followed ACGIH recommendations had

to find ways to reduce worker exposure. Analy-

sis by design engineers identified two methods by

which the high exposures associated with clean-

ing th e VC reactor vessel could be red uced: elim-ination of reactor fouling or mechanical or chem -ical removal of the polymer bu ildup. Hyd raulicreactor cleaning technology was adopted that re-duced the frequency of worker cleaning from onceper several reactor charges (loading th e reactor)to once per 25 to 30 charges and thereby reduced

worker exposure (256).

When VCM exposure was recognized in 1974as strongly related to angiosarcoma of the liver(a rare and deadly cancer) by health professionals,OSHA mandated a permissible exposure limit of 1 ppm. Feasible engineering and work practicecontrols were required to reduce exposure belowthis level (617).

Again, industrial hygiene analysis determinedthat exposure to gases during reactor cleaning wasa major problem. Re-investigation led the designengineers b ack to earlier considerations, of eithereliminating the fouling or finding an automatedcleaning method. But this time the design criterionwas to reduce drastically exposure from over 200ppm down to 1 ppm, and mechanical cleaningalone w as found to be inadeq uate. However,






should be taken to control exposure to thesematerials during installation (80).

Silica dust, which can cause lung disease, is oneof the oldest known occupational health hazards,and its control well illustrates the principle of sub-stitution (see case stud y, later in this chap ter).Silica du st is a problem in “sand blasting, ” incleaning and polishing moldings and metals, andin m ining and quarrying, where it is generated b yexplosives and mining machinery.

In foun dries, silica du st is generated du ringcleaning, during chipping and grinding of castingsbecause some sand from the cores and molds re-mains on the castings, and during abrasive clean-ing, which generates airborne silica dust. If abrasive cleaning is performed by sand blasting,silica dust may be generated from both the blastsand and the mold and core sand.

The most direct method of eliminating silicadu st is to mak e substitu tions for silica-containin gmaterial. A number of silica-sand substitutes areavailable for abrasive blasting, includin g metallicshot and grit, garnet, nut sh ells, cereal husk s, andsawdust, and have been widely used in abrasiveblasting operations and to some extent in found-ries (560).

In some cases, silica dust can be eliminated bysubstitution of a nonabrasive process—by clean-ing castings by th e salt bath p rocess, acid p ickl-ing, or ultrasonic cleanin g. Water jetting an d la-ser cutting to remove excess metal from castingshave been considered as alternatives to chippingand grinding (435).

Controlling Dispersion

If a source cannot be altered through design orsub stitution, the n ext choice is to control or con-tain the dispersion of the contaminant. This maybe d one b y isolating the source, preventing thetoxic material from b ecomin g airborne, or by ven -tilation.

Isolation

Isolation of a process involves the placement

of a barrier between the process and the worker.

In dusty operations for example, there are three

basic means of isolation: enclosure of an opera-

tion (to prevent dust, fumes, or vapors fromescaping into occupied areas); automation,through the u se of unattended m achines; and dis-tance, to place operations away from w orkers.

Isolation by enclosure has been used effectivelyto reduce silica exposure in foundries (359,569,577). Abrasive blasting operations maybe located

in en closed, ventilated b ooths. Enclosure is alsoused to reduce worker exposure in the asbestostextile industry. Card machines, among the dusti-est parts of th e asbestos textile man ufacture proc-ess, can b e completely enclosed an d asb estos dustfiltered from the air exhausted (80). Enclosure hasbeen applied successfully in containing contamina-tion from radioisotopes since the beginning of thenu clear ind ustry. A variation is to protect work -ers from physical and chemical hazards by locat-ing their work stations in ventilated control

booths.Many jobs with risk of exposure to toxic sub-

stances can be automated. For instance shakeout(a method for removing foundry sand from moldsor parts) in a foun dry can be d one by venti latedmachines rather than b y hand . Automobiles maybe spray painted or welded by automated ma-chines to remove workers from exposure to spraypaint and solvent and welding fumes, respectively.

Finally, explosive or extremely toxic materialscan be stored in remote and inaccessible areas andhazard-generating operations may be removed

from areas where workers are concentrated.Open-air sand blasting can be done at a distancefrom other work si tes to reduce the number of workers at potential risk. Persistently leakypum ps and piping for the transport of toxic sub-stances can b e isolated by placing them in areasremote from workers.

Wetting

Wetting d ust to p revent i t from becoming air-borne is used to reduce worker exposure. Spray-ing is a primary means of du st control in mining,

bu t i t is considered to be in adequ ate alone andis usually used in conjunction with ven ti lat ion(230,394). Substitution of wet processing andspraying for dry operations has been widel y usedto control silica d ust. In foundries, adding mois-

ture to sand has been found to reduce dust con-



Ch. 5—Technologies for Controlling Work-Related illness q 8.3

centrations substantially (435,569). By contrast,wet p rocessing in the manu facture of portland ce-

ment appeared to have no effect on respirable dust

levels (419).

Local Exhaust Ventilation

Local exhaust ventilation is one of the most

commonly used engineering controls. It aims toprotect the worker by capturing generated gases,

vapors, fumes, or particles in an exhaust air

stream and discharging them away from work-

ers. Examples ar e laboratory fume and kitchen-range hoods, both of which use fans to exhaustcontaminated air, Industrial operations are oftenplaced in hoods to obtain maximum contaminant

control with minimal exhaust air volume.

For example, local exhaust can be applied in

aluminum reduction operations to reduce worker

exposure to carcinogenic particulate, in spraypaint booths to control paint mist and solvent

vapors, in garages to control carbon mon oxidefrom auto exhaust, and in foundries to control

silica exposure from abrasive blasting an d grinding.

NIOSH is currently investigating “push-pull”

ventilation. Generally, local exhaust ventilation

depends on “pulling” air away from the opera-

tion and exhausting it at some distance from the

worker, If the emission source is over two feet

from the exhaust, a great quantity of room air

must be pulled into the exhaust, significantly re-

This hood in a secondary lead smelter illustrates theuse of local exhaust ventilation

ducing control effectiveness. Furthermore, energy

costs are increased to heat the air that replaces

the exhausted air.

Using a jet of air “upwind” from the exhaust

pushs the emissions toward the exhaust. This is

commonly referred to as push-pull ventilation.

NIOSH showed that push-pull ventilation con-

trolled emissions from chrome plating tanks with

just 25 percent of the exhaust needed if only pullwas used. The system thus controlled emissions

and reduced energy costs (582).

A successful local exhaust ventilation sys-tem.—As already indicated, controlling exposuresis best done by considering design of the health

hazard control at the time a process is established

and carefully monitoring performance of the sys-

tem. Anderson (20) describes the effective design

of a control system in a large electronics plant.

The process begins when a manufacturing engi-

neer asks to add or change a chemical process.

The request is submitted to the facilities engineer-

ing department and an engineer is assigned re-

sponsibility for installing the equipment to satisfyprocess, safety, health, and other requirements.

Part of the facilities engineer’s responsibility is to

review the need for local exhaust ventilation with

the ind ustrial hygienist, wh o is responsible for p ro-

viding health protection information including de-

tails about hood design and air volume require-ments. The preliminary design is then reviewed

by the environmental engineering department todetermine the need for air cleaning devices andemission permits. After the process design is

completed, it is given a final review by the indus-

trial hygiene, environmental engineering, safety,

maintenance, and manufacturing engineering de-

partments.

Installation is supervised by a coordinator who

ensures that contract specifications are followed,

Changes must be approved by the facilities engi-

neer. The contract coordinator informs the facil-

ities engineer when the job is done and puts a

warning tag on each completed hood.

Before the hood can be u sed it mu st be adjusted

to meet design specifications by the facilities engi-

neer and the maintenance ventilation technician,

who enters information about the system in a data




base for scheduling preventive maintenance and the gradual introduction and mixing of fresh airwho also tags the hood to indicate that this has with, and exhausting of, workplace air . Con-

been done. After this the hood is inspected by the tinuous air exchange in buildings reduces non-

industrial hygienist, who reviews its use with the taminants that resist other control means while

workers and ensures that the proper chemical contributing to maintenance of a comfortable en-

identification labels are placed at each station. vironment. General dilution ventilation is defined

Hood effectiveness is measured periodically and

data entered into a computer. Each week the com-

puter system generates a card for each hood per-

forming below specified levels for review by the

industrial hygienist. If the hood is in need of at-

tention, the card is forwarded to building main-

tenance. If that department is unable to fix thehood, the facilities engineering department treats

the failure as a unique project, and then follows

the same procedure that is used in d esigning a new

hood,

If a hood is found to be dangerously deficient

by the ventilation technician, it is tagged “Do NotOperate” and imm ediately reported to the dep art-

ment manager, facilities engineering department,

and industrial hygiene department.

The main features of this well-thought-out sys-

tem for designing and managing controls are:

q coordination among all concerned parties,. integration of occupational health concerns

at the beginning and throughout the design

process,. integration of occupational health concerns

following installation, and

q execution of a well-planned preventive main-

tenance program.

The company has found that this approach

greatly lowers costs by reducing the need to

retrofit processes. B efore th i s m e thod w asadopted, newly installed exhaust systems fre-

quently failed because of improper design or in-

stallation. Post-installation approval guarantees

all concerned parties that the system works from

the start as it was designed. A well-planned,

computer-based, preventive maintenance pro-

gram assures continued effectiveness.

General Dilution Ventilation

as “the process of supplying or removing air bynatural or mechanical means, to or from any

space” (71). The air circulation systems found in

most buildings are examples of general dilution

ventilation.

This technique requires careful planning, and

it can fail if inadequate consideration is paid to

contaminant generation rates. Furthermore, pro-

vision mu st by made for adequate fresh “makeup ”

or “replacement” air, for heating or cooling the

makeup air, and for avoiding contamination of

makeup air.

Recent interest in energy conservation hasadded new considerations. Increased building in-

sulation has greatly reduced the flow of air from

“leaks,” which requires more makeup air. Chap-

ter 16 describes particular problems among office

workers in new “tighter” buildings, Office work-

ers report health effects from microorganisms,

organic chemicals, asbestos, tobacco smoke, and

other sources in buildings with inadequate ven-

tilation (25).

Control by general ventilation is aided byremoving sources, such as smoking, and by clean-

ing air. Since most building ventilation systemsnow recirculate air, cleaning the air becomes espe-

cially important. This is a relatively new prob-

lem; before energy conservation was given em-

phasis, accepted engineering practice was to

completely exchange building air to avoid con-

tamination buildup. Now, building air is often

cleaned and then recirculated to reduce energy

cost. Systems are available for cleaning both gas

and particulate, but care must be taken to ensure

that the system is reliable and the cleaning com-

plete (563).

Neither local nor general ventilation acts to pre-vent generation of hazards; it can only capture

or dilute contaminated air and take it to another

location. The air may still have to be cleaned

While local exhaust systems are applied at a before discharge to the ambient environment, to

particular point to remove contaminants at rela- meet Environmental Protection Agency or other

tively high rates, general dilution ventilation is ambient-air standards (6,562,563).



Ch 5- Technologles for Controlling Work-Related Illness q 8 5

CASE STUDY:CONTROLLING WORKER EXPOSURE TO COTTON DUST



86 . Preventing Illness and Injury in the Workplace —

The quote was made in reference to a respira-

tory disease suffered by workers in English-tex-

tile m ills 150 years ago. That disease—byssinosis,

or “brown lung’’—was recognized in this country

much later than in Europe. The reasons for the

late recognition are complex. Many occupational

health authorities suggest ignorance or refusal torecognize particular respiratory diseases that were

common to mill workers to spare employers the

costs of installing controls. In addition, social con-

ditions inhibited workers from making their com-

plaints known and prevented actions on thosecomplaints. Also, local and State Governments

were reluctant to act because they feared the loss

of textile indu stry jobs as a resu lt of requiring pre-vention of w ork-related injury and illness. Finally,

a lack of scientific studies showing an associationbetween cotton dust and illness in the United

States contributed to the tardy recognition of the

disease and inhibited action to prevent it untilOSHA came into being (124).

The OSHA Cotton Dust Standard

Although the exact disease-causing agent with-

in cotton dust has eluded identification, it isknown that the dusts from the early stages of

processing are more hazardous than those from

later stages. Opening cotton bales and sorting,

picking, and blending raw cotton present greater

risks than do weaving and finishing.

In 1964, the American Conference of Govern-mental Industrial Hygienists considered the evi-

dence for establishing a recommended limit for

cotton dust exposures. Two years later, the Con-

ference agreed on a Threshold Limit Value of

1,000 micrograms/ m3 as the maximum exposu re

that was consistent with maintaining workers’

health. In 1969, the Secretary of Labor incor-

porated ACGIH’s recommended TLV into Fed-

eral standards for employers with Government

contracts (see ch. 11 for a discussion of the Walsh-

Healey Act).

The Occupational Safety and Health Act of 1970 required that the newly established OSHA

adopt the Walsh-Healey Act standards and apply

them to all the Nation’s workplaces. Thus, the cot-

ton d ust standard of 1,000 micrograms/ m 3 w as

adopted as a startup standard by OSHA in 1971

(see Ch. 12).

In 1974, ACGIH revised its TLV downward to

200 micrograms/ m3(the method of measurement

changed also, and the “n ew” 200 micrograms/ m3

is not directly comparable to the ‘ old” 1,000

micrograms/ m 3). That same year, the Director of NIOSH recommended that exposure to cotton

du st should be redu ced to the lowest feasible level,

and that it should in no case exceed 200 micro-

g ra m s/ m3.

In 1976 OSHA prop osed a 200 micrograms/ m3

standard. The final standard, issued in 1978, set

three different exposure limits—200 microgram s/ m3

for cotton yarn manu facturing, 750 micrograms/

m3for “slashing and weaving” operations, and 500

micrograms/ m3for exposures in other operations.

This standard was contested by the textile indus-

try through legal suits. While the Supreme Courtupheld the standard for the textile industry in

1981, in the same year the current administration

moved to reconsider it. This action is pending.

Table 5-3 shows how the suggested and recom-

mended levels for cotton dust came downward

after the substance was regulated as a health haz-

ard in the United States.

Changes in Cotton Dust Levels

Table 5-4 presents North Carolina Department

of Labor measurements of the percentage of tex-

tile plant departments that were in compliancewith the OSHA cotton dust standard i n 1981. Ascan be seen, just two years after promulgation of

the new standard and du ring the period the stand-

ard was being challenged in the courts, over half

the departments complied with the standard.

Some problems remain, as higher frequencies of

noncompliance were found in the early stages of

the process-opening, picking, carding, drawing,

and combing. In th ese stages, workers ar e exposed

to the more hazardous dusts associated with un-

processed cotton. overall, however, the cotton

industry is coming into compliance with the new

standard.

The industry trade association, the American

Textile Manufacturers Institute, estimates that

about 75 percent of the industry was in compli-



ance within two years of the standard being in-troduced. Some plants that have been completely

modernized are in full complian ce (413).

In 1981, the U.S. textile industry purchased $1.6

billion worth of new machinery. About 70 per-

cent of those purchases were for the purposes of

modernization to increase productivity (413) in

the face of increased foreign competition and, to

some extent, to comply with the OSHA stand-

ard for reduced cotton dust levels.

Ruttenberg (413) concludes that it is impossi-

ble to decide the relative importance of increas-

ing productivity and compliance with OSHA reg-

ulations in the modernization of the American

textile industry’, but that both have made a con-tribution.

The U.S. Occupational Safety and HealthAdm inistration dust regulations have had a d ra-matic effect on . . . processing equipment design

Photo credit O. SF/A, Office of Information and Consumer Affairs

The spinning of cotton fibers into yarn and weavingyarn into fabric are two of the operations regulated bythe OSHA cotton dust standard. In recent years, thetextile industry has invested heavily in modernizedequipment in order to comply with the standard and

to improve productivity

and purchasing. Machine suppliers modifiedequipment to comply w ith OSHA regulations andthis equipment has been accepted on a worldwid ebasis as well as in the USA. The dust controlshave also contributed to mu ch better operatingresults. . . (U.S. Departm ent of Comm erce (551).Quoted in 413).




Table 5-3.-Suggested and Recommended Levels for Cotton Dust Exposure

Levela

Organization Year (micrograms/m3)

American Conference of Governmentalindustrial Hygienists (ACGIH) . . . . . . . 1964

ACGIH recommendation . . . . . . . . . . . . . 1968Secretary of Labor . . . . . . . . . . . . . . . . . . 1968Occupational Safety and Health Admin-

istration (OSHA). . . . . . . . . . . . . . . . . . . 1971British Occupational Hygiene

Society . . . . . . . . . . . . . . . . . . . . . . . . . . 1972

ACGIH recommendation . . . . . . . . . . . . . 1974National Institute for Occupational

Safety and Health (NIOSH) . . . . . . . . . 1974OSHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1976OSHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1978

1,0001,0001,000

1,000

500

200200

b

200

tentative recommendationformalWalsh-Healey Act standard

OSHA standard

recommended standard forBritain

formal

recommendationproposed standardfinal standard

~h e levels from 1964 through 1972 were based on techniques that measured the concentration of total dust in the workplace

atmosphere. From 1974 on, the levels are based on the use of the vertical elutriator —a device that measures the quantity

of small, resplrable dust particles. Levels based on the these two methods are not dirwctly comparable%he 200 limit is for yard manufacturing, 750 for slashing and weaving, and 500 for all other processes The Iim!t goes up

as the cotton dust becomes cleaner

SOURCE Adapted from (413).

Table 5-4.—Cotton Dust Measurements Before Promulgation of theOSHA Cotton Dust Standard and Percentage of CompaniesClaiming Compliance with the Standard in North Carolina

Range of measurementsbefore OSHA standard

Area of plant (micrograms/m3)

Opening . . . . . . . . . . . . . . 300-3,000Picking. . . . . . . . . . . . . . . 700-1,700Carding . . . . . . . . . . . . . . 300-1,800Drawing . . . . . . . . . . . . . . 400-800Combing . . . . . . . . . . . . . NARoving . . . . . . . . . . . . . . . NASpinning ., , . . . . . . . . . . 200-300Winding . . . . . . . . . . . . . . 1,200

Twisting. . . . . . . . . . . . . . 1,200Slashing. . . . . . . . . . . . . . NAWeaving . . . . . . . . . . . . . . 400-1,000Knitting , . . . . . . . . . . . . . NAWaste Processing . . . . . NAOther . . . . . . . . . . . . . . . . NA

Companies claimingLimit under compliance in

OSHA standard North Carolina(micrograms/m

3) (percent)

53200 61200 52200 63200 61200 81200 83200 76

200 80750 100750 96

10085

500 97SOURCE: (413).

Tougher government regulations on workers’health have, un expectedly, given the [U. S.] indu s-try a leg up . Tighter du st-control ru les for cottonplants caused firms to throw out tonn es of old in-efficient machinery and to replace it with the latestavailable from the world’s leading textile machin-

ery firms. (The Economist (160). Quoted in 413).

Costs of Compliance with theCotton Dust Standard

OSH A contracted for an econom ic analysis of the expected costs of compliance with the cottondust standard, and the contractor assumed that

compliance would be accomplished by “add-on”



Ch. 5—Technologies for Controlling Work-Related Illness q 8 9

ventilation equipment. However, the availability

of newer production equipment, which increased

productivity and reduced cotton dust exposures,

resulted in much lower costs than those estimated

at the time the standard was considered. As table

s-5 indicates, the initial 1974 estimates of capital

Table 5-5.—Estimated and Realized Costs ofCompliance with the OSHA Cotton Dust Standard

Millions of1982 dollars

Preregulatory estimates OSHA contractor, 1974 . . . . . . . . . . . . . . 1,941Revised OSHA contractor, 1974 . . . . . . . 1,388ATMl a contractor, 1977 . . . . . . . . . . . . . . 875OSHA, 1978 . . . . . . . . . . . . . . . . . . . . . . . . 970

Postregulatory estimate OSHA contractor, 1982 . . . . . . . . . . . . . . 245aAmer~can Textile Manufacturers !rTStitUte

SOURCE (413)

costs for compliance were nearly $2 billion (i n1982 dollars). At the time of promulgation in

1978, OSH A estimated costs of just un der $1 bil-lion (in 1982 dollars). Thus, while cost estimates

plummeted more than 50 percent by the time the

standard was issued, the reduced estimate was still

almost four times higher than the actual costs re-ported in 1982 in a poststandard contract report.

Although most of the more productive, less

dusty machinery now in use in U.S. textile mills

was available in the mid-1970s, its potential use

was ignored in the early estimates of compliance

costs. Even if purchase of new technology had

been anticipated, it would have been difficult to

assign the proper fraction of its costs to dust con-

trol. In the event, new technologies greatly re-

duced the costs.

CASE STUDY:CONTROLLING WORKER EXPOSURE TO SILICA DUST

Silica is a major component of the earth’s crust;

it is the sand covering the beaches, the sand

sprinkled on icy winter streets, the grit in the dust

on windy days—it is everywhere. It is also widely

used in industry. Over 402 million tons of silica-

containing sand were produced in the United

States in 1980. Of this total, nearly 300 milliontons were used for glassmaking, as molding sand

in foundries, and as industrial abrasives. Since itis ubiquitous, silica is frequently found as an un-

wanted constituent of ores mined for other minerals.

In those cases, it must be removed and discarded.

Silicosis is a disabling lung disease resulting

from the inhalation, deposition, and retention in

the lu ngs of respirable crystalline silica d ust. Acute

silicosis can occur within six months following ex-

posure to extremely high silica dust concentra-

tions. Silicosis victims appear to suffer more

episodes of chest illness than workers without the

disease. The mortality for nonmalignant respira-

tory disease is significantly higher among work-ers receiving compensation benefits for silicosis

than in the general population. A complication

of silicosis, progressive massive fibrosis, results

in significant impairment in lung function and

may result in respiratory failure and secondary

heart disease. Tuberculosis and other pulmonary

infections may complicate acute or chronic sili-

cosis and significantly shorten life expectancy.

Hickey, et al. (210) discuss these silica-related

health problems and reported associations be-

tween worker exposure to silica dust and an in-

creased risk of lung cancer.

Since diagnostic procedures do not detect

silicosis at a reversible stage, and since medical

treatment will not alter the course of the disease

after it is found, emphasis on exposure control

is imperative. Yet, even though the cause of the

disease has been well understood and technologies

for controlling exposure have been available for

decades, silicosis continues to occur in the United

States at an alarming rate. A minimum of 59,000

cases of silicosis may be expected based on know l-

edge about current exposure levels and numbers

of exposed workers at risk in 1980 in U.S. indus-

try (210).

Hickey, et al. (210) estimate that there are 1.3

million production workers with potential expo-

sure to silica dust—40 percent of whom are in



90 q Preventing Illness and Injury In the Workplace

workplaces lacking exposure control. Historicallythe most severe exposures to silica have occurredin granite and stone working, foundries, mining,and abrasive blasting. Workers producing andusing silica flour (silica ground so fine that it ap -pears to be refined grain flour) have recently been

recognized to be at high risk for silicosis, becauseof the extremely fine size of the particles produced.

Regulatory Activities forSilicosis Control

The current OSHA standard for silica is basedon an eq uation that limits the total amount of freesilica to 100 microgram s per cub ic me ter. Thisstandard was adopted as a start-up standard in1971 (see ch. 11). Evaluation of the silica stand-ard shows that it may be inadequate at its pres-ent level. In 1974, NIOSH recommended limiting

silica exposure to 50 micrograms per cubic me-ter—half the current level. The studies on wh ichNIOSH b ased i ts recommend ation used p ulmo-nary function performance as the measure of health effect—a more sensitive indicator of silicosis than X-ray methods.

In certain circumstances, such as in abrasiveblasting where alternatives to silica are available,substitution may be the most appropriate methodof control. The Un ited Kingdom b anned the useof silica sand for abrasive blasting in 1948, an dNIOSH h as recommend ed a similar prohibit ionin this country (560). Sweden banned silica as anabrasive in manu al abrasive blasting in 1981 (210).A California standard requ ires that prior to use,not more than 1 percent, by weight, of abrasivesand mu st pass a No. 70 U.S. standard sieve (0.3

mm ). After use, the sand m ust have no m ore than1.8 percent of its weight as particles 5 micrometersor less in diameter (211). These restrictions on sizereduce the number of respirable particles.

In 1978, OSHA cond ucted a technological fea-sibility assessment and economic impact analy-sis for a specific standard addressing use of silicasand in abrasive blasting (211). The study con-

sidered three alternatives: banning use of silicasand in abrasive blasting, setting minimum cri-teria on size and hardness of blasting sand, andcontrolling exposure through work practices. Todate no revised standard h as been issued.

However, due to the serious silicosis problem,OSHA has made a special effort to enforce theexisting silica stand ard. In 1972, silica w as oneof five major health hazards selected for specialenforcement efforts in the ‘Target Health HazardProgram” (414). Silica was again given priority

in the 1975 National Emphasis Program, as oneof the major worker health hazards in foundries(339). In both cases OSHA industrial hygienistsfocused health inspections on plants where silicawas l ikely to be found .

Control Technologies:Engineering Methods

Silicosis is an entirely preventable disease. Ex-posure occurs whenever materials containing crys-talline-free silica are processed and dust is gener-ated. Processes include ab rasion (sand b lasting,

grinding, milling, etc. ) that creates dusts of par-ticularly small particle size (less than 5 microme-ters in diameter). These dusts are too small to beeasily seen as a “cloud.” Too small to settle, theyremain airborne and “respirable’’—-that is, theymay readily pass through the u pp er respiratorypassages and be deposited in the alveolar spacesof the lung (the small air sacs deep in the lungwhere gas is exchanged with the blood).

The most direct method of eliminating silicadust is to substitute less hazardous materials forthe silica-containing material. This control hasbeen widely used in abrasive blasting operationsand to some extent in foundries. Silica-sand sub-stitutes include m etallic shot and grit, garnet, nutshells, cereal husks, and sawdust. Olivine (mag-nesium iron silicate) has been used for mold mak-ing in foundries to reduce silica dust exposure, butit is not clear how effective this method will be(210).

Process change may also b e used to controlsilica d ust exposure. For instance, water m ay beadded to foundry m olding sand or sprayed on atthe point of dust generation in granite sawing andprocessing of portland cement. In some situations,

du st-producing abrasive processes may be re-placed by other typ es of cleaning su ch as saltbaths, acid pickling, or ultrasonic cleaning. Water jetting an d laser cutting for rem oval of excessmetal from castings have been considered as alter-



——


substitutes that are suitable for replacing silica. should be refined to provide a better way of

Also, for those situations where engineering con- worker protection. Information about the toxicity

trol maybe infeasible, further improvement in res- of silica and technologies for controlling exposure

pirator effectiveness is necessary. Medical proce- could be provided to w orkers and emp loyers using

dures for detection of the early stages of silicosis it.

CASE STUDY:CONTROLLING WORKER EXPOSURE TO LEAD

Early efforts against industrial lead intoxication

in this country were championed by Alice Hamil-

ton. Her au tobiography, Exploring the DangerousTrades (199), presents many examples of terrible

exposures that were corrected when managers and

owners were convinced that lead was causing the

“colic, “ “lead fits, ” and blindness that occurred

in lead workers. Until they were convinced, own-ers and managers preferred to believe that the ill-

nesses resulted from bad personal habits—drink-

ing, smoking, or the consumption of coffee.

Some firms refused to act voluntarily, and

states began passing “lead laws” in the 1910s that

set limits on occupational exposures. These early

efforts were the forerunners of the revised OSHA

lead standard, which was issued in 1978.

The current standard regulates exposure to lead

in over 40 different industries. With only few ex-ceptions, most industries comply with the s O

m i cr o gr a m s/ m3

permissible exposure limit forworkplace air concentration. The exceptions in-

clude primary and secondary lead smelting and

lead-acid battery manufacture, where controls are

most difficult and economic conditions have been

unfavorable. (Primary smelters purify lead from

lead concentrate, which is lead ore enriched by

milling. Secondary smelters recover lead from

discarded lead-containing products—in particu-lar, worn-out batteries. Battery plants make lead-

acid batteries. ) Although the standard was con-

tested by both union and management and it is

impossible to be certain of the future of these in-

dustries or of the burdens placed on them by thestandard, it is clear that workers’ health has been

improved as measured by reduced lead levels in

their blood.

Some Features of the OSHALead Standard

The lead standard sets limits on ambient con-

centrations of the metal in workplace air, requiresengineering controls and work practices to reachthose limits, and requires that workers be in-formed about lead, its effects, and the methods

used to protect against them. TWO f ea tu res—

Medical Removal Protection (MRP) and the ex-

tended time periods granted to selected industries

before engineering controls are required—dis-

tinguish the lead standard from other OSHA

health standards.

MRP requires employers to measure workers’

blood lead levels regularly. If the measuredconcentration of lead in the blood exceeds certain

limits, the worker must be removed from lead ex-

posure until the level drops to an acceptable value.

For up to 18 months, the employer must main-

tain the worker’s wages and seniority status even

if the person cannot perform his or her regular

job.

OSHA requires that air lead levels be reduced

to an effective concentration of 50 micrograms/ m3.

Since reported exposures have ranged above 2,000

micrograms/ m3, reaching the regulatory limit

poses many problems for employers. The regu-

lation gives companies 3 to 10 years to attain the

so micrograms/ m 3 limit through engineering con-trols; in the meantime, employers can require the




natives to chipping and grinding in foundries.Vacuum cleaning may be substituted for dustycompressed air cleaning and screw conveyors usedinstead of dust-producing pneumatic conveyors.

How ever, care must be taken to assure that such

treatment, while suppressing visible dust, also

controls the smaller, more hazardous, respirablesilica dust particles.

Where silica remains in use and worker expo-

sure is possible, local exhaust ventilation may beused to capture and carry dust away. Environ-

mental Protection Agency or other ambient-air

standard regulations may require that ventilated

air be cleaned before discharge to the outside.

Control Technologies: PersonalProtection and Administrative Controls

Respiratory protection an d face, eye, and bodyprotection against ph ysical inju ry are also re-quired by OSHA in specific regulations for abra-

sive blasting. NIOSH has specified the respirator

types required for protection from various air con-

centrations of silica, but these often prove to beinadequate in practice (210). Employer-provided

and -maintained protective clothing and facilitiesfor changing at work plus training about personal

hygiene prevent exposed workers from exposingfamily members to silica dust when taking work

clothing home.

NIOSH (and others) recommend: administra-

tive measures that help reduce risk of silicosis;training managers and workers about the hazards

of silica dust; the effective use of personal pro-

tection equipment; and work practices that pre-

vent the generation of silica dust, Dust-reducing

practices include vacuum cleaning, regular main-

tenance of dust-producing and dust-controlling

systems, and good housekeeping. Dusty work

may be scheduled or located to reduce the num-

ber of workers at risk. However, Hickey, et al.

(210) report that company dust-control policies

are often unenforced.

Strategies for Silica Dust Control

One might ask why a well-recognized, entirelypreventable, work-related illness, for which the

etiology is understood and for which engineering

and other controls are available, remains a prob-

lem. Hickey, et al. (210) note some possible

reasons:

q

q

q

q

the current OSHA standard is inadequate

and based on outdated information,

compliance with the inadequate standard is

insufficiently monitored,accurately measuring silica concentrations inrespirable du st samp les is difficult and costly,

an dthere is too much reliance on after-the-fact

control methods that control the dust after

it is generated rather than on methods that

eliminate silica dust.

An underlying reason for failure of worker pro-

tection against silicosis is the cost of controllingexposures.

To attack this problem, Hickey, et al. (210) sug-

gest promulgating a protective standard based on

the latest medical knowledge and streamlining en-

forcement by developing an accurate, inexpensive,

and rapid measurement method. These initial

steps will provide the basis for developing more

effective technology to prevent generation of silica

dust. Greater emphasis should be placed on pre-venting generation than on refinement of meas-

ures for control after the dust is generated. Re-search should be conducted to find nontoxic

Photo credit OSHA, Office of Information and Consumer Affairs

Abrasive blasting workers are frequently exposed tohigh levels of silica dust



——

Ch. 5—Technologies for Controlling Work-Related Illness . 93

use of respirators to reduce workers’to airborne lead.

Control Methods: Engineeringand Respirators

exposures

Table 5-6 lists categories of control measuresthat can be employed to reduce lead exposures.

In general, major changes in processes will be in-

troduced only when a plant is rebuilt for other

reasons. (An example of the costs involved in sub-

stituting a new process in primary smelters com-

pared with adding on controls is presented inch.

16.) Add-on controls, in particular better ventila-

tion, are probably the most common form of engi-

neering controls, although far simpler controls—

such as covering stockpiles and putting tops on

reaction vessels—are an important part of engi-

neering controls.

A number of process innovations are being

made in the secondary smelting industry and in

Table 5-6.—Measures To Reduce Air Lead andBlood Lead Levels

A.

B.

c.

D.

E.

Measures that affect air lead levels in the plant1. Changes in production processes (direct smelting

processes, more automated battery productionlines)

2. Add-on controls (ventilation systems)3. Changes in operating practice (keeping floors

cleaner)4. Greater or lesser use of lead-emitting equipmentMeasures that do not affect air lead levels but limittimes workers spend in lead-contaminated at-mospheres1. Isolation booths with filtered air supply2. Changes in work practices to limit time in high

lead areasMeasures that do not affect air lead levels but limitworkers’ lead absorption1. Respirators2. Showers, changing clothes before and after enter-

ing work areas3. Business cycle factors: layoffs, overtimeMeasures that do not necessarily affect exposure ofthe work force as a whole but affect the distributionof exposures among the work force1. Monitoring of workers and removing those with

biological indicators of exposure to areas withlower lead contamination

2. Rotation of workers3. Firing of highly exposed workersExternal measures that impact on lead exposure1. Changes of lead level in out-of-plant environment2. Changes of lead content in food and water

SOURCE (164)

battery manufacture that reduce worker exposure

to lead. A major source of lead exposure here has

been the breaking open of old lead storage bat-

teries. Goble, et al. (184) mention two new proc-

esses that significantly reduce the liberation of lead

in that process. In addition, technological changes

recently introduced in the manufacture of newlead storage batteries reduce worker exposure

while increasing productivity.

Table 5-6 includes personal protective equip-

ment as well as business cycle factors that influ-

ence the number of workers exposed. The role of

respirators in providing protection until engineer-

ing controls are installed is clearly recognized in

the OSHA standard. The standard does require

that ultimately compliance shall be achieved

through the use of feasible engineering controls.

Medical Removal ProtectionThe OSHA lead standard provides that when

the amount of lead in a worker’s blood exceeds

a trigger level, he or she is to be removed from

exposure or placed in an area of lower exposure

until the blood lead level drops (see table 5-7).

When th e amou nt falls to a specified reinstatement

level, the worker can return to his or her regular

job.

When the OSHA standard was being consid-

ered, employers pointed at MRP as a source of

high costs. They argued that older, more experi-enced w orkers who were paid a p remium for their

knowledge would be removed to less skilled jobs,

causing losses in productivity. In addition, since

MRP requires that the worker’s wages be main-

Table 5-7.—Blood Lead Levels That TriggerMedical Removal From and Return to

Lead-Contaminated Atmospheres

Blood lead Ievelsa

(micrograms/100g blood) for

Date Removal Return

March 1979 . . . . . . . . . . . 80 60March 1980 . . . . . . . . . . . 70 50September 1981b . . . ~ . . 60 40

March 1983b . . . . . . . . . . 50 40

%Vorkers’ blood levels are to be monitored quarterly except workers with 10WJISgreater than 40 micrograms/100g are to be monitored monthly.

b ManyfirmS have been given extensions of the time fOr the 60/40 and 50/40

trlgffers

SOURCE (164)





—


Table 5-9.— Reductions in Average Air Lead Levels,1977-78 and 1981-82

Average airlead levels

(micrograms/m’) PercentIndustry 1977-78 1981-82 reduction

Primary lead smelting. . . . . 740 565 24Secondary lead smelting . . 285 205 28Battery manufacture . . . 160 80 50Seven battery plants . . . . . . 160 90 50

SOURCE (184)

by half in battery plants. Confidence about the

validity of these estimates, especially for battery

plants, is increased by the access Goble, et al. had

to detailed, company-collected exposure data

from seven battery plants. The percentage reduc-

tion observed in those plants is the same as the

calculated reduction for the industry overall.

The data in table 5-9 show what are probably

minimal estimates of reductions in air lead levelsbecause of systematic errors in the calculations.

Clearly, however, levels are coming down. Equal-

ly clearly, there is some distance to go before the

eventual goal of 50 m icrogram s / m3is reached.

OSHA recognized that engineering control of air

lead levels would take time, up to 10 years in some

industries. The decreases shown in table s-9 were

achieved in less than 5 years and during the periodwhen the standard was still being challenged in

the courts.

Changes in Blood Lead LevelsData on blood lead levels for the period before

promulgation of the lead standard are not so plen-tiful as air lead d ata. The estimates shown in table

5-10 for 1977-78 are from information presented

in OSHA hearings. The data shown for 1981-82

are from measurements reported in a Charles

Table 5-10.—Average Blood Levels Before and AfterPromulgation of the OSHA Lead Standard

Approximate averageblood lead levels

(micrograms/100g blood)

Industry 1977-78 1981-82 Difference

Primary lead smelting. . . . . 49.4 41.6 7.8

Secondary lead smelting . . 56.5 44.2 12.3Battery manufacture . . . . . . 53.2 42.4 10.8

Seven battery plants . . . . . . 53.0 38.3 14.7

SOURCE (184)

River Associates (103) report prepared for OSHA,

and those are probably more reliable.

A satisfying drop in blood lead levels was seen

in less than 5 years between 1977 and 1982. Not

shown on the table is the finding that the num-

ber of workers with blood lead levels greater than

80 micrograms/ 100g blood d ropp ed from l,553

(2 percent of 2,200 primary smelter workers plus

16 percent of 3,170 secondary smelter workers

plus 6 percent of 16,700 battery workers) to about

20 (0.1 percent of 2,470 primary smelter workers

plus 0.6 percent of 3,000 secondary smelter work-

ers and no battery workers).

Fur thermore , the number of workers wi th

blood lead levels above 40 micrograms/ 100g

dropped from 17,217 to 6,738. This significant de-

crease is especially important because that is the

lowest action level required at any stage of MRP.

In other words, the almost 9,000 workers whohave moved from the over-40 to under-40 micro-

grams/ 100g category are now at a level that

means they would not have to be removed from

their current jobs even as the threshold level for

medical removal drops.

In 1978, OSHA had estimates prepared of the

blood lead levels to be expected if the statutory

limits for lead were set and realized at 50, 100,

or 200 micrograms/ m 3. The levels were expected

to fall as exposures decreased and workers elimi-nated some of the lead accumulated during their

previous high exposures.

Measured blood lead levels two-and-a-half

years after the introduction of the standard were

consistent with projections made on the basis of

achieving a level near so micrograms/ m3in the

battery indu stry and 100 micrograms/ m3in the

other two indu stries (184). These measurementsare somewhat surprising because the air lead levelsin the industries are above so or 100 micro-

g ra m s/ m3. Effective respirator programs and at-

tention to personal hygiene have probably con-

tributed to the lowering of blood lead levels.

Although no blood lead level has been estab-lished below which symptoms are never found,

and there is no level at which symptoms will nec-

essarily occur, there is agreement that lower blood

lead levels are associated with lower risks (174).




OSHA has established 40 micrograms/100g as anaction level; when the lead standard is fully im-plemented, workers with blood levels above 50micrograms/100g must be removed from lead ex-posure u nti l their blood lead levels drop b elow40. The Centers for Disease Control (558) have

concentrated on 30 microgram s/ 100g as a levelat which concern should be raised.

costs

Capital expenditures for current controls runat about $1,000 to $1,500 per worker each year.To that must be added the expense of respirators,clothing, and facilities for personal hygiene(showers, changing rooms, etc.)–between $1,000and $1,700 per w orker p er year. Mon itoring andmedical surveillance cost about $500 per workerannually, and the tranfer costs under MRP are

expected to run between $300 and $600 per work-er yearly. Taken altogether, complying with thelead stand ard is estimated b y Gob le, et al. to costbetween $2,800 and $4,300 per worker yearly.

In addition to the current costs, Goble, et al.(184) project that future conventional industrial

hygiene controls will cost between $8,000 and

$9,000 per w orker per year in secondary smeltersand battery plants. Future costs in primary smelt-ers are expected to b e lower, about $5,200.

Table 5-11 presents estimates of the engineer-

ing cost of reducing air lead levels to 50 or 150

Table 5-1 I.—Projected lndustry-Wide Annual Costs ofCompliance With Air Lead Levels of

50 and 150 micrograms/m3

Millions of 1962 dollars

Industry 50 150micrograms/m

3micrograms/m

3

Primary lead smelting . . 15.5 16.0Secondary lead

smelting . . . . . . . . . . . 24.5 26.4Battery manufacture . . . 97.4 not done

SOURCE: (1S4).

micrograms/m3. The costs are qu ite close. On e

reason is that (according to engineers employedby Charles River Associates (184)) the best con-ventional engin eering controls will not reduce ex-posu re to 150 micrograms/m

3. Anoth er reason is

that isolation b ooths, if installed, could reduce ex-

posures to less than 50 micrograms/ 3

for aboutthe same as it would cost to reach 150 micro-g ra m s/ m 3.

Major process changes, although costing more

in capital expenditures, are expected to result in

operating savings. In general, the capital costs of process change may be appropriate if a new plantis to be built, but they outweigh the costs of add-ons in an existing plant u nless significant tax sav-ings or credits accompany installation of the newprocess.

Summary of ImprovementsThe data about w orkplace air lead an d b lood

lead levels show that both have decreased sincethe issuance of the OSHA lead standard. Whilethe air lead levels have dropped about 25 percent

in primary and secondary smelters and about so

percent in battery plants, they still remain much

higher than 50 micrograms/ m3 that is the goal of

the standard. At the same time, however, bloodlead levels have dropped appreciably, and in gen-eral are close to the levels predicted for reachingair lead levels between 50 and 100 micrograms/m

3.

A nu mb er of factors—includin g decreases in leaduptake from the environment in general, changesin the m ethods for measuring lead, errors in th emodel that is u sed to project blood leads b asedon air leads, and greater-than-expected impactsof respirator programs and hygiene practices—have contributed to the apparent better realiza-t ion of reductions in blood levels than w as pre-dicted. Whatever combination of factors is respon-sible, the falls in blood lead levels are gratifyingand bode well for better health among leadworkers.




EXTENT OF CONTROL TECHNOLOGY USAGE IN THE UNITED STATES

The National Occupational Exposure Survey

(NOES) (see chs. 2 and 12) includes data that de-

scribe the extent of the usage of control technol-

ogies for the prevention of work-related illness.

NOES, conducted from 1980-82, estimates the ex-

tent of worker exposure to potentially hazardous

workplace agents. This survey was conducted as

a followup to a similar survey, the National Oc-

cupational Hazard Survey, conducted in 1972-74.

The sample of businesses in the NOES surveyconsists of approximately 4,000 establishments in67 metropolitan areas throughout the UnitedStates. The sample represents all nonagriculturalbusinesses covered under the Occupational Safetyand Health Act. Data were collected on site byteams of engineers and industrial hygienists spe-

cially trained for the survey.

NO ES was conceived for the pu rpose of record-ing specific worker exposures to potential work-place health h azards. Among the q uestions thatthe survey attempted to answer were:

q

q

q

q

q

What occup ational group s are exposed towhat types of potential health hazards in theUnited States?In what types of industries are these hazardsfound?What control techn ologies are present to pre-vent work-related disease in terms of p lantoperation and occupational safety and healthpractice?What are the exposures by intensity, dura-tion, type of control?What trade name products were present?

Both surveys included questions about demog-raphy an d occupational safety and health p rac-tice, followed by a walk-through survey of theplant work area to inventory potential exposures.A series of questions specifically aimed at the prac-tice of using controls was asked in NOES.

With the control questions asked in N OES itis possible to analyze the extent of engineeringcontrol usage in the manufacturing sector of thecountry. Areas include practices of material sub-

stitution, process change, and the managementof personal protective equipment programs. Thesedata are uniqu e in that there are no other com-prehensive assessments of work-related exposurecontrol practice. Control technology usage maybe classified by plan t size and by ind ustry, allow-ing distr ibutions to be done for comparison.

These data may be used to pinpoint patternsof control technology use within and among in -dustry groupings, giving insight about areas whereimprovement is n eeded. This analysis may alsobe used to assist in setting priorities for control

technology research.

Information About Controls andAreas for Research

The vin yl chloride, indu strial solvent, lead, cot-ton dust, and silica examples show that controltechnologies for workplace exposures can be engi-neered once commitment to control is made.Commitment, however, is often difficult toachieve. For example, in the regulatory proceed-ings concerning new health standards, argumentsare often raised about the harmful health effectsof existing exposure levels, and th e costs and fea-sibility of controls (see ch. 14 and box 12-1 in ch.12). In addition, opposition to some governmentalregulation may result simply from employers’ con-cern that an outside authority is telling them whatthey mu st do to protect workers.

However, as shown by the vinyl chloride andcotton dust examples, the installation of technol-ogies to control w orkplace hazards can be accom-panied by greater productivity. As seen in the caseof the ventilation control system in the electronics




industry, there are advantages to planning, install-ing, and maintaining control technologies in a sys-tematic way. Anticipation of work-related healthproblems very often reduces the cost of theircontrol.

Access to information about control technol-ogies for workp lace health and safety could beimproved. Perhaps the greatest current need is forpublished information about controls in the occu-pational safety and health literature. While thereare journals ded icated to toxicology and ep idemi-ology, there are none specific to industrial hygieneengineering. Industrial hygiene journals infre-quently and engineering technical journals onlyrarely include articles about techn ologies for con-trolling worker exposure to hazardous materials.Yet it has been suggested that such informationshould be p art of every engineer’s training and

be readily available as reference material to thepracticing engineer (587).

Published information about specifics of work-place control is sp arse for several reasons. First,and probably most significantly, companies thatdevelop controls simply do n ot take the t ime topublish details since it is not their business. Onthe other hand, it is likely that some consider theinformation proprietary and k eep it unp ublishedfor competitive reasons.

In some cases, such as for the control of expo-sures to vinyl chloride, a few companies marketnew techn ology for preventing w ork-related in - jury and illness. This, however, appears to be in-frequent and be limited to very large companiessuch as B.F. Goodrich and Dupont. Probablymost companies that have found and use inno-vative control technologies in their plants simplyhave yet to explore workplace control technol-ogies as a market.

Universi ty and governm ent researchers h avepublished some practical information that can beused b y design engineers but the volume of thismaterial is l imited. One widely used hand book

specific to ventilation is the ACGIH VentilationManual that is published annually (6). Programssuch as the NIOSH Control Technology Assess-ments have produced useful information for haz-ard control in some sp ecific and some genericmanufacturing processes (see ch. 12).

There is also a dearth of new approaches in thisarea. For instance, First (173) pointed out that littlehas been added to the theory of ventilation sincetwo Ph.D. theses done at Harvard in the 1930s.The tendency has been to retrofit control solu-tions after problems app ear rather than to an-

ticipate them. Yet there is promise of new meth-ods on the horizon.

Brief and colleagues (74), recognizing the limita-tions of retrofit solutions in preventin g work-related inju ry and illn ess, have explored tech-niques for designing new plants with n ew controlsystems bu ilt in. They have found that in the past

retrofit control procedures were recommendedwithou t being able to jud ge the effectiveness of controls, until after installation and operation.This retrofit ap proach is p robably not as cost ef-

fective as designed-in controls, although cost ef-fectiveness was rar ely tested. In many cases ad-ditional administrative and p ersonal protectiveprograms w ere used to achieve desired w orkerprotection.

We have embarked on a new era involvingsome major comp anies and governm ent agenciesinvestigating the impact of engineering design onthe w orkplace environm ent. The objective is sim-ple. It states that w e will attempt to d esign intoour plants and operating facilities the necessaryengineered controls to meet occupational healthstand ard s. Intu itively, we believe that it is morecost-effective to install engineering controls in new

plant d esigns than to r etrofit later. Equally as im-portan t is the practicality of having an environ-mentally sound plant at the start, rather than onewhich requires modifications later. Retrofitting .controls may be difficult to implement due tophysical factors and the time to implement thechanges after the plant is run ning.

In this innovative approach, design is based on

selection of process equipment controls appropri-

ate to the process. The key is to determine emis-

sion rates of contamin ants from each type of p roc-ess equipment used. These data may then be usedto build a near-field dispersion model (a mathe-

matical expression of the release and buildup of contaminant in workers’ breathing zones) to cal-culate collective concentrations to which work-ers could b e exposed. By trying various combina-tions of equipment and controls in the m odel andtesting them against recommended health stand-



Ch. 5—Technologies for Controlling Work-Related Illness 99

ards, engineers can predict potential worker ex- plied, particularly in plant design stages. Technol-posure and thus design processes with optimum ogies are available but in formation abou t specificworker protection and production. These in- solutions is difficult to find because it is seldomvestigators stress the need for interaction between published. Retrofi t is the dominant mode evenengineers and occupational safety and health pro- though there is recognition that solutions shouldfessionals at the design stage for this to succeed. be d esigned into new p rocesses.

Thus, control technology for work-related ill-ness prevention is possible but insufficiently ap-

SUMMARY

Workplace exposures to toxic substances canbe controlled at their source, du ring transmission,and at the worker. Control at the source includeschanges in th e design of a process and su bsti tu-tion of non toxic or less toxic materials. Control-

ling the transmission of a toxic substance can bedone by isolating or enclosing hazard sources,wetting toxic dusts to prevent dispersion, install-ing local exhaust ventilation to capture and carrytoxic substances away, or reducing toxic concen-tration through the use of general dilution ventila-tion. Control at the worker includ es the use of personal protective equipment (see ch. 8), workpractices, and administrative procedures. Engi-neering controls that can be designed into a workprocess to control hazard sources and dispersionof contaminants are preferred to other measuresthat may provide less reliable protection. Train-

ing (see ch. 10) of supervisors and w orkers is re-quired to make sure control programs are ef-fective.

Three case studies p repared for this assessmentprovide information on controls for health haz-ards. Exposures to cotton d ust cause a d ebilitatingrespiratory disease known as byssinosis. In th eyears following the issuance of a revised OSHAhealth standard concerning cotton dust, the U.S.textile industry has invested heavily in moderniz-zing its operations. The new equip ment h as led toimproved p roductivity in this ind ustry, as well

as reduced w orker exposures.

Data about workp lace air lead and blood leadlevels show that b oth h ave decreased since the is-suance of the revised OSHA lead standard in1978. The possible factors to explain the improve-ments in blood lead levels include changes in ex-

posures to lead in the workplace air, the use of medical removal protection, decreases in theamount of lead absorbed from the environment,changes in lead measuring methods, and improve-ments in respirator programs and hygiene practices.

Silicosis—a disabling lung disease-is causedby silica dust. Control measures include substi-tution with safe abrasives, ventilation, wetting,as well as th e use of resp irators, work practices,main tenance of ventilation systems, and goodhousekeeping practices.

A considerable amount of information abouthow to design and implement control technologyfor worker protection is available but is not widelydissemin ated. Research on improved control tech-nology design and implementation is also needed.For example, little has been added to the basictheory about ventilation since the 1930s. The Na-tional Occupational Exposure Survey conductedby NIOSH collected information which will giveestimates of the extent of worker exposure to po-tential hazards and the current practice of con-trol technology use. These data can potentiallyassist in setting priorities for research on improved

controls.



6.

Technologies for Controlling

Work-Related Injuries



Contents

Page

Preventing Motor Veh icle-Relate d In ju ries an d Fataliti es . . . . . . . . . . . . . . . . . . . .106Preventing Construction-Related Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106Prev en tin g M an ufactu rin g-Rela ted In ju ries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108

Wood working Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108Metalworking--Cutting, Welding, and Cold Forming.. . . . . . . . . . . . . . . . . . . . 109

Metalworking-Hot Working.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Preventive Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .....9... 112Fire and Explosion Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113Injury Control Programs Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116The DuPont Injury Contro l Prog ram .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117summary .. q q....... q. q. q. . q. q. q. q. . . . . . . q.. q. q. q. . . . q. . . q q. . q. q q118

LIST OF TABLESTable No. Page

6-1.

6-2.6-3.6-4.

6-5.

6-6.

6-7.

6-8.6-9.

6-10.

Principles of Preventing Work-Related Injury . . . . . . . . . . . . . . . . . . . . . . . . . 104Prevention Checklist To Be Used Before Starting a Production Plant . . . . 105Examples of Injury Control in Plant Layout .. .. a s . . . . . . . . . . . . . . . . . . . . 105Technologies for Preventing Work-Related Injury From

Woodworking Machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109Technologies for Preventing Work-Related Injury FromMetalworking Machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Technologies fo r Preventing Work-Related Injury During Work withHot Metal in Foundries . . . . . q . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112Technologies for Preventing Work-Related Injury Through Maintenan ceof Structures ..... ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113common Ignition sources of Industrial Fires q q q . q . .... q .. q q q q q . 114National Fire Protection Association Fire Classification . . . . . . . . . . . . . . . . 116Du Pont Calculations of Cost Savings From In juryControl . . . . . . . . . . . . 118



Technologies for ControllingWork-Related Injury

Injuries are caused by “abnormal energy trans-fers or interferences with energy transfer” (198).

One analytical method breaks the injury-causing

event into three parts: 1) the source of hazard,

2) its transmission, 3) and the worker; this method

is patterned after the traditional public health

model of disease transmission (“agent,” “vector,”

and “host”).

Control technologies suggested by this ap-proach consider: control at the source of energy,

control of transmission of energy, and control at

the worker. Although there are many similaritiesbetween safety engineers’ approach to injury con-trol and the p ub lic health app roach, their ter-minology and methods have usually been quitedifferent. Safety engineers have tended to usecodes, standards, and models of “good practice”that are oriented around particular topics: fire pre-vention, electrical safety, design of machinery,plant layout, etc.

This chapter describes how d esigners and engi-neers can plan sites, plant layout, and equipmentdesign in order to prevent work-related injury.

“Safe” design presents particular difficulties in theconstruction industry where constantly changingconditions create constantly changing workplacehazards against which workers must be protected.In m anu facturing, the work site is relatively morestable but there is still a great deal of worker ex-posure to hazardous releases of energy. Fire andexplosion prevention is an area that not only canprevent human deaths and injuries, but also canprevent very large economic losses. Probably forthat reason, fire and explosion prevention has re-ceived a great deal of attention from the safetyprofession.

Finally, this chapter discusses injury preventionprograms. Because management has the primaryresponsibility for prevention of work-related in-

jury and illness, a successful injury preventionprogram must start with a strong commitment

from management. The stronger the commitment

at the top, the greater the likelihood of success.

The success of one such program is illustrated b ya discussion of the injury prevention program of one large company—Du Pont.

Workplace injuries can be prevented by properdesign of structures, machines, and operations (seetable 6-l). Proper design considers the stresses tobe placed on the building structure, the arrange-ment of spaces for the work to be accomplished,and specific safety requirements. For example,

falls on w orking su rfaces, the single most com-mon cause of workplace injuries (13.5 percent of all nonfatal injuries), can b e largely prevented bydesigning proper walking and working surfaces.

Appropriate design, including safe constructionplans, can prevent work-related injuries as build-ings go up and equipment is installed. Structurecollapse during concrete pouring may k ill or in- jure a number of workers at once. Such catastro-phes get media attention w hereas the b ulk of work-related inju ries and fatalities that occursingly do n ot. One disaster at Willow Island, WV,

Photo credit: Office of Technology Assessment

The rear of this construction site shows the use ofshoring to prevent the collapse of surrounding soil

103




Table 6-1.-Princlples of Preventing Work-Related Injury

Injury-prevention Relevantobjective Examples control principle

1. To prevent the creation of the hazard.

2. To reduce the amount of hazard.

3. To prevent release of the hazard.

4. To modify the rate or spatialdistribution of release of the hazard.

5. To separate, in time or space, thehazard and that which is to beprotected.

6. To separate the hazard from workers byinterposition of a material barrier.

7. To modify relevant basic qualities of thehazard.

8, To make what is to be protected moreresistant to damage from the hazard.

9, To counter the damage already done.

10. To stabilize, repair, and rehabilitate the

object of the damage.

One-story buildings reducing need for ladders

Reducing speeds of vehicles.

Bolting or timbering mine roofs.

Brakes, shutoff valves, reactor control rods.

Walkways over or around hazards, evacuation.

Operator control booths.

Using breakaway roadside poles, making cribslat spacing too narrow to strangle a child.

Making structures more fire- and earthquake-resistant.

Rescuing the shipwrecked, reattaching severedlimbs, extricating trapped miners.

Posttraumatic cosmetic surgery, physical

rehabilitation, rebuilding after fires andearthquakes.

Elimination, substitution

Process design

Enclosure

Ventilation

Isolation Administrativecontrols

Isolation, Personalprotective equipment

Process design

Process design

NA

NA

SOURCE: (71,197).

in 1979 was found by the Occupational Safety andHealth Administration (OSHA) and National Bu-reau of Standards investigators to be related toconcrete failure from improper pouring and frominsufficient allowance of curing time. The Na-tional Institute for Occupational Safety andHealth (NIOSH) (584) is refinin g equations to pre-dict more accurately concrete’s curing time as anaid to preventing similar disasters.

In 1981, 11 workers were killed and 23 injuredin Cocoa Beach, FL, when a five-story bu ildin gcollapsed d urin g placement of a concrete roof slab. Analysis of this catastrophe showed two fac-tors

q

q

caused the failure:

A design error: a check for pun ching shear(the stress or force around holes cut in beams)was omitted.A construction error: supports for reinforc-ing steel other than those-specified by the de-sign were used and p roved to be inadequ ate.

A failure at one column precipitated a progres-sive failure of the slab, which, when it fell, causedsuccessive collapse of all lower floors (271). Trag-ically, this d isaster closely resembled a collapseof similar construction in Jackson , MI, in 1956.

Information ab out these and other failures isnow available in a d ata base maintained b y theUniversity of Maryland’s Architecture and Engi-neering Performance Information Center. Thiscomp uter compilat ion of analyses of design er-rors enables designers and engineers to search forand comp are information on fai lures of similardesigns.

Checklists have been developed for engineers,architects, and designers to guide their attentionto methods of reducing injury risks. An abbrevi-ated example of such a list is given in table 6-2.

Codes and standards for building structure, forsteam, heating, and electrical systems, and for fireand injury prevention are also used as design cri-teria. The sou rces for these codes includ e theAmerican National Standards Institute, the Na-tional Electrical Codes, the National Fire Protec-tion Association (NFPA) Codes, OSHA regula-t ions, and recommendations made by NIOSH.

Site planning an d p lant layout for location of buildings, facilities, and processes and other de-sign p ractices can b e don e in w ays to preventwork-related inju ry. Table 6-3 provides examplesof injury control practices that are possible



Ch. 6–Technologies for Controlling Work-Related Injury 105

Table 6-2.—Prevention Checklist To Be Used BeforeStarting a Production Plant

Section l—Boiler and machinery reviewA. BoilersB. Pressure vesselsC. Piping and valves

D. MachinerySection n-Electrical safety review

Section Ill—Fire protection review

Section lV—Personnel safety reviewA. Project site locationB. Building and structuresC. Operating areasD. Yard

Section V—Process safety reviewA. MaterialsB. ReactionsC. Equipment

Section Vi—Environment control auditA. Atmospheric dischargesB. Liquid dischargesC. Solid discharges

Section VIl—Periodic plant loss preventionreview (manufacturing) to:A.B.

C.

D.

E.

Keep operating personnel alerted to the hazards.Determine whether operating procedures requirerevision.Carefully screen the operation for changes that mayhave introduced new hazards, or changes thatshould be made to reduce existing hazards.Reevaluate property and business interruption lossexposures.Uncover potential hazards not previously recog-nized, especially in the light of experience or newinformation.

SOURCE (172)

Photo credit: Department of Labor, Historical Office

Electrocutions account for about 6 percent of reported

work-related fatalities

through plant layout. The isolation of hazardous

materials and machinery, for instance, can be

achieved through building special rooms or build-

ings. Falls can be prevented by providing adequate

walkways and lighting. Again, specific codes are

available to guide designers and planners in theseareas.

Many vehicular-related injuries and fatalitiesin and around factories maybe prevented through

Table 6-3.—Examples of Injury Control In Plant Layout

Source of injury Design solutions

Contact with moving machinery

Potentially explosive or inflammable processesand substances

Crane loads striking worker

Building fire

Chemical burns

Falls from trestles

Falls in pits or bins

Falls on stairs and from ladders

Electrocution and electrical burns

Being caught in machinery during maintenance

Being caught in machinery during operation

Explosion related to broken light bulbs

SOURCE (322)

Adequate space between and around machines

Remote siting; separate buildings to contain explosion or fire;isolated storage areas

Site cranes away from work areas

Adequate space between buildings to prevent spread of fire

Use corrosive-resistant containers, remote siting, and specialhandling procedures

Provide adequately wide walkways along trestles, and adequatelighting

Provide grating screens and covers, and adequate Iighting

Design stairs with non-slip tread; provide adequate lighting

Adequate grounding; wiring inaccessible to inadvertent insulationwear

Interlocks and tag-out procedures to prevent inadvertent start-up

Adequate illumination

Special lamps and enclosures where physical conditions may shatterordinary bulbs



I&i q Preventing Illness and Injury in the Workplace

careful planning of transportation facilities, in-cluding shipping and receiving departments, rail-road sidings, parking lots, and roadways. Work-site roadways and walkways can be laid out anddesigned according to safe engineering practicesto prevent traffic-related injuries. Adequate an-

ticipation of traffic to, from, and d uring w ork andlandscape design to eliminate blind spots can alsoreduce risk. Railings on stairs and walking inclinesprevent falls.

Shipping and receiving, whether by truck,train, ship, or airplane, pose special potential forwork-related injury. Facilities can be designed to

reduce overexert ion an d b ack in jury by p rovid-ing working surfaces at correct height and allow-ing room for m echan ical lifting devices. Shipp ingand receiving docks can be isolated to preventharm from mishap wh en loading or unloading in-flammab le, explosive, or extremely toxic sub -

stances and from falling objects.

Sensible plant layout, including considerationof headroom, aisle width, and access for mainte-nance can both lower injury risk and increase pro-ductivity (322). Clearly, the risk of inju ry is re-duced by designing work stations that are locatedaway from hazardous areas.

PREVENTING MOTOR VEHICLE= RELATED INJURIES AND FATALITIES

Analysis of injury statistics shows that motorvehicle-related fatalities account for 30 to 40 per-cent of work-related fatalities and are among the5 leading causes of w ork-related in juries (seeWorking Paper #l). While a good deal of publicattention is given to “defensive driving, ” speedlimits, collision protection through passive andactive restraints, and reducing the number of drunk drivers, little of the industrial injury-pre-vention literature relates to the occupational useof motor veh icles (40).

precautions. For examp le, braking systems onearth-moving equ ipmen t, large trucks, and longdistance tractor-trailers should be maintained withemph asis on safety rather than m ere schedu les.Drivers should be properly trained to operateequipment safely under different road and weath-er conditions. Vehicles used for employee trans-port should meet appropriate requirements forboth driver and passenger safety; for example,proper emergency exits should be available t o

al low escape.

An insurance company has prepared a hand-

book that describes both routine and part icular

PREVENTING CONSTRUCTION= RELATED INJURIES

The lost-workday rate from job-related inju riesis much h igher in the construction sector than theall-ind ustry average. The constantly changin gconditions of construction sites create a varietyof workplace hazards against which workers mustbe protected.

Specialized, often large, machines that comeand go to construction si tes bring their own me-chanical energy-related h azards. The “b eep-beep-beep” of backing earth-moving equipment alertsworkers on the ground; the cages around drivers’seats protect against falling and swinging objectsand from being crushed if the machine tips over.

Seat belts or other restraining devices protect vehi-cle operators from harm during collisions.

A frequently reported cause of injury is fallsfrom h eights—31 percent of construction fatali-ties. These may occur from inapp ropriate ladders,improperly erected scaffolds, poorly designedtemporary stairs, or inadequately protected open-ings in floors, elevator shafts, and roofs underconstruction. Yet available equipment and pro-cedu res can protect against each of these h azards.Manu factured ladders that meet codes and lad-ders constructed on the job that meet minim umrequirements will reduce the number of falls. Rail-



Ch. 6—Technologies for Controlling Work-Related Injury q 107

Photo credit Department of Labor. Hisforlcal Office

Earthmoving equipment is now built to includeprotection from falling objects and accidental rollovers

Photo credit: OSHA, Office of Information and Consumer Affairs

Falls from heights are a frequent source of fatal injuriesin the construction industry


Improperly shored trenches can be a source of seriousinjury when laying pipes and pipelines

ings that are sufficiently strong and high will pre-

vent a worker from slipping through openingsinadvertently. Adequate scaffolds have been de-

scribed for particular construction tasks; bricklay-ing and stonework require sturdier scaffolding

than light carpentry.

Another source of injuries and fatalities is

trenching. Collapsing trenches can bury workers

alive. This can be prevented by shoring trenchesor by sloping trench sides as they are dug to pre-vent collapse.

Scaffolding, railings, and blocked holes in floorsunder construction are day-to-day steps taken toprevent injury. These temporary measures mustbe pu t up, taken down , and supervised each d ayor as each floor in a n ew b uildin g is completed.

Construction workers depend on personal pro-tective equ ipment —hard hats, gloves, and steel-

toed shoes-for immediate protection but consid-eration of worksite layout to prevent workers

entering areas likely to be filled with flying objects plays an important role in preventing con-struction-related injuries and death.




In all these cases, the persons responsible forsafety must be given authority to require that pre-cautions be taken. The urgency to finish a job andthe false confidence that comes with “I’ve doneit a thousand times this way” lead both workersand management to ignore hazards. These human

tendencies are among the reasons that involve-ment of managemen t from the top d own is nec-essary for injury control.


Mechanical power presses are an important safetyhazard in many manufacturing plants

PREVENTING MANUFACTURING= RELATED INJURIES

Thou gh th e rates are not as high as th e con-struction industry, the manufacturing sector stillhas injury and illness rates higher than the all-industry average (see ch. 4 and Working Paper#l). It also offers many opportunities for injury

prevention because it is a relatively stable workenvironment. Workers make products generallyusing the same methods day after day, while man-agement closely controls the entire operation.

Manu facturing in volves app lying energy towood, metals, or other materials to shape theminto usable products. Even handtools multiplyhuman muscle forces greatly; the cautionary in-structions about hammers, screwdrivers, saws,and snips delivered from parent to child or fromteacher to stud ent often in clud e gory descriptionsof injuries know n first or second h and. Power

tools move faster, generate greater energy, and,hence, involve a greater degree of hazard.

The following selected examples of dangerousoperations among the w ide variety found in m an-ufacturing operations illustrate injuries that may

be related to man ufacturing and p rovide a sum -mary of control strategies.

Woodworking Processes

Table 6-4 lists woodworking processes, possi-ble injuries, and preventive technologies. Devicesused to cut, shape, and join w ood—including avariety of power saws, planers, shapers, lathes,and routers—are capable of causing serious injury, especially to th e h and or eye. Preventingsuch injuries depends on design of special guards,on work practice, and on personal protectiveequipment. For instance, a guard would preventcontact with a power saw, a lock would preventthe saw from being turned on while maintenancework is in progress, and gloves and goggles would

protect the worker’s hands and eyes from flyingchips.

Many items of equipment can be purchasedwith b uilt-in guards (322). There is general agree-ment that built-in guards are less expensive, more



Ch. 6—Technologies for Controlling Work-Related Injury 109

Photo credit OSHA, Office of lnformation and Consumer Affairs

Improper use of powered woodworking tools, such asthis saw, can lead to serious injuries,

including cuts and amputations

effective, and less likely to interfere with produc-

tion than “bolt-ons.” Unfortunately, the extra

cost—coming at a time managers are spending

money on new machinery-may inhibit purchase

of the safer equipment.

Metalworking— Cutting, Welding,and Cold Forming

The most casual sidewalk superintendent can

appreciate the hazards inherent in welding and

cutting metals. These involve high temperatures,hot m etal, and intense visible and ultraviolet light.

Table 6-5 shows a summary of the potential haz-

ards of each process and gives examples of the

types of control technologies that can be used toprevent injury.

The hazards of welding and cutting are simi-

lar. Skin may be injured by infrared, visible, orultraviolet radiation or by fire, hot metal parts,

explosions, or electrical shock. Eye injury or burns

may result from flying sparks, hot metals, or theimmensely strong light emitted in the infrared, vis-

ible, and ultraviolet spectrum. Gases including

oxygen, acetylene, hydrogen, and others, usuallystored under pressure in special cylinders, may

explode, or injury may result from physical han-

dling of the cylinders. Shielding can protect ad-

jacent workers, and face masks can protect the

welder (322). One type of welding—resistancewelding— is usually done by a special machine

that eliminates many sources of injury.

Table 6-4.—Technologies for Preventing Work-Related Injury From Woodworking Machinery

Process, Injury Examples of preventiondevice, or tool potential technology available

Saws Cuts, amputation, eye damage, Kickback and hood guards, jigsa, operating methods, pushprojectile wounds, hearing loss sticks, maintenance goggles, hearing protectors

Jointers, planers Hand and finger cuts Swing guards, hold down clamps, maintenance

Shapers Hand and finger cuts, projectile Use of solid cutters instead of knives, maintenance, safetywounds collars, brakes, operating methods, holding jigs

a, goggles

Power-feed Hearing loss, projectile wounds Isolation, goggles, maintenance, hearing protectorsplaners

Sanders Abrasions, projectile wounds Guards, goggles

Lathes Eye and projectile wounds Goggles, face shields

Routers Hand cuts Jigsawith handles

device for mechanically holding a of work in the correct position while working on

SOURCE (322)




Photo credit Department of Labor, Historical Office

Lack of attention to prevention can resultin equipment collapse

Cold forming involves applying great cuttingand punching forces to metal. The power of the

machines for turning, boring, milling, planing,grinding, and power pressing is a obvious haz-

ard. Table 6-5 also includes a summary of thetypes of injuries associated with these machines.

Cuts, eye injuries, injuries from being caught in

the machine, and foot injuries from dropping

heavy chucks (devices that hold the cutting tool

in place during machine work) are the main prob-

lems. Control technology ranges from careful de-

sign that considers safety to personal protectiveequipment.

OSHA and NIOSH studied self-tripping power

presses that use presence-sensing devices such as

photoelectric detectors and light beams to prevent

hands from entering the presses. Use of these de-

Photo credit” OSHA, Off/cc of Information and Consumer Affairs

The hazards of welding include heat, flying sparks,and fumes, as well as infrared, visible,

and ultraviolet radiation

vices to activate power p resses could increase pro-

ductivity as compared with the use of two-handed

switch activators. Although photoelectric devices

for these purposes are ordinarily prohibited by

an OSHA regulation, a variance was granted to

one company to evaluate the relative degree of injury control among workers using self-tripping

devices and those using two-handed switches. In-vestigations found no significant difference in

observed injuries or stress as measured by heartrate, blood pressure, and subjective responses to

a questionnaire among the two groups of work-

ers tested (588).

Al though the p hotoelectric devices provid e pro-

tection equal to traditional methods, and at the

same time increase productivity, NIOSH studies

have found other innovations less positive. For

instance, presence-sensing devices that halt ma-

chine operation when a worker’s hand interrupts

a radiofrequency field in the danger zone proved

inadequate for reliable injury prevention. These

studies have also shown that the current stand-

ards for two-handed activator switches for power

presses may be inadequate. Under some condi-



—

Ch, 6—Technologies for Controlling Work-Related Injury q 11 1

Table 6-5.–Technologies for Preventing Work. Related injury From Metalworking Machinery

Process, Injury or illness Examples of preventiondevice, or tool potential technology available

Welding and cutting Shock trauma; eye injury; back injury fromhandling heavy gas cylinders; cuts fromsharp edges on finished work; hearing loss

Metalworking machinery; Eye injury (flying chips), scalping (hairturning machines; boring caught in machinery), foot injury frommachines (drills, boring dropped chucks; hand, finger, or limbmills); milling machines injury; skin irritation (cutting fluids),(saws, gear cutters, electrical shock (EDMa)electrical discharge—EDMa); planing machines

Grinding machines

Power presses; hand- or Finger or hand amputation or injury; fingerfoot-operated presses; punctures; fatigue; eye injury, foot injury;metal shears; press brakes lacerations

aMlll!ng by electric arc

b sy~tem~ for Preventing (nadvertanf machrne operation during mafnfenance

SOURCE (322)

tions workers could activate the power press and

have time to reach into the press before the press

ram completes its cycle (588).

Metalworking—Hot Working

Hot metal work is done primarily in foundries.

It is characterized by massive, often older, ma-

chinery. The size of the operations and the weight

and heat of the materials being worked result in

many injuries. The processes range from handlingraw material—ore concentrates, coal, coke—to

working with heating and shaping ovens and pro-

Careful layout of equipment, process, andjob; arc and spark-shielding; properinsulation of electrical cable; goggles;

welding hoods; welders’ helmets; gloves;ultraviolet-energy-resistant clothing

Machine design, including shielding, properelectrical insulation, local exhaustventilation for grinding wheel discharge andfor discharge gases from EDM

amachines,

provision of emergency stop buttonsSafe working practices, including keepingtools sharp, never leaving machineunattended, using handtools instead ofhands to work metal

Inspection of grinding wheels for integrityand balance; good maintenance; shields toprevent flying chips; use of personalprotective devices, including goggles,hearing protectors, closely fitted clothing,

haircaps, safety shoesEnclosure of the die during operation;adjustable, fixed, or interlock press barrierguards; point-of-operation safe-guarding withmovable barriers, two-handed trippingdevices, presence-sensing devices;semiautomatic feed systems to avoid use ofhands; electrical controls such as interlocks,emergency stop switches, and ground faultprotection; apparatus for transferring dies;anti-repeat clutches and magnetic brakes toprevent inadvertent triggering of powerpress or shear; frequent machine inspection;careful maintenance; special handtools forfeeding pieces into the machine

duction equipment, to non-destructive testing of

finished products. Injury risk is high to the eye,

head, foot, trunk, and limbs.

Injury prevention depends on proper design of

the job, good work practices, and personal pro-tective equipment (table 6-6). Bums are prevented

by spark shielding, special clothing, and insula-

tion of electrical cables. Electric shock prevention

methods include shielding, guarding, good work

practices, proper electrical insulation, and main-

tenance. Eye protection is needed where sparks

and hot metal particles may fly. Fire and ultra-




violet-energy-resistant clothing is important forworker protection. Gloves are needed to protecthands from bums. Welders’ helmets are requiredfor electric-arc w eldin g.

Preventive Maintenance

Careful attention to the plant, its operations,and workers is necessary to maintain controls.Table 6-7 shows a range of maintenance opera-tions required to prevent injury in manufactur-ing operations. Maintenance of everything fromfoun dations and footing to electric bu lbs can pre-vent injuries.

Photo credit: Department of Labor, Historical OffIce

This machine will not operate unless both of theoperator’s hands are on the control switches. The

use of “two-handed controls” represents onemethod of preventing injuries associated with

power presses and shears

Table 6-6.—Technologies for Preventing Work. Related Injury During Work with Hot Metal In Foundries

Process, Examples of preventiondevice, or tool lnjury potential technology available

Handling of materials such Injury from electrical shock, heat, being Ladles equipped with automatic safety locksas sand, coke, and coal struck by or against, or being caught or brakes; devices to warn when ladles are

between; explosions, vibration, noise; injury being moved; appropriately guardedto hand and foot, eye, trunk, limbs, or other conveyors for transport of sand and moldsbody parts; death from trauma orasphyxiation

Cupolas, crucibles, ovens Mechanical devices for charging cupolas;blast gates to prevent injury from gasexplosion

Production equipment Venting molds to prevent explosions; two-hand controls for molding and core-blowingmachine operators; dust-tight sandblastrooms; guards, two-handed tripping controlsfor forging hammers, presses, and upsetters;careful and frequent equipment inspectionPersonal protective equipment, as required,

including hard hats, gloves, leather aprons,steel-toed shoes, metatarsal guards, safetyglasses, goggles, flame-retardant clothing;devices to prevent doors and other movableparts from hitting workers; material-handlingdevices to eliminate heavy lifting andpossible spills or splashes of solids andliquids

SOURCE (322)



—

Ch. 6–Technologies for Controlling Work-Related Injury q 113

Table 6-7.—Technologies for Preventing Work-Related Injury Through Maintenance of Structures

Process, Injury or illness Examples of preventiondevice, or tool potential technology available

Foundations

Structural members, walls,

floors, roofs, and canopies

Stacks, tanks, and towers

Platforms and loadingdocks

Sidewalks and driveways

Underground utility repair

and maintenance

Lighting systems

Stairs and exits

Grounds maintenance

Injuries and fatalities from buildingcollapse

Injuries and fatalities from plant building

collapse

Injuries and fatalities from structuralcollapse; asphyxiation and acute poisoningfrom tank gases; injuries from explosionsduring tank cleaning or repair

Injuries from slips and falls

Injuries from slips, falls, or collision withmoving vehicles

Injuries and fatalities related to sewer gas

explosion; asphyxiation from oxygendepletion; injuries or fatalities fromcollapsed trenches; drowning or injury fromfailure of underground pipelines

Cuts from broken bulbs; injury from electricshock, fails, or poor illumination

Injuries from slips and falls; injuriescrowding in emergency situations

from

Injury from grounds maintenance; cutsfrom mower blades and snow throwers; eye

injury from frying objects; collapse fromquick-acting pesticides

Check for and repair settling footings andcolumns, cracked foundations

Check for and repair settling walls, defective

columns, joists, beams, and girders; crackedbuilding materials such as steel, concrete,wood; cracked walls and windows; saggingor rotted roofs and ceilings; rotted, sagging,cracked floors

Place railing around edges of platforms;check structural integrity; use properprocedures for maintenance work

Use metal protectors on edges of concreteplatforming; check surfaces for rotting,holes, or other hazards

Repair damaged sidewalks and motorways;install and maintain warning signs andmarkings

Test for gases and oxygen deficiency before

attempting maintenance work inunderground tunnels and sewers; providecontaminant-free ventilation duringmaintenance work; slope trenches at anglesto prevent collapse

Provide proper equipment for disposal ofburned-out lamps; use properly designedladders and platforms; clean and replaceburned-out bulbs on a regular schedule

Install and maintain adequate handrails,illumination, and walking surfaces on stairs;keep passageways and stairs free for exit;install unobstructed exit doors for fire andemergencies

Maintain tools and equipment; provideguards for belts, chains, and other moving

parts

SOURCE: (322)

FIRE AND EXPLOSION PREVENTION

Fire and explosions levy an enorm ous cost onindustry and continue to cause many deaths andinjuries among workers and the general pub lic.Of fire-related deaths, 75 percent are due to in-halation of sm oke and toxic gases and th e other

25 percent to direct flame. Injury and death fromfires can be prevented by proper design and con-struction of bu ildin gs, vigilant insp ection, earlydetection and warning, and approp riate controlmethods.

Building designers play an important role in fireprevention. Engineers and architects can antici-pate fire problems in the d esign of b uildings andfacilities and thereby protect workers and the pub-lic from in jury. A stu dy of over 25,000 fires be-

tween 1968 to 1977 resulted in a listing of igni-t ion sources ranging from the most common—electrical ignition and arson—to the least com-mon—lightning (table 6-8). These findings pointto areas wh ere controls are most needed and on





The hazards of hot metalworking are found in steel mills and foundries

Table 6-8.—Common Ignition Sources of Industrial Fires

FrequencySource (percent) Means of prevention

Electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Design and maintenance

Incendiarism (arson). . . . . . . . . . . . . . . . . . . . . . . 10 SecuritySmoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Supervision, substitutionHot surfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Design and maintenanceFriction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Design and maintenanceOverheated materials . . . . . . . . . . . . . . . . . . . . . . 7 Work practice and controlCutting and welding . . . . . . . . . . . . . . . . . . . . . . . 7 Work practiceBurner flames . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Design and maintenanceSpontaneous ignition . . . . . . . . . . . . . . . . . . . . . . 5 HousekeepingExposure (fire from adjacent property) . . . . . . . 4 DesignCombustion sparks . . . . . . . . . . . . . . . . . . . . . . . 3 DesignMiscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Design and otherMechanical sparks . . . . . . . . . . . . . . . . . . . . . . . . 2 HousekeepingMolten substances . . . . . . . . . . . . . . . . . . . . . . . . 2 Work practice and maintenanceStatic sparks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Design (grounding)Chemical action . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Work practiceLightning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Design (grounding)

of that cigarettes to burn for longer times would reduce the number Of cigarette-caused that

kill 3,000 Americans annually.SOURCE: (322).






Table 6.9.—National Fire Protection Association Fire Classification

Class Description Means of control

A. Fires occurring in ordinary material such as Cooling and quenching by water to reduce heat iswood, paper, etc. recommended. Special dry chemicals may be used to control

flame.

B. Fires that occur in the vapor-air mixture over Since water tends to spread such fires, dry chemicals, carbon

the surface of flammable liquids such as dioxide, foam, or halogenated agents are preferred.gasoline, oil, etc.

c . Fires that occur in or near equipment using Non-conducting agents such as dry chemical or carbon dioxideelectrical energy. must be used to extinguish to prevent electric shock.

D. Fires that occur in combustible metals such as Since ordinary means of control such as water may increasemagnesium, lithium, potassium, etc. the intensity of such fires, special equipment and materials

are required to control this tvpe of fire.. r –

SOURCE (322)

terns. Both manual and automatic fire extinguish-ing systems sh ould be strategically located to limit

fires in their early stages. Fire-safe stairwells, ade-

quate aisle space, and appropriate stairwell width

are essential for safe and rapid exit. Emergency

stairwell lighting should be provided.

The use of fire-resistant materials, the design

and construction of building frameworks, ventila-

tion systems, concealed spaces, storage areas, ex-

teriors, fuel sources, and building uses—all part

of the designer’s functions—make a difference.Widespread use of masonry in the interiors of Eu-

ropean dwellings is thought to be a factor in their

superior fire record. Plastic interiors used in this

country, on the other hand, are the source of

deadly toxic gases during fires.

Explosions are a special preventive concern of

designers. Explosive atmospheres result from the

accumulation of organic dusts and from gases and

vapors. The U.S. Department of Agriculture lists

133 dusts by degree of explosibility (322). Dusts

produced from phenolic, urea, vinyl, and other

synthetic resins and powders used in the plastics

industry also explode under certain conditions.

The Explosion Venting Guide of the NFPA pro-

vides specifications for buildings where the risk

of explosion is high.

Explosion prevention can be accomplished by

inert gas systems that displace oxygen so that

gases and dusts are incombustible and by ade-

quate ventilation, proper process operation, and

vigilant maintenance. Gas lines and valves should

be inspected frequently for leaks.

Since three-fourths of fire-related deaths arefrom toxic fumes and since industrial fires may

involve extremely toxic materials, it is important

for firefighters to be able to identify chemical and

material inventories in establishments under their

jurisdiction. Several municipalities and Stateshave developed systems for this. The OSHA haz-

ard communication (labeling) standard may also

be useful for this purpose.

INJURY CONTROL PROGRAMS IN INDUSTRY

Effective control of work-related injury dep ends

in part on how well a company is organized to

deal with it. Management has the p rimary respon-

sibility for prevention. Relevant programs include

training workers, supervisors, and managers to

recognize workplace hazards and take steps to

control them (see ch. 10).

Successful injury prevention must start with a

s t rong commitment f rom management . The

stronger the commitment at the top the greater

the likelihood of success. Typical management

programs for preventing work-related injury (and

illness) include:

. establishing clearly stated company policies

for prevention;

• avoiding work -related injury an d illness by

planning ahead w hen designing new plant or

modifying existing processes;



.

Ch. 6–Technologies for Controlling Work-Related Injury q 117

q analyzing each hazardous operation to de- q

termine the steps required to do the job with-

out causing injury or illness; q

. identifying hazards through workplace sur-

veys and investigating the factors surround-

ing an event that caused or nearly caused in- q

juries or illnesses;

maintaining accurate and complete records

of the causes of injuries and illnesses;

training workers, supervisors, and managers

to identify hazards and prevent injury and

illness that could result from them; and

placing and maintaining people in jobs suit-

able to their physical status.

THE DU PONT INJURY CONTROL PROGRAM

Perhaps the best source of information about

how to run an injury-control program is avail-

able from the successful companies. Determining

one best program is impossible, of course, for

hazards vary from industry to industry, plant to

plant, and department to department, making

comparisons of overall rates difficult. This sec-

tion focuses on the Du Pont Company not because

its program is best, but because it is good enough

that Du Pont sells it to other companies and much

information is available about it. Du Pont plants

have very low injury rates, which have dropped

dramatically since 1912, falling even more than

the all-industry average according to National

Safety Council data. A key to the company’s suc-

cess in preventing injuries at work is its commit-ment in this area. Its program consists of four

main parts:

. establishing injury prevention as a top man-

agement object ive;

q establishing injury prevention as a line-man-

agement responsibility;

q adopting an injury-control philosophy to

guide management action; and. e s t ab l i sh ing an o rgan iza t ion fo r i n ju ry

control.

Du Pent’s success in preventing injuries may

largely be attributed to strong commitment of top

management. The founder of the company was

personally committed to preventing injury among

his workers, often family or friends, who were

in the high-risk business of manufacturing gun-powder.

els of management is partly dependent on success

in preventing injury. Du Pont lists the following

as incentives for making injury control a manage-

ment objective:

q protect workers,

q improve profits,

q improve product quality,. improve productivity,

. improve employee-management relations,

an dq comply with OSHA regulations.

Du Pont finds that injury control increases prof-

its. Using National Safety Council statistics for

1976, Du Pont estimated the average cost of each

disabling injury to be $7,182. The company then

compared its estimated costs for 1977 (based ontheir rate of 0.2 disabling injuries per m illion hou rs

worked) with the projected cost if the rate had

been at the all-industry level of 10.87. Table 6-10 shows Du Pont’s estimated savings were greater

than $15 million, based on the all-industry injury

rate; a more representative comparison, however,

would be with large chemical companies, which

as a group have lower injury rates than the all-

industry average. Nevertheless, Du Pont’s own

comparisons were impressive enough to be fea-

tured in a Fortune article about savings from pre-

venting work-related injury (284).

Line-management emphasis on preventing in-

jury is another critical element of success. Respon-

sibility for preventing injury is as much a condi-

tion of employment in Du Pont as getting the job

done, High-level staff meetings often begin with

Commitment to injury prevention still perme- reports of job injuries, and any fatality has first

ates this Fortune 500 corporation from the top priority at any management meeting, including

down. For example, performance rating at all lev- the presidents.




Table 6-10.–Du Pent Calculations of Cost Savings From Injury Control

Du Pont U.S.A. Totals if at allactual (1977) industry rate (1976)

Disabling injuries/million worker-hours. . . . . . . . . . . . 0.20 10.87Disabling injuries/year . . . . . . . . . . . . . . . . . . . . . . . . . . 2,174Average cost/injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . $7,182 $7,182Cost/year (total injuries) . . . . . . . . . . . . . . . . . . . . . . . . $287,280 $15.613.668. ,SOURCE: (156)

Five basic beliefs underlie Du Pont’s program:

q

q

q

q

q

all personal injuries can b e prevented,man agers and supervisors must personallyaccept their responsibilities to prevent per-sonal injuries,reasonable safeguards are possible for all con-struction and operating exposures that mayresult in injury,

efficiency and economy are enhanced when

personal injuries are prevented, and

all employees must be trained to understand

the advantages to them, as well as to the

company, of taking responsibility to prevent

personal injuries.

Du Pont’s Safety Training Observation Pro-

gram (STOP) uses programed self-study courses

to enhance injury prevention. It is one of more

than 200 vocational courses developed for indus-

trial craft skill training. The objective of STOP

is to train line managers to notice workplace con-

ditions that might lead to an injury or illness.

STOP presents seven broad categories that aresuggested for observation rather than having de-

SUMMARY

Perhaps because of the more obvious sources

of injury as compared to illness, safety engineer-

ing appears to be more pragmatic than industrial

hygiene. Engineers have, to some extent, directed

their attention to sources of hazard such as elec-

tricity, falls, and fires, and produced codes and

standards for good practice.

tailed checklists of hazardous working conditions.

The manager looks for injury potential associated

with procedures, tools, equipment, orderliness,

personal protective equipment, positions of peo-ple, and a ctions of peop le. A training unit dividedinto eight parts is used for instruction and includ es

pocket-size cards to record workplace observa-tions as practice between teaching units.

The administrator of the course is key to its ef-

fectiveness. To show management commitment

to the course and to motivate supervisors to be

equally committed, the administrator must be

highly placed in the management structure.

The desired outcome of the training, which

should take only 12 to 16 hours away from work,

is supervisors who are able to recognize hazard-

ous conditions, to assign responsibility for cor-

recting it, and to ensure the elimination of the

hazard. The success of the program has been

measured through reduced injury rates in firms

that have purchased and used the training pro-

gram from Du Pont.

These codes and guides to good practice appear

often to be based on the personal experience and

judgment of the practitioners who happen to writesafety textbooks or are members of the commit-

tees who write the codes. This field has relied on

experience and jud gment instead of scientific anal-

ysis, systematic data collection, the application



Ch, 6–Technologies for Controlling Work-Related Injury . 119

of epidemiologic techniques, and experimental re-search. It is probab ly fair to say that u p to th epresent there has been little that might be calleda “science” of safety. In addition, as described inchapter 4 on the identification of injury hazards,the attempt to attribute most injuries to so-called

unsafe acts has often diverted attention away fromthe design of plant and equ ipmen t that can pre-vent “unsafe acts” or minimize the adverse con-sequences of “unsafe acts. ” However, it is unclearwhat differences a more theory-based rather thanthe pragmatic approach would have made.

Several specific areas where injury control can

be applied were discussed in this chapter. A nu m-ber of different methods and techn ologies areavailable for preventing injuries related to motorvehicles, construction activities, manufacturingprocesses, and fire and explosion hazards. These

include the p roper planning of plant sites and thedesign of equ ipmen t, as well as the use of guards,personal protective equipmen t, and approp riatework practices. Adequate attention to preventivemainten ance, and th e trainin g of work ers andmanagers, also play roles in inju ry prevention.

Successful injury control programs start with astrong commitment to injury prevention at al llevels of management.

Controls are known for many hazards. How-ever, they are not always used because they werenot built into a plant, are not available at a par-ticular worksite, or are pushed aside to get the job d one. All of these reasons for not u sing con-trols emphasize the important role of managementin provid ing controls and seeing that they areused.



7.

Ergonomics and Human Factors



.’

.

.

Figure

7-1.7-2.

7-3.

7-4*7-5.7-6.7-7.7-8,7-9.

“ 7-1o.

139 ‘

P a g e .

127

137-

138

LIST OF FIGURESI No.

Schem atic Repr esen tation of a M an-M achin e System . . . . . . . . . . . . . . .Control Burn er Arrangem ents of Simu lated Stove Used in Experim entAb ou t Logi cal Ar ran gem en ts . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . .M ajor N erv es i n th e Arm an d H an d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Th e Car pa l Tu nn el . . . . . . . . . . . .

q q q + q q . . q q q q . . . . , . q . q . . . q q . q . . . ,, .Flexion an d Extens ion of t h e Wr ist . . . . . . . . . . . . . . . . . . . . . q.Job An aly sis: Ass em b ly T ask s . . . . . . . . . . . . . . . . . . . . . . .

q. . q q q,1 q

. * . . . . . . . . . .G ood an d Bad D esigns for Con tainers an d W orkb en ch- . . . . . . . . . . .G ood an d Bad D esig n s for Pow ered D rive rs. . . . . . . . . . . . . . . . . . . . . . .A Knife Designed to Redu ce Cum ulative Trauma D isorders inPo u ltr y P rocess in g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Poten tial Ergonom ic Risk Factors Associated w ith VD T De sign ... , . .

Page

1 . . . 124

. . * 125

.** 129q . . 130. . . 130q . . 132. . . 133

‘ 134#. .

. . . 135

. . . 137

.



— —

7Ergonomics and Human Factors

Neither workers, nor machines, nor workplaces

exist apart from each other. To accomplish work,

all come together, and injuries and illnesses some-

times result from their interactions. The study of these interactions is called “ergonomics,” or “humanfactors engineering. ”

The term ergonomics was coined in the UnitedKingdom after World War II to describe a dis-cipline created during the war. It had been notedthat “bombs and bullets often missed their mark,planes crashed, friendly ships fired upon andsunk, and whales were depth charged” (471). Inresponse to this situation, research on designingmilitary equipment to match more closely the ca-

pacit ies of the u sers began on both sides of th eAtlantic. Attention was thus devoted to the inter-action between the human operators and their ma-chines.

One name for this new discipline, ergonomics,is derived from two Greek words, ergo, meaningwork, and nomos, meanin g laws. Ergonomics isthe science devoted to understanding the laws orprinciples that govern the design of work systems.A British professional group—the Ergonomics Re-search Society —was formed by the practitionersof this new discipline. An organization with simi-

lar aims, the Human Factors Society, was foundedin th e United States in 1957. The work of theoriginal memb ers was termed “hu man factorsengineering, ” or engineering psychology. Whetherthey are called human factors engineers or ergo-nomists, the scientists who practice this disciplinedraw on a nu mber of other d isciplines, includingmedicine, physiology, psychology, sociology,engineering, and physics.

Ergonom ists are concerned w ith safety, effec-tiveness, and efficiency wherever peop le are partof a system (380). The d iscipline is “an ap plied

science concerned with the design of facilities,equipment, tools, and tasks that are compatiblewith the anatomical, physiological, biomechani-cal, perceptual, and. behavioral characteristics of

humans” (250). The principle behind ergonomicdesign is that the machine should fit the worker,rather than forcing the worker to fit the machine.To quote from one ergonomics guide (655):

Man’s physical limits for bending , stretching,and/ or compressing are such that the machinemust be mad e to adapt to the man rather than theconverse. Behavior chara cteristics are somew hatmore flexible. Man can ad just h is sensory-motorbehavior to some degree, and . . . can utilizealternate procedures and make up for certainequipm ent inad equacies. How ever . . . as oper-ator load increases due to task complexity, fatiguemay r edu ce operator reliability; system p erform-

ance could d egrade at a critical time . . . Work-place layout shou ld favor the m an’s ph ysical andbehavioral capability in all cases in which a likelyerror in human performance could affect . . .safety . . , The designer cannot assum e that per-sonnel selection and training will be a panacea forimproper workplace considerations.

Figure 7-1 is a schematic representation of a

human-machine system. The person processes in -formation abou t the environment and acts on i tby using the machine’s controls. The importantfeatures of the machine include the controls usedby the worker, the operations of the machine, and

the displays used to feed information back to theworker. The task of the ergonomist is to analyzehow the worker obtains the information neededto operate the machine, how that in formation isprocessed to reach a decision concerning theappropriate way to control the machine, and whatworker actions are appropriate to control the ma-chine in a fashion that is safe and meets produc-tion criteria (380).

Other considerations, especially improving theprod uctivity of workers, fit easily into the goalsof ergonomics. Opportunities exist for workplace

designs that simultaneously improve productionoutput and reduce the risks of injury. For instance,C. G. Drury reported th at new h andtools in thecomponent-assembly department of a large com-

123




puter company and changes in seating, lighting, and savings, and the number of rejected compo-

and workbenches led to improved p roduction and nents fell to half the previous level. The workers

the elimination of repetitive motion injuries. The involved expressed increased satisfaction with

costs of the redesign” were earned back 4.3 times their jobs (340).

within one year through increased p roductivity

Figure 7-1.—Schematic Representation of a Human-Machine System

SOURCE (292)

CLASSIFICATIONS OF ERGONOMICS

Ergonomists usually subdivide the field into in-formation ergonomics and physical ergonomics.Information ergonomics is concerned with the col-lection, display, sensing, and processing of infor-mation. Physical ergonomics is concerned withworker size, strength, capabilities for motion, andworking posture.

Ergonomists use a num ber of techn iques thatinclude the evaluation of the transmission of in-formation between the machine and the worker(link analysis), discovery and evaluation of sys-

tem failures (critical incidence analysis), detailedexamination of the sequence of actions taken byworkers (task analysis), and analysis of situationsthat may arise from unprogrammed events or hu-man errors (contingency analysis) (380). Ergon-omists also make extensive use of anthrop ometricdata concerning the physical dimensions and ca-pabilities of the human population. In addition,the techniques of biomechanical analysis are usedto measure expected physical stresses encounteredby parts of the body w hile performing; work tasks.



Ch. 7—Ergonomics and Human Factors 125

Information Ergonomics

Information ergonomics is generally concerned

with what the worker senses in the w orkplace andhow that information is processed by the worker,The two major sources of sensory information are

visual and auditory.Visual displays in the w orkplace include me-

ter scales, control labels, warning signs, cathode-ray tube (CRT) displays, and printed text. To this

list can be added video display terminals (VDTs),

which can be CRT displays, liquid crystal dis-

plays, or other technologies. Three factors impor-

tant to the operator m ust be considered in d esign-ing a visual disp lay: the size of the critical detailin the display, its brightness, and the contrast of the d isplay against the b ackground . There are anumber of techniques available to achieve these

goals in design and to evaluate existing equipment.There are also many guidelines for special applica-tions, including the special needs of groups suchas older workers (23).

Workers also receive information through

sound. These can include tones (bells, whistles,beepers, etc. ) as well as speech. Designers andergonomists often face the q uestion of wh etherto provide information through visual or auditorymeans. In general, if the message is simple, short,or calls for immed iate action, if the w orker isalready overburdened with visual messages, orif the workplace is too dark or too bright forvisual displays, an auditory presentation is rec-ommended. If the message is complex, long, anddoes n ot necessitate immed iate action, or theauditory system of the worker is already over-burdened, or if the workplace is too noisy, avisual display may be preferred (23).

Finally, information ergonomics is concerned

with th e p rocessing of information by the worker

and the design of the workplace, including the de-sign of controls. Research that has measured theabilities of humans to accurately process infor-mation has shown that people often will not be

able to make quick, accurate responses in com-plex or un expected situations, Second, the studieshave also shown that “compatibility” in display-control design is very important. Comp atibilityrefers to the relationships between stimuli and re-

sponses, and generally falls into three categories:spatial (the compatibility of physical features orspatial arrangement for displays and controls),movement (the direction of movement of displaysand controls), and conceptual (the associationspeople hold concerning th e meanin g of signals,

such as in the Un ited States the association of thecolor green w ith “go”) (292).

One example of an everyday problem in com-patibility will perhaps clarify this notion. Figure7-2 presents four possible arrangements of the

burners and burner-controls for a stove. For sev-

eral of these patterns, the relationships betweenburners and controls can be difficult to learn and

hard to remember because the arrangements lack

spatial compatibility. To examine this, research-

ers in the 1950s setup an experiment in wh ich theytold a grou p of subjects to tur n on specific burners.

The subjects’ reaction times were measured andthe nu mb er of errors was noted. Design I, asso-

Figure 7-2.–Control Burner Arrangements ofSimulated Stove Used in Experiment About

Logical Arrangements

I

III

I

Ill

I

Iv I

Number of errors in 1,200 trials:arrangement

1 0II 76Ill 116IV 129

SOURCE: (292)

I




ciated with both the fewest errors (zero) and the The cherry-picker accident discussed in box C il-best reaction time, was considered to b e the m ost lustrates the importance of controls layout.compatible (292).

Physical ErgonomicsMany workp laces have dozens of incompati-

ble control configurations, which often lead to Physical ergonomics, concerned with the workeroperator errors and subsequent serious injury (23). as a physical comp onen t of the work p rocess,



—.

Ch. 7—Ergonomics and Human Factors q 12 7

often u ses the techn iques and equipm ent of an-thropometry and biomechanics. Anthropometryis the measurement of the physical dimensions of the human body, including both the structure of the body in fixed positions and the extent of move-ment possible, such as reach or lifting capacity.

Biomechanics is the study of the mechanical

operations of the human body. The muscles,

bones, and connective tissue can be analyzed as

a mechanical system using the fundamental laws

of Newtonian mechanics. The forces acting on themuscles, bones, joints, and spine can be deter-

mined for the lifting of an object, for instance.

Through such analysis, it is possible to calculate

the size and direction of forces acting on the bod y.

These can be compared with expected human tol-erances to judge whether the activity in question

will cause harm.

ERGONOMICS AND PREVENTION OF MUSCULOSKELETAL INJURIES

Ergonomic principles can be applied to prevent

both overt and cumulative traumas. An example

in the overt category is the risk of falling from

a ladder, which can be reduced by considering the

sizes and mobility of people when deciding how

far apart to place a ladder’s rungs (250). C u m u -

lative traumas are not the result of single events

or stresses; they stem from the repeated perform-

ance of certain tasks. Back problems are by far

the most common cumulative trauma injuries.

Evaluation and redesign of tasks to prevent back

injuries is discussed later in this chapter.

Repetitive motion disorders are a type of cumu-

lative trauma associated with repeated, often

forceful movements, usually involving the wristor elbow. Some 20 million workers on assembly

lines and in other jobs that require repetitive,strain-producing motions are at increased risk of

developing such disorders. Redesigning work sta-

tions, equipment, and handtools can significantly

reduce the awkward, forceful movements com-

mon to many jobs on assembly lines, in food proc-

essing, in the garment industry, and in offices.

Carpal tunnel syndrome, one of this class of

disorders, illustrates the potential for prevention

offered by the integration of ergonomics, medi-

cal surveillance, and treatment.

Carpal Tunnel SyndromeA wide variety of workers (see table 7-I), from

aircraft assemblers to upholsterers, are among

those at risk for carpal tunnel syndrome (CTS),a progressively disabling and painful condition

Table 7.1.—Occupations and Activities AssociatedWith Carpal Tunnel Syndrome

Aircraft assemblyAutomobile assemblyBuffingCoke makingElectronic assemblyFabric cutting/sewingFruit packingGardeningHay makingWaitressingHousekeeping

SOURCE (60)

InspectingMeat processingMetal fabricatingMusiciansPackagingPostal workersTextile workersTire and rubber workersTypingUpholstering

of the hand. Because the musculoskeletal strain

from repeatedly flexing the wrist or applying arm-

wrist-finger force does not cause observable in-

juries, it often takes months or years for workers

to detect damage.

The incidence and prevalence of CTS in the

work force is not known. The National Institute

for Occupational Safety and Health (567) reports

that 15 to 20 percent of workers employed in con-

struction, food preparation, clerical work, pro-

duction fabrication, and mining are at risk for

cumulative trauma disorders. The Bureau of La-

bor Statistics (603) reports 23,000 occupationally

related repetitive motion disorders in 1980, al-

though the number of CTS cases is not specified.

CTS is u ndou btedly und erreported in aggregate

statistics. Research in particular high-risk plantsprovides some insight into the extent of the prob-

lem. In a study at an athletic products plant, 35,8percent of workers had a compensable repetitive

trauma disorder. In some jobs within the plant,





Work on an automobile assembly line can involve cramped working positions. A Volvo assembly plant in Kalmar,Sweden, uses “tipper trolley s.” These trolleys hold the automobile bodies and can be tipped 90 degrees to allow

work on the underside of the car

the rate was as high as 44.1 percent, and carpaltunnel syndrome occurred in 3.4 percent of the

workers (21,23). Many industries claim that the

incidence of CTS is increasing and is one of their

most disabling and costly medical problems (60).

Symptoms

The onset of symptoms of CTS is usually in-

sidious. Frequently, the first complaint is of at-

tacks of painful tingling in one or both hands at

night, sufficient to wake the sufferer after a few

hours of sleep. Accompanying this is a subjective

feeling of uselessness in the fingers, which aresometimes described as feeling swollen. Yet little

or no swelling is app arent. As symptoms increase,

attacks of tingling may develop during the day,

but the associated pain in the arm is much less

common th an at night. Patients may detect changes

in sensation and power to squeeze things but some

peop le suffer severe attacks of pain for m any years

without developing abnormal neurological signs.

Ultimately, in advanced cases, the thenar muscle

at the base of the thumb atrophies, and strength

is lost.

Compression of the median nerve is the imme-diate cause of CTS. The median nerve comes

down the arm, through the wrist, then branches

in the hand, supplying the thumb, forefinger, mid-

dle finger, and h alf the ring finger w ith nerves (fig.

7-3). The carpal tunnel itself, located in the wrist,

is formed by the concave arch of the carpal bonesand is roofed by the transverse carpal ligament

(fig. 7-4). These structures form a rigid compart-ment through which nine finger tendons and the

median nerve must pass. Any compromise of this

unyielding space usually compresses the median

nerve.

Risk Factors

Repetitive motions, such as those required in

many jobs, is one of a number of risk factors for

CTS. It is probably the most readily controllable

cause, however. Certain diseases, acute trauma,congenital defects, wrist size, pregnancy, oral con-

traceptive use, and gynecological surgery all may

contribute to the likelihood of developing CTS.

Overall, the incidence of CTS is higher in women

than in men, perhaps because of some of these

risk factors.

Occupational tasks responsible for the devel-

opment of CTS include physical exertions withcertain hand postures or against certain objects,

and exposures to vibration or cold temperatures.Repeated and forceful up-and-down motions of

the wrist (flexion and extension) (fig. 7-5), causethe finger tendons to rub on the structures form-

ing the carpal tunnel. This constant rubbing can

cause the tendons to swell (tenosynovitis), even-

tually putting pressure on the median nerve in-

side the carpal tunnel. The nerve itself is stretched



Ch. 7—Ergonomics and Human Factors . 129

Figure 7-3.—Major Nerves in the Arm and Hand

Pal mar(a)

(b)

SOURCE (60)




Figure 7-4.--The Carpal Tunnel

Median nerve

Finger flexor

SOURCE (60)

Figure 7-5.— Flexion and Extension of the Wrist

a.

Bending the wrist causes the finger flexor tendons to rub onadjacent surfaces of the carpal tunnel.

SOURCE’ (60)

Flexor retinaculum

(transverse carpal ligament)

by repeated exertions, and comp ressed betweenthe walls of the carpal tunnel.

Forceful movements and the direction of themovement are only two of the underlying causesof tenosynovitis that can lead to CTS. The speedof movements and incorrect posture while work-ing also are important (275). Median nerve com-

pression also can be caused by tasks that requirea sustained or repeated stress over the b ase of thepalm (247). Examples include the use of screw-drivers, scrapers, paint b rushes, and bu ffers.

Although the mechanism is not yet understood,low frequency vibration is a recognized risk fac-tor for CTS (405). Vibration exposure may resultfrom air- or motor-powered drills, drivers, saws,sanders, or buffers. Cannon (95) examined med-ical records at an aircraft company and found astrong association between CTS and use of vibrat-ing tools.

Control of CTS

Control of CTS requ ires a two-pronged ap-proach. The primary strategy to prevent cases isthe use of ergonomic principles to modify hand-tools and to improve work-station design and



Ch. 7—Ergonomics and Human Factors 131

work practices. Even a successful ergonomic pro-gram will not prevent all cases of CTS, however.The second im portant elemen t, therefore, is amedical surveillance program. This is particularlyimportant now wh en so little is known about theindividual factors that cause some people to de-velop CTS. Thus far, no programs focusing onthe m edical evaluation of CTS seem to exist (60).

Ways are needed to iden tify the earliest sign of CTS, to evaluate progression of the disease, andto examine the role of predisposing risk factors.The purpose of such a medical surveillance pro-gram is prevention of advanced disease by in-stituting therapy at early stages.

Although medical surveillance for CTS is stillin very early stages, ergonomic interventions havebeen remarkably successful where they have been

instituted. Armstrong (21) describes the steps in-volved in developing appropriate controls. First,plants and specific departments within plants inwh ich th ere is a documen ted high rate of CTSshould b e identified. Then each job should besystematically analyzed. Traditional time-and-motion stud ies, in w hich each movement or actis recorded, can be used. Each element of the jobcan then be checked against factors known to beassociated with CTS development. These includeposture of the hand and wrist, strength, stress con-centrations over the palm, vibration, cold tem-perature, and the presence of gloves.

Armstrong presents a typical work task as anexample. Figure 7-6 shows a worker taking partsout of a container and placing them on a con-veyor. The six elements involved in this task arereach, grasp, move, position, assemble, and re-lease. Reaching into the container involves wristflexion and pinching, during which the worker’swrist is likely to rub on the edge of the box. Theforearm is also l ikely to rub on the edge of th ework bench while the part is positioned. The re-designed work station should reduce stress on thehand and wrist, and eliminate sharp edges. Good

and bad designs for the container and the work-bench with jig in this hypothetical case are illus-trated in figure 7-7.

Powered hand tools can also be designed an dused to minim ize stress. As illustrated in figure7-8, good designs allow the w ork to be don e withlittle or no flexion or extension of the wrist.

Armstrong and his colleagues have investigated

cumulative trauma disorders in a p oultry proc-essing plant u sing the p rocedures described above.They discovered that workers in the “thigh bon-ing” section had the highest incidence of cumula-

tive trauma disorders of all departments. Thigh

boning involves grabbing the thigh with one hand

on a moving overhead conveyor, then making

four cuts with the other to separate the meat from

the bone. Each worker makes an estimated 15,120

cuts per shift. Ergonomic improvements to the

process recommended by Armstrong and col-

leagues include training workers in the “proper

work methods and knife maintenance to minimizethe time and , hence, the d istance that mu st bereached and force that mu st be exerted on th ethigh.” The work stat ion could be modified tominimize the distance to be reached. The w ork-ers wear wire mesh gloves with rubber glovesunderneath, which increase the force necessaryto grasp the thigh an d pu ll the meat away. Glovesshould fit well, and the addition of barbs on thepalm of the wire mesh glove might facilitate thehand actions. A new kn ife handle d esign, to re-duce the force required to hold the knife and makethe cuts—e.g., that pictured in figure 7-9—is sug-

gested (22). Such a d esign wou ld also min imizewrist flexion.

A high incidence of repetitive trauma disorders,including carpal tunnel syndrome, in a telephoneassembly plant prompted management to considerhow to prevent future cases. McKenzie and col-leagues (299) noted the highest rates in areas usingvibratory air screwdrivers, and in jobs requiringrepetitive grasping, squeezing, or clipping mo-tions. Ergonomic chan ges recomm end ed in clud edmodifying the screwdrivers with sleeve guards andchanging work posit ions to minim ize hand and

wrist stress. The changes were instituted withalmost immediate results: from 2.2 percent annualinciden ce of repetitive traum a disord ers in 1979




Figure 7-6.-Job Analysis: Assembly Tasks

Job analysis

1. Reach for part - 2. Grasp part

.

4. Position part i5. Assemble part

• Assembling parts on a moving conveyor can be described by a series of six elements,

SOURCE (21)

to 0.79 in 1981. Lost and restricted workdays fellfrom 5,471 in 1979 to 1,111 in 1981, and furtherreductions were expected in subsequent years.

Back Disorders

The Bureau of Labor Statistics completed a sur-vey of workers who had incurred back injurieswh ile lifting, placing, carrying, holding, or low er-ing objects (605). Of the 900 workers includ ed inthe tabulated results, more than 75 percent werelifting at the time of the injury, Surprisingly, theback injuries were concentrated in younger work-ers; almost 75 percent occurred in 20- to 44-year-olds. Both the weight and the bulkiness of thelifted objects were often associated w ith in juries.

About half the injured workers had received someinstruction ab out p roper lifting.

Manual lifting presents a risk of overexertioninjuries and cumulative damage to the soft tissuesaround the spin e. Overexertion injuries to theback constitute th e largest single category of workers’ compensation claims, amounting to 25to 30 percent of all disability cases Lower-backinjuries are often extremely painful and signifi-cantly diminish the q uality of life of the afflicted

workers. Many of these can be prevented by joband equipment redesign.

The conventional wisd om about h ow to liftsomething is to squ at, pick up the object, and ,wh ile keeping th e back straight, lif t straight up





I&! . Preventing Illness and Injury in the Workplace

Figure 7-8.—Good and Bad Designs for Powered Drivers

Powered drivers

OK

Pistol handlevertical surface

Bad

Pistol handlehorizontal surfaceelbow height

OKInline handlehorizontal surface

OK

Pistol handlehorizontal surfacebelow waist height

Bad Inline handhorizontalsurfacebelow elbowheight

Wrist posture is determined by the elevation and orientation of the work surface with respect to the workers and the shapeof the tool..-

SOURCE: (21)

with the legs. This procedure is thought to p re-vent inju ry to the back. In man y cases this pro-cedure is justified, but there are many other situ-ations where it is not.

Work-Load Evaluation

There are at least four basic sets of criteria fordetermining acceptable work loads: biomechani-cal, physiological, psychophysical, and epidemi-ological (453). Biomechanical criteria are based

on pressures and stress exerted on the body, par-ticularly on the sp inal column . Limits of tolerancehave been d eveloped b y observing d amage tocadavers when pressure is applied. Physiologicalcriteria are primarily metabolic, e.g. oxygen con-sumption and heart rate. The psychophysical

method incorporates workers’ perceptions andsensations in to the assessment of w ork load forboth static and dynamic strength. Epidemiologiccriteria are derived from aggregate data concern-ing the incidence, severity, and distribution of lowback pain . These four app roaches can be inte-grated and guidelines established with input fromeach. The N ational Institute for O ccupationalSafety and Health has developed recommenda-tions in this way.

Maximum acceptable work loads are often ex-

pressed in terms of the weight and frequency of lifting. For instance, 75 percent of th e ind ustrialmale p opu lation can lift a 13-kilogram box of fixed proportions every 5 seconds, and a 34-kilogram b ox every 30 minutes without trigger-ing or aggravating low-back injury symptoms.



Ch. 7—Ergonomics and Human Factors q 135

Figure 7-9.—A Knife Designed to Reduce Cumulative Trauma Disorders in Poultry Processing

One possible knife handle with three blades for reduced wrist deviations. The handle is designedto reduce the tendency for the knife to fall out of the hand in thigh boning.

SOURCE (22)

There is great practical significance to having compensable back problems. For case histories of very specific work-load recommendations. They task evaluation and redesign carried out by the

can be used both for determining that a task is Liberty Mutual Insurance Co., see boxes D and

unacceptable and as guidelines for redesigning the E. According to Snook (453), “most industrial

task. Recognition of a problem often occurs only tasks with unacceptable work loads can be mod-

after a number of compensation claims have been ified for less than the average cost of a single low

awarded, triggering investigation. Insurance com- back compensation claim. ”

panics have a direct incentive to cut down on

A P P L Y I N G E R GO N O M I C S T O V D T D E S I G N

The first reports from Europe concerning po- cluded that there were no known radia t iontential adverse h ealth effects associated w ith video hazards and that the real hazards were ergonomic

display terminals included accounts of many re- problems: musculoskeletal problems, visual prob-ported musculoskeletal and visual problems. Early lems, and fatigue. Poor design of equipment or

U.S. studies of potential VDT hazards also con- poor job design may produce such problems.




Musculoskeletal problems among office work-

ers range from discomfort to pain and medical

disability. The back, neck, and shoulders are the

most frequent sites of problems. Table 7-2 sum-

marizes the results from several studies of VDT

workers. There is general agreement that muscu-

loskeletal problems are associated with poor

working positions, repetitive motions, and the

length of work time without a break.

Figure 7- IO illustrates risk factors contributing

to musculoskeletal problems associated with

Box E.—Ergonomics-Task Evaluationand Redesign

This case history involves back injuries tomateriaI handlers in the packing department of a metal office equipment and desk accessory

manufacturer. The six female material handlersare required to m anu ally lift boxes of varioussizes and weights from a conveyor and stackthem on wooden pallets. There were six com-pensable back injuries reported between Feb-ruary 1980 and September 1982, with a cost of $131,415.

Boxed products are transported by b elt con-veyors to the position of the material handler,where they are taken off the line and loweredand/or lifted onto pallets. Due to the wide varie-ty of Sire, shap es, and weights, the b oxeshandled vary in weight from a pound to largebulk y boxes weighing 50 pound s. Full p allets are

taken by forklift to a warehouse.

Source: (675}.

VDTs, including equipment design (VDTs, work

stations, and chairs) and job design (constrained

working positions, repetitive work, and inade-quate rest breaks). Any of these can be changed.

The keyboards and screens of many early VDT

work stations were fixed relative to each other and

the height of the work station was not adjustable.



Ch. 7—Ergonomics and Human Factors . 137

Table 7-2.—Frequency of Reported Musculoskeletal Problems From Various Studiesof VDT Workers

Percent reporting frequent or daily problemsa

Study/type of worker Neck-shoulder Back Arm-hand

Arndt, 1980:Telephone operator

b. . . . . . . . . . . . . . . . . 8-17 15 12

Service assistant . . . . . . . . . . . . . . . . . . . 9-14 14 6Accounting clerk

b. . . . . . . . . . . . . . . . . . 7-1o 10 5

Laubli, et al., 1980:Data-entry VDT operator. . . . . . . . . . . . . . 11-15 N.A. 6-15Accounting machine operator . . . . . . . . . 3-4 N.A. 8Conversational VDT operator. . . . . . . . . . 4-5 N.A. 7-11Typist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 N.A. 4-5Traditional office worker . . . . . . . . . . . . . 1 N.A. 1

Hunting, et al., 1981:VDT operator . . . . . . . . . . . . . . . . . . . . . . . 6-12 6-10 6-12Typist , . . . . . . . . . . . . . . . . . . . . . . . . . . . . , 6-12 6-10 6-10Traditional office worker , . . . . . . . . . . . . 2-5 2-5 2-5

Canadian Labour Congress, 1982:VDT operator . . . . . . . ... . . . . . . . . . . . . 10-12 10-15 2-3Non-VDT operator . . . . . . . . . . . . . . . . . . . 7-8 9-14 4

Sauter, et al., 1983:VDT operator . . . . . . . . . . . . . . . . . . . . . . . 24-34 27-35 3-4Non-VDT operator . . . . . . . . . . . . . . . . . . . 19-28 22-29 4-6

reporting almo st frequent, often constant Ranges represent Quest ions33 percent use

N A =

SOURCE (25)

Figure 7-10.— Potential Ergonomic Risk Factors Associated with VDT Design

Displayheight

keyboardIocat ion

Chairheight

Foot

SOURCE (25)




Equipm ent can b e redesigned and made to fit thevarious sizes of people. Many manu facturers n owoffer, usually at a higher price, office furnitureand equipment that has been “ergonomically de-signed. ” Although this equipment has been adver-tised as being vastly sup erior to ordinary office

equipment, its biggest advantage from an ergono-mic persp ective is the simplest—it is adjustable.Job redesign to reduce repetitiveness and toalleviate constrained postu res is also possible.Finally, rest breaks can be instituted to reducefatigue from w orking in one position for long peri-ods of time. Rest breaks often result in increasedproductivity as well as fewer musculoskeletalcomplaints (25).

Visual problems reported amon g VDT users in -clude eyestrain, burning/itching eyes, blurred vi-

sion, double vision, color fringes, and deteriora-

tion of acuity (table 7-3). A recent review by aNational Research Council panel (321) concluded,

however, that there was no evidence that the use

of VDTs led to visual system problems different

from symptoms reported by workers engaged in

other tasks involving intensive close work.

The problems reported are related to the visual

demands of VDT work. The intensity and dura-

tion of visual demands, the quality of the VDT

image, and illumination are important. VDTs

have often been manufactured and introduced in

workplaces without sufficient attention to the

these factors. The National Research Council (321)report notes that “[i]n many instances . . . VDTs

have been designed without attention to existing

scientific data on image quality, and many VDTs

on the market do not provide the legibility of

high-quality printed material.” Snyder (454) has

estimated that nearly half of all VDTs now in use

are improperly designed for intensive office use.

VDTs have usually been placed into workplaces

without consideration of the available lighting.

There has been a tendency to believe that more

light creates a better environment for office work-

ers. The result is that many offices are overlit ortoo bright for certain activities. This is a particu-

lar problem in offices with VDTs, Increasing the

light level, up to a point, improves contrast and

visibility for most office tasks. VDTs, however,

emit their own light and increasing illumination

Table 7-3.--Frequency of Reported Visual Problems From Various Studiesof VDT Workers

Percent reporting frequent problemsa

Burning,itching, Blurring,

Study/type of worker Eyestrain irritation double visionHoller, et al., 1975:

VDT user . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 N.A. 7Arndt, 1980:

Telephone operatorb. . . . . . . . . . . . . . . . . . . . . . . 8 N.A. 1-5

Service assistant . . . . . . . . . . . . . . . . . . . . . . . . . 9 N.A. 1-4Accounting clerk

b. . . . . . . . . . . . . . . . . . . . . . . . . 6 N.A. 1-3

Laubli, et al., 1980:Data-entry VDT operator. . . . . . . . . . . . . . . . . . . . 20 N.A. N.A.Conversational VDT operator. . . . . . . . . . . . . . . . 28 N.A. N.A.Typist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 N.A. N.A.Traditional office worker . . . . . . . . . . . . . . . . . . . 5 N.A. N.A.

Canadian Labour Congress, 1982:VDT operator ... , . . . . . . . . . . . . . . . . . . . . . . . . . N.A. 9-17 13-16Non-VDT operator . . . . . . . . . . . . . . . . . . . . . . . . . N.A. 7-8 8-9

Sauter, et al., 1982:VDT newspaper editor . . . . . . . . . . . . . . . . . . . . . 40 43-46 N.A.

Non-VDT newspaper editor . . . . . . . . . . . . . . . . . 17 17-22 N.A.Sauter, et al., 1983:

VDT operator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 19-27 5Non-VDT operator . . . . . . . . . . . . . . . . . . . . . . . . . 20 21-23 5

aFreqUenCY of problems reported daily, constantly, often, vew often, freWJentlY.bApproximately 33 percent used ‘fDTs.

N.A. = Not available.

SOURCE: (25).



Ch. 7—Ergonomics and Human Factors q 139

levels actually reduces the contrast and visibilityof the screen image.

It is frequently suggested that the general light-ing level in a room be somewhat reduced for

screen-based work. An alternative recommenda-

tion is to provide even lower levels, with sup-plementary task lighting for reading text from

paper and for other non-VDT work. Other i l lumi-

SUMMARY

Ergonomics —techniques for examining worker-machine interactions and design of m achines tofit workers better—can be important in reducinginjuries and discomfort from repetitive motions

and other work activities. Information ergonomics

involves workers’ receipt of sensory information

and how it is processed; physical ergonom ics deals

with worker body size, strength, and stresses

while working. Generally, when faced with a

problem in the workplace, ergonomists systemat-

ically analyze the job using biomechanical, phy-

siological, psychophysical, and epidemiological

analyses; each job element is compared with fac-

tors known to be associated with overt or repeti-

nation problems that must be addressed concern

reflections off the VDT screen, glare, and contrast.

There are techniques for reducing and eliminat-

ing most of these problems and for enhancing the

ability of each worker to adjust the environment

of the VDT to fit his or her needs. Unfortunately,

these techniques have very often been ignored by

manufacturers, vendors, and employers (25).

tive trauma injuries. Changing work practices,

tools, and machine design and redesigning plant

layout are among the principal ergonomic solu-

tions. There are many examples of the incidence

of carpal tunnel syndrome and back disorders,

two common repetitive trauma injuries among in-dustrial and office workers, being reduced through

the use of ergonomic designs. In addition to pre-

venting overt and cumulative trauma injuries,

ergonomic design has been shown to increaseworker productivity and efficiency by making the

machine or tool more closely fit the worker andthe worker’s capabilities.



8.Personal Protective Equipment





8Personal Protective Equipment

Based on an analysis of the literature about per-

sonal protective equipment, OTA concludes thatthe effectiveness of many of these devices, espe-cially und er cond itions of use in the wor kplace,

has not been demonstrated. Instead, many devices

have been tested only in laboratory situations that

do not duplicate and may not even approximate

workplace conditions. The overall impression is

that test results tend to exaggerate the effective-

ness of personal protective devices. Additionally,

the few in-workplace evaluations reveal that con-

tinual maintenance and supervision, which are sel-

dom provided, are necessary for acceptable per-

formance.This discussion is divided into three parts.

Greater emphasis is placed on respirators and

hearing protectors than on all other personal pro-

tective devices. Respirators and hearing protec-

tion devices are primarily intended to protect

workers’ health, while most other personal pro-

tective devices are important for safety. Further-

more, both respirators and hearing protectors are

frequently mentioned in arguments about the costsof workplace health. They have been and con-

RESPIRATORS

Dust masks, gas masks, and devices that supply

clean air to workers through hoses or from tanks

are all called respirators. The most common are

“dust masks” that employ fiber filters to prevent

particles from being inhaled (see fig. 8-l). The sec-

ond general class of respirators are “gas masks, ”

familiar to most veterans of the armed forces.

They purify air contaminated with fumes and va-

pors by passing it through a chemical “sorbent. ”

Less common are air-supply devices. Figure 8-1

illustrates a variety of respirators. The disposable

face mask “dust mask” and the “reusable air-

purifying respirator” are negative-pressure respi-rators and rely on the wearer’s breathing to pull

“outside” air across the filter or sorbent. The other

Photo credit E.I. du Pont de Nemours & Co.

Signs are frequently used to indicate when the use ofprotective equipment is mandatory

tinue to be suggested as less expensive and equally

effective alternatives to engineering controls forhealth risks. Knowledge of the effectiveness of

these devices is thus important for making com-

parisons of the costs and benefits of personal pro-

tective equipment versus engineering controls.

respirators shown in the figure, all air-supply de-vices, are positive-pressure respirators, which

supply clean air to the wearer from a tank, from

a hose that originates in an area of clean air, orfrom a hose that supplies air that has been purifiedby passage through a filter or sorbent.

Federal involvement in testing and certifying

respirators originated in congressional and pub-

lic concern about coal mine safety. Beginning inthe Civil War period, a number of bills were in-

troduced and passed by one or the other House

of Congress to set up an agency with responsibil-ity over mineral industries. In 1910, a series of

dramatic mine disasters led Congress to establish

143





Ch. 8—Persona/ Protective Equipment 145


An example of a respirator from earlier in this century

the Bureau of Min es in the Departm ent of the In-

terior. The Bureau was interested in techniques

and equipment for use in mine rescue operations,

and, because the air in mines following cave-ins

and fires was often unfit to breathe, some effortwas devoted to development of respiratory pro-

tection.

The use of poison gases during World War I

spurred on the work of the Bureau of Mines,

which cooperated with the military to develop

masks for use by American soldiers in France. In

1919, following the war, the Bureau publishedprocedures by which manufacturers could apply

for certification of gas masks and breathing appa-ratus for use in mine rescues (438).

In 1969, Congress brought the Department of

Health, Education, and Welfare into respiratoryprotection certification. The Federal Coal Mine

Health and Safety Act of that year included the

Department’s Bureau of Occupational Safety and

Health in a joint certification and testing program

with the Bureau of Mines. A year later, the Bu-reau of Occupational Safety and Health was re-

placed by the newly created National Institute for

Occupational Safety and Health (NIOSH), and

responsibility for testing and certifying respiratorswas assigned jointly to NIOSH and the Bureau

of Mines by the Occupational Safety and Health

(OSH) Act. (The mine safety function was moved

to the Department of Labor in 1977 and is n o w

called the Mine Safety and Health Administration(MSHA).) More importantly, Federal regulations

require that industrial users select federally ap-proved respirators, if they are available.

Under authority of the Federal Mine Safety and

Health Act of 1977, NIOSH established a labora-

tory to certify respiratory protective devices, Al-

though the Occupational Safety and Health Ad-ministration (OSHA) can accept testing results for

certification from any laboratory, it has chosen

to accept only NIOSH certifications. Therefore,there is one lab oratory responsib le for respiratoryprotection certification (68).

Qualitative and QuantitativeFit Testing of Respirators

Most tests of respirator effectiveness are con-ducted in laboratories and usually maximize the

apparent effectiveness of the devices. For instance,

most air-purifying (negative-pressure) respirators

depend on the user’s inhalation to create a nega-

tive pressure inside the mask. In theory, the only

source of air to equalize the pressure is air that

passes through the air-purifying system (i.e., a fil-

ter or sorbent). The practical realization of the

theory requires that the seal between the edges

of the mask and the wearer’s face be sufficiently

tight to prevent contaminated air leaking in from

the sides.

Many factors may reduce the security of the

seal-changes in the tension of the headstraps that




secure th e mask, daily growth of facial hair orthe presence or absence of a beard, perspiration,head m ovements, and talking. Although labora-tory tests attempt to make allowances for suchfactors, no test duplicates “field situations.” Twogeneral methods are available to test whether the

respirator is properly worn, and, indeed, if a par-ticular respirator can protect an individual.

The “q ualitative fit test” relies on th e sensoryperception of the worker wearing the mask . Achemical that has a distinctive smell or taste (iso-amyl acetate, which smells like bananas, or sac-charin) or that is an irritant (stannic chloride ortitanium tetrachloride) is introduced into a cham-ber where someone is wearing a respirator. If thewearer detects the smell or irritation, the fit of the mask is judged to be inadequate. In a programdesigned to match appropriate respirators to peo-

ple with different facial shapes, other masks wouldbe tried u ntil one was found that passed the qu al-itative fit test.

The “quantitative fit test,” on the other hand,uses instrum ents to measure concentrations of thecontaminant inside and outside the mask. Forinstance, the respirator-wearing worker can besub jected to an atmosp here containin g dioctylphthalate (DOP), and instruments can be used tomeasure concentrations of DOP. This method hastwo obvious advan tages: I t does not dep end onhuman sensory perceptions, which may vary be-

tween workers and for a single worker depend -ing on a number of factors, and it provides aqu anti tative measure of how well the respiratorworks.

The quantitative measure is generally expressedas a “p rotection factor” or “PF,” th e ratio of th econcentration of the test substance outside andinside the mask. One disadvantage is cost. Thetesting requires highly trained personnel and thenecessary equipment costs up to $10,000, accord-in g to a 1978 NIOSH estimate. Another disadvan-tage is that DO P, as is the case with man y phth al-

ates, is a suspect carcinogen. Substitution of anoth er test agent is p ossible, and aerosols of sodiu m chloride (table salt) have been u sed insome tests.

Wilmes (673,674) provides a readable and in-formative discussion of the two types of fit tests.He maintains that quantitative measurements, al-though providing greater precision, are not worththe ad ditional costs. Instead, the mon ey savedfrom not doing the quanti tat ive tests would be

better spent by increasing efforts directed at in-struction of w orkers and reinforcement of goodrespirator habits, careful maintenance, and edu-cation of workers, supervisors, and managersabou t the imp ortance of respirators. Add itionally,he states that provision of different mod els of respirators, wh ich costs mon ey, is a better invest-men t because it allows workers to choose respira-tors on th e basis of comfort. A respirator that isnot worn provides no protection; having a singlemod el of respirator that, in tests, provides ex-cellent protection bu t is u ncomfortable d oes notprovide good workplace protection.

Wilmes’s position is n ot shared by oth ers. BothNIO SH an d th e Los Alamos Scientific Laboratory(LASL) endorse quantitative fit procedures. Intheir opinion, a worker’s sense of smell and tastemay be insen sitive und er certain cond itions—allowing m istakes to be m ade. Mistakes may b eespecially comm on if th e work er tries severalmasks and his or her senses become jaded to thetest sub stance. A worker wh o is in a hu rry maysay that the respirator is “okay” too quickly.Alternatively, as demon strated by a study d is-cussed later in this chapter, the worker may

“smell” the test substance even though it is notdetectable by instruments. Finally, only a quanti-tative fit test provides information about the de-gree of protection.

Disagreements about the merits of quantitativefit tests have been going on for years, with OSHA,for instance, taking different positions at differenttimes. The lead stand ard that became final in 1978

required quantitative fit testing. However, revi-

sions m ade in 1982 allow q ualitative testing. If,as is expected, NIOSH formally requires quanti-tative tests in its revised respirator testing regu-

lations, the argumen t abou t certification tests willbe settled. Arguments will probably continueabout what methods employers should use to fitrespirators.






At the end of the first phase of testing, LASLassigned PFs to the classes of respirators it tested

and extrapolated PF values for other classes (219).

As expected, positive-pressure masks provided

higher PFs, from 1,000 to 10,000. Positive pres-

sure tends to blow contaminants away from any

leaks or ventings around the mask, minimizingthe influence of differences in p ersonal anatomy.

By contrast, negative-pressure respirators tendto suck contamin ants into th e protective mask through any openings, which makes proper f i t-ting critical. The highest PF assigned to any classof negative-pressure respirator was 50, althoughsome specific respirators in some classes achievedmuch higher PFs. The PF assigned to a class was

judged to be applicable for all respirators of thatclass that are used in a resp irator program that

includes routine equipment maintenance and qu al-

itative fit testing.In a subsequent phase of testing, LASL meas-

ured PFs for other classes of respirators and com-pared them w ith the extrapolated PFs. In the ex-amples of this work given in table 8-1, measuredPFs were foun d to b e higher for positive-pressurerespirators than the earlier extrapolated values,and the m easured PFs for a class of negative-pres-sure masks was lower (196).

Also shown in tab le 8-1 is an exception to thegeneral trend of extrapolated values for positive-pressure respirators underestimating their effec-tiveness. NIOSH (580), after a complaint,, earnedout field stud ies of one model of “high -efficiencyPowered Air-Purifying Respirator (PAPR)” and

found that measured PFs in the w orkplace weresignificantly below the PF of 1,000 extrapolatedfrom LASL tests.

Before 1969, when the LASL studies began, noone had conducted laboratory tests of respiratorsin a systematic fashion. Furthermore, the first fieldstudies of respirator effectiveness were not pub-lished until 1973 (see section on field testing laterin this chapter) and few have been reported. Twomillion workers who wear respirators rely on thislimited research for assurance of protection.

“Dust Masks"

The progenitor of the m ost widely used typeof respiratory protection was a defective bra cupthat fell off an assembly line in 1972. “Someonewith a bright idea at 3M Corporation clipped an

elastic band to the fiber cup and produced the first

disposable dust mask, which, with some modifi-

cations, now claims the largest share of the multi-

Table 8-1.—Comparison of Extrapolated and Measured Respirator Protection Factors

Extrapolated

Pressure protectionClass of respiratora

in mask factor Measured protection factor

Loose-fitting supplied air hood . . positive 2,000b,c

2 tests <1,0009 tests 1,000-10,000

36 tests >10,000

47 tests totald

Continuous-flow supplied air:Half-mask ., . . . . . . . . . . . . . . . . positive 1,000 10,000 (combined results,Full-facepiece ... , . . . . . . . . . . . positive 2,000 both half- and full-facepiece)e

Pressure demand:Half-mask . . . . . . . . . . . . . . . . . . positive 1$300 20,000 (combined results,Full-facepiece . . . . . . . . . . . . . . . positive 2,000 both half- and full-facepiece)e

Demand:Half-mask . . . . . . . . . . . . . . . . . . negative 10 <5 (93 percent attained PFFull-facepiece . . . . . . . . . . . . . . . negative 50 of 5)*

Powered air-purifying respirator(PAPR) . . . . . . . . . . . . . . . . . . . . . positive 1,000 <15 percent achieved PF of

1,000f

~h e respirators are descrlbad in Working Paper #9.bprotectlon factor (pF) reached by at least 95 percent of subjects wearing any respirator of that class

cHyatt (219).dbu~la~l Hesch, and LOWV (152)

‘Hack, et al. (196)

‘NIOSH (580)

SOURCE Office of Technology Assessment from cited references.



Ch. 8—Personal Protectlve Equipment q 149

Photo credit: NIOSH

A worker wears a powered air-purifying respirator(PAPR) during a NIOSH field study

million dollar market for industrial respirators. . .“(178a).

Lowry, Hesch, and Revoir (272) tested sixmasks on a p anel of 5 males and 5 females. Qu an-titative measurements of th e leakage of sodiumchloide aerosols into the masks showed that onlytwo of the six masks provided a PF of at least 5for all 10 subjects. These find ings suggest th at the

LASL study (219), which had earlier assigned aPF of 5, overestimated the effectiveness of dustmasks.

Interestingly, the dust masks failed to providea PF of 5 far more often for females than formales. Gillen (181) pointed out that two modelsthat, as tested, provided a PF of at least 5 for menwould fail to provide that level of protection for

17 percent of wom en because of differences in facesize. Another model that, as tested, provided aPF of at least 5 for 94 percent of m en w ould failto provide that level of protection for 56 percent

of women. Given the large number of women em-ployed in some dusty trades, such as the textileindustry, and the increased participation in the la-bor force by women, the poor level of protectionaccorded women is especially noteworthy.

There is often little warning that a du st maskhas failed to p rovide protection. In very du styworkp laces, the first indication m ay be streaks of dust on the worker’s face. Short of such drasticfailures, tasting or feeling the dusty material onthe mou th or nose may alert the work er to the

absence of sufficient p rotection. On the otherhand, a person’s senses may become acclimatedto the dust, rendering the worker unable to detectthe mask’s failure.

Field Testing of Respirators

Duplicating a worker’s movements and activi-ties in a laboratory is difficult. In the course of a day, a worker walk s or rides or run s from placeto place, reaches and lifts, bends and stretches,gestures and converses, eats and drinks. Each of those actions may affect the fit of a respirator,

and some of them requ ire its removal. Even if therespirator, at the start of the workday, providedprotection equivalent to that measured in the lab-oratory, it is unlikely that th ose cond itions wou ldprevail at the end of a shift.

A few reports describe field testing of respira-tors. The m ore soph isticated tests in volve at-taching one sampling device to the worker’s cloth-ing and one inside the respirator and measuringconcentrations of airborne dusts, fumes, andvapors inside and outside the respirator. Otherevaluations depend on collecting “pencil and pa-

per” data about whether government-approvedrespirators are used in the workplace, whether themask is the appropriate type for the hazard,whether respirators are worn correctly and at theright times, and w hether the equipm ent is prop-erly maintained.

Protective Factors Realized in Field Studiesof Respirators

NIO SH (59) has reported on th e use of respira-tors in the ab rasive blasting indu stry durin g 1971-73. The

results were not encouraging. PFs (whichaccording to current NIOSH usage would be pro-gram protective factors; see box F) ranged fromless than 2 to 3,750. Lower PFs were associatedwith poor maintenance, poor training, poor fit-




ting of respirators, and inadequate supervision of use. Although in m any cases inappropriate res-pirators were used, low PFs (2 or less) were foundin at least some cases with all types of respirators,pointing to problems of fit, maintenance, and use.

Similar findings of poor respiratory protectionwere also reported in NIOSH-contracted studiesof paint-spraying operations (481) and coal min-ing (200,201,202). The coal mine study measuredthe effective protection factor (EPF) and theworkplace protection factor (WPF).

The EPF was determined by measuring dust

concentrations inside and outside th e respiratordu ring a complete worksh ift, wh ether the respira-tor was being used or was hanging from the wear-er’s neck. Twenty tests (11 percent) produced EPFsgreater than 10; 54 (29 percent), less than 2.0; and

16(9 percent), less than 1.0. The EPFs of less than1.0—which mean that the concentration inside themask was higher than the concentration outside—are thought to have resulted from dust collectingin respirators while hanging around miners’ necks.On e general conclusion reached from the stud y

was that miners did not wear their masks enough(201).

The WPF was measured du ring a half-shifttimespan after the respirator was donned accord-ing to the manufacturer’s instruction. As expected,WPFs tended to be h igher because of the atten-tion given to fitting the respirators. Two respira-tors produ ced mean average WPFs of greater than11 on all nin e of the min ers who p articipated inthe stu dy; all five tested respirators produ cedWPFs greater than 5 on all nine men. Therefore,the observed WPFs show that PFs approachingthose measured in the laboratory can be achieved,at least for relatively short periods of time undercond itions of close observation and continu oususe. However, the EPFs show that th ose highlevels of protection w ere seldom reached un derconditions of normal use.

Smith , et al. (450) observed a wid e range of EPFs (from 1.12 to 146) in a stu dy of cadm iumworkers, which resulted partly from workers de-ciding w hether or not to w ear respirators in d if-ferent situations.

The paucity of information on how effective

respirators are in the workplace is well illustratedby the observation of these authors that “only oneother published stud y was found on the effectiveprotection provided by intermittent respiratorusage.”

The major—and, in retrospect, perhaps obvi-ous—conclusions reached from the p apers byHams, et al. (201) and Smith, et al. (450) are thatrespirators do n ot afford protection u nless theyare worn and that the degree to which they af-ford protection depends on how well they fit andhow well they are maintained.

Figure 8-2 illustrates the rapid decrease in EPFas the tim e the respirator is not worn increases.The uppermost curve shows that not wearing aresp irator wi th a WPF of 10 for 1 minu te eachhour reduces the EPF to 90 percent of the WPF;



Ch. 8—Personal Protective Equipment 151

Figure 8-2.—Effect of “Non-wearing” on the Effectiveness of Respiratory

100 J

Protection

0 1 2 3 4 5

Minutes respirator is not worn per hour

SOURCE Adapted from (403)

for 6 minutes, it drops to less than 70 percent. The results of field testing. The LASL

EPFs, then, if a respirator with a WPF of 10 is assigned a PF of 10 to half-mask,

6

studies (219)air-purifying

not worn for 1 minute or 6 minutes each hour

become 9 and less than 7 respectively. The per-

centage decrease increases with higher WPFs; arespirator with a WPF of 100 that is n ot worn for1 minute per hour provides an EPF of only about40; if not worn for 6 minutes, the EPF is only

abou t 10 (403).

Before turning from the limited informationabout effectiveness of respirators in the work-place, the protective factors assigned on the basisof laboratory tests can be compared with the

respi rators. In th e coal min ers’ study (201), anoverall median EPF of 3.2 was observed; in thecadmium workers’ study (450), a geometric meanof 3.9 was noted, “which compares favorably withthe median 3.2 found by Hams, et al.” Overall,then, the protection factors realized by workers

in those two stud ies were about one-third th osepredicted in the laboratory.

The mean and median (or average) effective

protective factors obscure the high and low EPFs

obtained by some workers. In the study of coal




miners, 11 percent of EPFs exceeded 10; some wereas high as 20. In the cadm ium workers’ stud y, 22percent of EPFs exceeded 10. Furthermore, in thelatter study, one “fastidious worker,” who wasexposed to th e highest levels of cadm ium alsoachieved th e highest EPF. On the oth er hand ,

abou t 9 percent of min ers achieved EPFs of lessthan 1.0 and 29 percent had less than 2.0 (450).

Miners who realized EPFs of less than 1.0 wereworse off than if they had not worn a m ask atall. Those achieving EPFs of less than 2.0 w erelittle better off although th ey might h ave thoughtthey were protected from airborne hazards.

Dixon and Nel son (145) and Myers (315) re-ported EPFs that stand in mark ed contrast to thosereported ab ove. The first auth ors found WPFsrangin g from 40 to greater than 27,000 for work -ers who had been instructed in the proper use of respirators and w ho wore masks du ring the 30

min utes to 2 hou rs necessary to complete specifictasks. One reason offered for the greater efficiencywas the use of a new model of respirator (146).Use of silicon rub ber for the facepiece produ cesa much more comfortable fit with the face, andthe mask can b e worn for longer periods withoutcausing discomfort that leads to easing the respi-rator off th e face.

By another measure, Dixon and Nelson (145,146) determined the Program Protection Factor(PPF) for a respirator program directed againstlead. In six of seven groups of w orkers wh o wore

respirators, the PPF was about 36. Technicalproblems prevented accurate measurement of thePPF in the seventh group, but those workers alsoachieved significant protection.

Myers (315) measured WPFs in a primary leadsmelter and a blast furnace area. The medianWPFs were 450 and 130, respectively, with rangesfrom 110 to 2,200 and from 10 to greater than1,700. (The respirators that w ere used in th osework places had rated p rotective factors of 10based on the LASL studies.)

Dixon and Nelson (146) state that higher WPFswere seen in their own work and in Myers’ studiesbecause the research w as carried out in w ork-places with good respirator programs an d “ade-quate fit testing.”

Several reports of studies of respirator effective-ness in the workplace are soon to appear or have

just b een p ub lished (674a). The fou nd ing in 1982of a new professional society, the InternationalSociety for Respiratory Protection, and its pub-lication of an international journal are expected

to increase the availability of information abouttesting.

Deficiencies in Respirator Programs

Nicas (329) prepared a working paper aboutrespiratory protection p rograms for the use of un ions affected by the cotton du st and lead stand-ards. The paper drew attention to deficiencies inmany respirator programs because of poor main-tenance and supervision, to the limited testing of respirators in the workplace, and to the costs of maintaining an effective respirator program.

The sometimes high cost of a proper respira-tory protection program (111) was suggested asa bargaining chip in labor-management negotia-tions about whether to install engineering controlsor depend on respirator programs. The paper byNicas (329) is especially interesting because it pro-vides a concise, readable review of the respiratortesting literature. As it is available only in aph otocopied form, it has a l imited distr ibution,however.

Dixon an d N elson (146) point out the impor-tance of good respirator programs in achieving

high protection factors. Rosenthal and Paull (402)examined OSHA inspection records to determinehow frequently respirator programs were cited forfalling below OSHA standards. From 1977 through1982, at least one respirator program violationwas found in about 10 percent of all OSHA healthinspections. “All” health inspections includes thoseof establish men ts that have no respirator pro-grams. They (402) estimate that 27 percent of allrespirator programs were in violation of all

OSHA respirator program standard. This percent-age was constant over the 6 years from 1977 to

1982. The importance of respirator programs is

underlined by their finding that respirator pro-

gram deficiencies were found in 40 to 70 percent

of inspections in which overexposure was docu-

mented.



— -.


Adequate respirator programs include provid-ing, maintaining, and insisting on the properwearing of respirators. Given that more th an aqu arter of all OSHA-inspected respirator pro-grams are cited for noncompliance, simply pro-viding good respirators in a workplace is not

enough. Occupational health professionals insistthat careful attention to the respirator programis essential, and they also point out that the costsof such a complete program must be figured intoany comparison made between engineering con-trols and respirators (111).

NIOSH Certification of Respirators

NIOSH tests complete respirator systems con-sisting of the mask and any air-purifying filters,cartridges, and canisters or air-supply apparatus.The agen cy certifies the respirator for sp ecified

uses (for instance, against a particular chemical)and if the manufacturer subsequently decides thatcertification of the same respirator against anotherhazard is needed, the new use must be su bmittedfor NIOSH approval.

As part of this program, NIOSH purchases res-pirators from suppliers and checks that they meetcertification stand ards. Addition ally, a programthat was initiated to investigate complaints aboutinadequ ate respirator performance has been ex-panded to include field studies. The latter programhas been under way since 1981, and reports from

it are now appearing (315 and see below).In large part, NIOSH’s testing specifications (30

CFR Part 11) were developed, published, and re-

vised by the Bureau of Mines from 1920 through

1970. Those somewh at d ated specifications ad opted

by NIOSH in the early 1970s have been criticized

by industry (305,393) and Government officials

(360,572) because they are believed to restrict in-

novation in respirator design and to be inappro-

priate for testing devices that will be used in the

workplace (360, 610). To date, however, oppo-nents of the current regulation have been unsuc-cessful in gett ing a new version ad opted.

Increasing em ph asis on workp lace health h asbeen accompanied by a greatly increased workload ; in 53 years, the Bureau of Mines approved340 devices, or about 6 each year. In 1981, NIOSHissued 99 new approvals (67). This large number

of approvals does not show that innovative res-pirators have been introduced, for each time an“old” design is cleared for a new use, it receivesan addit ional approval.

In general, the resources of NIOSH are seen asbein g woefully inad equ ate to carry out all thedesired activities in the area of respiratory pro-tection research and development, testing, andcertification (305,393).

OTA staff heard many complaints about NIOSH’stesting and certification program—primarily thatit was slow, bureaucratic, restricted innovation,and depended on outdated criteria for an accept-able respirator. While all those complaints evi-den tly have some basis in fact, NIO SH is far fromsatisfied with all the companies in the respiratorind ustry. For instance, the first test that N IOSHapplies to a respirator when it arrives for testing,

“the shake test, ” reflects that quality control is notalways good. In that test, a NIOSH employee

takes the respirator out of the box in wh ich it ar-rives, shakes it vigorously, and if some p iece fallsoff, the mask is sent back to the m anufacturer.

Possible Changes in NIOSHCertification Procedures

NIOSH is considering changes in its respiratortesting regulations that would shift responsibilityfor testing from the NIOSH laboratory to themanufacturers (344). This approach follows sug-

gestions by a group of five consu ltants to NIOSH(73) wh o conclud ed th at routine testing consumedtoo many resources and that the current proce-dures lacked a feedback loop to alert NIOSH tofailures in respirators that were already on themarket. Evidently, the revisions forwarded to Dr.Donald Millar, the Director of NIOSH, in earlysum mer 1983 wou ld allow self-certification, bu the was not satisfied that NIOSH retained enoughauth ority to assure itself of the validity of theman ufacturers’ tests. The revisions are bein gredrafted.

These chan ges would significantly alter theprocess of test ing respirators. NIOSH would nolonger receive samples of respirators and evaluatethem in its own lab oratory. Instead, manu fac-turers would test respirators against standards tobe developed by N IOSH, and, wh en they are



154 q Preventing illness and Injury in the Workplace

satisfied that th e devices meet th e requiremen ts,they would be allowed to represent th e respira-tor as up to NIOSH standards. NIOSH’s rolewould be essentially twofold: It would write thestandards, and i t would carry out “spot checks”of respirators on the market .

To play a more active role in self-certification,NIO SH may, as part of the revised 30 CFR Part

11, reserve the right to see any data produced by

manufacturers in the self-certification process. Inaddit ion, i t could require notif ication by m anu-facturers of any major modifications in theirproducts .

The reported information (344) did not m entiona feedback loop for manufacturers or users to alertNIOSH about failures in respirators. Such a proc-ess would seem to be necessary to ensure thatNIOSH could alert users to possible difficulties.

Union representatives, while generally support-ing changes in the regulations about testing andcertification that would make the tests more pre-dictive of workplace performance, favor NIOSHcontinuing its testing and certification. One areathey single out for attention in any revision ischanges in the recertification process, by whichrespirators are removed from commerce and usewhen NIOSH finds they are deficient (610).

There are many rather vague suggestions thatthe testing requirements of 30 CFR Part 11 bechanged to encourage innovations in respirator

design. John Moran, then chairman of the respi-rator Research Subcommittee and now directorof Safety Research at NIOSH, made a specific sug-gestion (310): that a minimum standard b e set forapproval of all respirators of each class, as is nowdone, and that higher standards also be indicated.In this way, a manufacturer who produced a res-pirator that was significantly better than otherson the market would be rewarded with a higherdegree of certification, which would be useful inmarketing.

HEARING PROTECTORS

Exposure to continuous noise at levels greaterthan 80 decibels (dB), about th e noise level of agarbage disp osal at 3 feet or of a diesel truck trav-

Third= Party Testing of Respirators

An alternative both to NIOSH testing and cer-tification and to self-certification would be to havethe testing done by a third party, such as theSafety Equ ipm ent Institu te (SEI), wh ich springs

from the In du strial Safety Equ ipm ent Association(334). SEI wou ld u nd ertake certification on lyif

NIOSH leaves the field of routine respiratortesting, for there is no future in being a competi-tor with Government testing and certification. (Adescription of SEI testing of other personal pro-tective equ ipmen t is provided at the end of thischapter. )

SEI argues that a third-party laboratory wouldfree the Government from routine testing and pro-vide public assurance of higher quali ty test ingthan is p ossible u nd er self-certification. If ar-rangements were made for a third-party certifica-

tion program, SEI estimates that it could estab-lish a program within a year by contracting withexisting laboratories (672). Other estimates arethat 2 to 3 years would b e needed to equ ip andstaff an adequate testing laboratory (610).

The idea of a third-party testing and certifica-tion program is supported by some manufacturersbu t not others. Those who su pp ort it see an op-portunity to have a m ore t imely and responsiveprogram than NIOSH has been able to provideand, at the same time, to increase acceptance overwhat would be expected from self-certification.

Supp orters draw an analogy between the su g-gested function and the Underwriters Laboratorythat certifies many electrical devices. Those whooppose third-party certification see it as essentiallya self-certification p rogram b ecause safety equ ip-men t man ufacturers are involved in SEI’s direc-tion; although these critics do not fau lt self-certi-fication, they are uneasy about a third-partytesting program that they see as under control of the manufacturers.

cling at 40 miles per hour so feet away, may beassociated w ith p rogressive loss of hearing. Noiseabove 90 dB is definitely associated with hearing



Ch. 8—Personal Protective Equipment q 155

loss. Redu ced noise exposures can be accom-plished by engineering controls (redesigning, muf-fling, or enclosing machinery or providing work-ers with soun dp roof areas), by adm inistrativecontrols (reducing the time workers spend in n oisyareas), and by use of hearing protectors that re-

duce the level of noise reaching the workers’ ears.OSHA requires employers to reduce workpace

noise levels to 90 dB (about the noise level en-countered in a newspaper press room) by the useof engineering or administrative controls. Whensuch controls are infeasible or cannot achieve 90

dB, employers must issue and require the use of hearing protectors to reduce the noise exposureto less than 90 dB (29 CFR 1910.95). In add ition ,any worker who has lost a certain amount of hearing ability, as defined by OSHA, must wearhearing protectors if exposed to noise greater than

85 dB. The hearing p rotectors must work wellenough to reduce the noise that reaches the work-ers’ ears either to no more than 90 dB or, if somehearing loss has already occurred, to no more than85 dB.

Hearing Conservation Programs

Programs designed to reduce hearing loss gen-erally have three components: identification of noisy areas; implementation of engineering, ad-ministrative, and personal protection controls to

reduce exposure to noise; and au diometric testingof work ers to check th at the controls are protec-ting hearing. Hearing protectors are an essentialpart of hearing-conservation programs.

Econom ic considerations m ake it un likely thatnoise can be reduced at the source to acceptablelevels in the immediate future and isolation of workers in sound-attenuating enclosures or reduc-tion of an individ ual’s exposure tim e is not always

practical (389).

The Du Pont Compan y has maintained a pro-gram to protect workers’ hearing since the 1940s(364). A stud y was un dertaken of the h earing acu-i ty among w orkers in three d ifferent si tuations:qu iet, office-like areas; work areas w ith noiselevels in the general range of 85 to 94 dBs; andthe noisiest work areas. Each of the men in thestudy worked in one of the three noise levels for5 years. The ability of each to hear noise at

various frequencies was established at the begin-nin g of the 5-year exposu re period an d testedagain at the end.

Evidently the hearing conservation programwas q uite su ccessful over a period of at least 5years. Changes in the hearing levels of workers

in the three noise levels were essentially the sameand d id not vary depending on the hearing levelobserved in the first measurement. The latter pointis important because there is the possibility thatworkers who are already hearing-impaired mightbe more sensitive to continued noise. Results fromthe Du Pont study (364) showed that hearing-im-paired workers, as well as workers with n ormalhearing, were protected from further loss of hear-ing by a program that used hearing protectors innoisy areas.

Despite those results, some reservations must

be attached to the conclusions draw n from th estudy. Hearing loss is known to increase with timeof exposure, and studies conducted over periodslonger than 5 years are necessary to be certain of the continued success of hearing conservation pro-grams. The importance of longer-term studies isapparent when it is remembered that many peo-ple w ork 40 to 45 years, and th eir hearing sh ouldbe conserved throughout that t ime.

Temporary Threshold Shift

Immediately following exposure to a suffi-

ciently loud noise, the ability of a person to hearquiet noises is reduced. Over time, unless therehas been permanent hearing impairment, the abil-ity to hear quiet noises will return. Temporaryloss of hearing acuity is called tem porary [hear-ing] thresh old sh ift (TTS).

In hearing conservation programs, hearing testsare administered 14 hours after the last exposureto loud n oise so that TTS will not interfere in theperson’s ability to hear. Richman (387), however,argues that hearing loss involves a lengthen ing of the period of TTS. He suggests that audiometrictesting within 4 or 6 hours after exposure wouldpick up cases of TTS, and altered TTS readingswould alert the responsible authorities that hear-ing p rotection w as insu fficient. (Of course, in or-der to have a baseline for comparison, the initialhearing tests should b e made 14 or more hours

after the last noise exposure. )




By changing the t ime of routine aud iometrictesting to within 4 to 6 hours after exposure,Richm an (387) believes the tests w ould be m oreuseful for prevention of hearing loss. Testing onlyat 14 hours after exposure, he feels, leaves the testsunable to predict permanent hearing loss before

i t can b e prevented.

Methods of Aud iometric Testing

Riko and Alberti (389) briefly describe the threeclasses of audiom etric testing, which d iffer in theamount of reliance they place on the human senseof hearing as opposed to the ability of instrumentsto detect noise.

Real-Ear Attenuation at Threshold.—Thismethod depends on a person’s report of being ableto hear sounds. It resembles the classic “hearingtest” of a nurse or doctor whispering across the

room and asking the patient if the whisper canbe heard. In the workplace and in clinics, the real-ear attenuation at thresh old (REAL) test involvesplacing someone in an acoustically quiet room andusing earphones to generate defined levels of noiseat various frequencies. The worker then puts onhearing protection, and the machine generatesnoises at the same frequencies. The difference inthe intensity of noise that is heard with and w ith-out th e protectors is a measure of th e protectionafforded.

The REAL test is used more common ly than th e

other tw o tests (“semiobjective” and “objective”)described here. The audiometric tests used in hear-ing conservation programs are similar; the low estintensity of sound that a worker can hear is deter-mined and recorded at the t ime of f irst emp loy-ment. Subsequently—at the t ime of an annualphysical examination, perhaps—another REALtest is administered.

Semiobjective. —This method eliminates thecomplete dep enden ce of the REAL method on aperson’s hearing, which is, to some extent, subjective. In the semiobjective test, a tiny micro-

phone is positioned in the ear and the noise energyis measured with and without a protector in place.The major drawback of this test is that it is vir-tually impossible to evaluate any protectors thatare inserted into the ears.

Objective. —This method also uses micro-ph ones to detect noise levels, but it uses “an arti-ficial head or ear” instead of a hu man subject. Al-though it is attractive to manufacture of hearingprotection devices because it would be convenientfor quality control, it has proved to be very dif-

ficult to simulate a human head.

Acceptance of Hearing Protectors

OSHA’s noise standard and its Hearing Conser-vation Amendment (625, 640) require employersto provide hearing protection to their employeesand ensure that the protectors are worn. Compli-ance with requ irements to wear h earing protec-tors is undermined by dissatisfaction with the de-vices. Workers often object to wearing earmuffsin hot, humid conditions, and earplugs are so un-

comfortable that some workers reject them. Ad-ditionally, earplugs can contribute to infectionsin d usty, dirty environmen ts, and earmuffs can-not be w orn with glasses.

Furthermore, althou gh some h earing protectorsare more comfortable than oth ers, they all workby creating a physical barrier to the passage of sound, The seal between the protector and theworker’s head or ear is of great importance to theeffectiveness of the protector. In general the sealis created by p ressure. The pressure creates dis-comfort and , for some work ers, pain .

An interest ing stud y (686) demonstrated thatqu ick feedb ack abou t the value of hearing p ro-tectors promoted their use. Hearing tests wereadministered to some members of a metal fabrica-tion department at the beginning and end of theirwork shifts on 2 days over a l-mon th p eriod. Ex-posure to workp lace n oise reduced aural acuitysufficiently that pre- and post-work hearing testsdiffered when hearing protection was not worn.The people providing the tests discussed the im-plications of the results with workers, who con-gregated around the results that were posted inthe department, unti l everyone understood the

meaning of the test results.

According to the authors, workers’ apprecia-tion of the value of the protectors resulted in achange in accepted behavior; 5 months after the




program began, 85 to 90 percent of the workersin the department wore their hearing protectors.

In contrast, only 10 percent of workers in another,

equally noisy, department who received a “stand-

ard lecture” about hearing conservation protec-

tion wore hearing protection. A subsequent at-

tempt to discipline workers in that departmentwho did not wear hearing protectors failed be-

cause of both union and management resistance.

Union members objected because the disciplinary

action (removing workers from the noisy depart-

ment) reduced the workers’ earnings, while man-

agement did not like losing the services of experi-

enced workers.

Noise Reduction Ratings

As a result of the Noise Control Act of 1972,the Environmental Protection Agency (EPA) be-

ginning in 1979 required that all hearing protec-tors be labeled with a noise reduction rating(NRR). The NRR is a single number that describes

the attenuation of noise that can be expected from

wearing the protectors. NRRs are used in connec-

tion with measured noise levels in the workplace

(640) to select appropriate hearing protectors.

As discussed in the beginning of this chapter,

all models of each class of respirator receive the

same protection factor, and only extrapolated PFs

are available for some classes of respirators(219,580). In contrast, EPA required that each

model of hearing protector be labeled with its ownNRR.

Problems With N oise Reduction Ratings

The importan ce of accurately determ ining NRRs

was recognized by EPA, and that agency con-

ducted a study to determine if NRRs were in

agreement by having four models of hearing pro-

tectors tested in seven laboratories. The NRRs re-

ported on the labels of the four models tested had

all been determined in a single laboratory, which

was referred to as laboratory 8 in the study. Al-

though EPA was unable to analyze the results be-cause of budget cutbacks, three employees of two

private-sector companies did analyze the study (50).

The various laboratories differed quite consist-

ently in measuring NRRs. That is, each labora-

tory tended to report low, medium, or high NRRs,

in comparison w ith the others, regard less of wh ich

device was being tested, The auth ors felt “this fact

suggests the likelihood of a systematic bias in the

testing procedure. ” The paper explores the influ-

ence of proper or improper fitting of the hearing

protector, subject selection and training, and data

reduction techniques in producing the variabilityamong the laboratory measurements.

Perhaps the most striking finding was that

The labeled NRRs for all four devices werebased upon data from Laboratory 8, and eventhough in some cases they were d erated by themanufacturers, all devices would have failed anEPA comp liance aud it test cond ucted at any on eof the other seven facilities. This w ould have r e-quired relabeling. Since there now will be no en-forcement of the labeling regulation [because of EPA bud get cutbacks], it is likely that m anu fac-turer’s data w ill continue to reflect the highestmeasurable values found today.

OSHA Use of Noise Reduction Ratings

One of the authors of the paper that comparedNRRs measured in d ifferent laboratories presentedsimilar evidence to OSHA du ring a hearing onthe Hearing Conservation Amendment (48). Inaddition, he said that the laboratory that reported

the highest NRRs was responsible for “85 percent

of manufacturers’ reported NRRs. ” He also ex-

pressed the opinion of his company (E.A.R. Divi-

sion of the Cabot Corp. ) that the NRRs shouldbe “de-rated” for two reasons: the generally high

NRRs determined by laboratory 8, and the sub-

stantial difference between results of laboratory

and field testing of hearing protectors.

OSHA mentions this testimony in its latest pre-

amble to the Hearing Conservation Amendment

(640), and says that it will consider it in anymodification of the noise standard. In a 1983directive, OSHA has instructed its inspectors not

to cite exposures between 90 and 100 dB as viola-

tions of the hearing conservation standard pro-

vided that the employees are wearing adequatehearing protection. “Adequate” was described as

the NRR de-rated by 50 percent.

The situation regarding noise reduction ratings

needs correction, but there appears to be little

chance of that hap pening. A pu blished report has




presented evidence that the NRRs that appear onpackage labels are higher than the NRRs deter-mined in seven of the eight laboratories equipped

to carry out the appropriate tests (so). A com-

pany that manufactures hearing protectors has

written OSHA that the effectiveness of its prod-

uct is overstated and that the protection offeredby the p rotectors in the field is lower than thatobtained in th e laboratory. The Agency (EPA) re-sponsible for ensuring that NRRs are assigned tohearing protectors and that they are accurate hasdiscontinued i ts NRR program b ecause of bud -get cutbacks and evidently will not change existingNRRs. OSHA has instructed inspectors that theNRRs are in error, bu t OSH A’s instru ctions toemployers about selecting appropriate hearingprotection (640) continu e to rely on NRRs thatare almost certainly too high.

Field Testing of Hearing Protectors

Poor agreement b etween laboratory and fieldtests was demon strated by a NIO SH test of 420

workers at 15 industrial plants (267). Fifty per-

cent of the workers achieved considerably less

than half the potential protection demonstratedin the laboratory (table 8-2). Also shown in thetable is the level of protection achieved by th e 10

percent of workers who received the least protec-tion. At least 10 percent of the users of preformedtypes of hearing protectors received no protection;

at least 10 percent of the users of the other types

of “earplug” hearing protectors received only 3dB protection.

These results are consistent with the findingsof Riko and Alberti (389), who measured the at-tenuation of noise achieved by 400 workers using

their own protective devices. Although they do

not present numerical results, they state

. . . for both muffs an d plugs, the average at-tenuation w as less than that expected from m an-ufacturer specifications and was considerably lessthan th eir theoretical potential. Mean attenuationwas n ot as revealing, however, as the scatter of attenuation scores, which was wide. For given fre-quencies, values ranging from O to 50 dB betweenindividu als were obtained . The use of standarddeviation measurement was avoided deliberatelybecause the distribution of attenuation w as notsufficiently uniform and was skewed in the direc-tion of poorer attenuation values.

Riko and Alberti’s comments about the scatterof attenuation are often repeated in discussinghearing p rotection. Although some work ers ob-tain satisfactory protection, others obtain noneor hardly any. In some cases, the hearing protec-tion simp ly doesn’t fit or doesn’t work . The solu-tion generally suggested for that problem is to of-fer the worker a variety of protectors so thatcomfortable ones can be selected; the worker’sselection should be checked by an audiometric testto be certain that it provides hearing protection.Another solution is to reduce noise exposu res

through engineering controls.

Table 8-2.—Comparison of Noise Reduction Achieved by Insert-TypeHearing Protector In the Laboratory and in Field Use

Median noise reduction ratingsa

Protection obtained byType of protector laboratory field lowest 10°/0 in fieldb

All earplugs. . . . . . . . . . . 28 13 —

Preformed types. . . . . . . 29 7 0Acoustic Wool . . . . . . . . 26 10 3Custom-molded

c. . . . . . 20 3

Acoustic foam . . . . . . . . 36 : 3%Aeaeurementa in dB.bAvarage noise reduction mhlevm by tha 1(I percent of workera who obtained tha pooreet nOISe ProtOCtlon.cln one plent, the Custorn.rnolded earpiuga wera fabricated by the plant nurse; In the other PlOnt, thay were fabricated by the

manufacturer.

SOURCE: (267).



Ch. 8—Persona/ Protective Equipment . 159

OTHER TYPES OF PERSONAL PROTECTIVE EQUIPMENT

NIOSH tests and certifies respirators, but no

other personal protective equipment. Formerly,

NIOSH also tested and certified several types of

measuring equipment, such as gas detector tubes,

coal-mine-dust personal sampler units, and indus-trial sound-level meters, but these programs were

discontinued in 1983.

According to NIOSH, some equipment is ad-

vertised as meeting “Federal” or “OSHA” stand-

ards. In fact, there are no general Federal or

OSHA standards for personal protective equip-

ment. In some regulations OSHA requires thatsafety equipment be worn and stipulates that theequipment meet certain requirements, generallyANSI standards. NIOSH concluded that the “Fed-eral” or “OSHA” standard statements arise from

those requirements.Personal protective equipment other than res-

pirators is “self-certified” by the manufacturers,wh o may test it to determine if it meets ANSIstandards. Equipment that conforms to the stand-ard can be so advertised. Since few purchasershave the facilities, professional staff, and otherresources to test safety equipment, knowing thata device meets ANSI standards should provideassurance to the purchaser and user that the equip-ment will provide a specified level of protection.

NIOSH TestsIn the mid-1970s NIOSH purchased samples of

personal protective equipment that was advertised

and sold as meeting ANSI standards. NIOSHtested the samp les to determine if they did, in fact,

meet the appropriate standard.

In several cases NIOSH noted some ambiguityin the ANSI standards. Because of the possibility

of various interpretations of some standards,

NIOSH called together representatives of manu-

facturers, labor unions, and Federal agencies to

discuss the test procedures to be used in evalua ting

the particular classes of equipment. In all cases,NIOSH tested equipment against the ANSI stand-

ard, sometimes including mod ifications mad e after

the meeting; the agency did not draw up its ownrequirements.

The principal finding from the NIOSH tests wasthat many items of personal protective equipmentdid not fun ction as expected, given th e ANSIspecifications (see table 8-3 for a summary of the

data in this section).

Head Protection

Hard Hats.—Protective headwear, all of whichis designed to protect against impacts, is classifiedas A, B, or C depen din g on its resistance to trans-mitting electricity. Class A requires limited elec-trical protection, Class B requires higher electri-cal protection, and Class C requires no electricalprotection. (Reviewers of drafts of this report re-marked on th e classification that p laced th e mostprotective un its in th e mid dle of an A-B-C classi-

fication scheme. )NIOSH tested Class B industrial helmets “be-

cause they, as a class, offer the most comprehen-sive head protection available to the industrialworker.” The tests revealed a distressingly highfailure rate. Only 4 of the 21 tested models passedall the ANSI p erformance tests. On ly 7 passed theimpact resistance test; 16, the electrical resistancetest. Hats that failed the impact test were foundto transmit too much force, and those that failedthe electrical test did not insulate as well asclaimed.


Many employees are now required to wear hardhatsduring the workday



160 . Preventing illness and Injury in the Workplace

Table 8-3.--NIOSH Testing of Various Types of Personal Protection Equipment

Number (percent)Equipment type (reference) Number of models tested meeting ANSI performance standards

Head protection:Class B industrial helmets (“hard hats” with

highest electrical resistance) (Cook andGroce (1 16))

Miners’ safety caps (Cook and Love (120))

Firefighters’ helmets (Cook (117))

Eye protection: Glass piano safety spectacles (Campbell and

Collins (92))

Plastic piano safety spectacles (Collins andWolfe (113))

Flexible fitting safety goggles (Campbell andCollins (92))

Eyecup goggles (Campbell, Collins, andWolfe (93))

Welding filter plates (Campbell (91))

Face protection: Industrial face shieids (Campbell (90))

Hand protection: Linemen’s rubber insulating gloves (Cook

and Fletcher (119))

21 (“randomly selected”)

16 (all available models)

8 (6 advertised as meetingANSI standard)

22 (1 model frommanufacturer)

17 (1 model frommanufacturer)

each

each

50 (all availablemodels)

clear-lens

24 (1 model from eachmanufacturer)

94 (all available shademodels)

37 (“representative

sample”)

12 (randomly selected andrepresentative of 155available models)

4 (19°/0) met all performance standards7 (33%) passed impact resistance test

16 (76%) electrical resistance test

20 (95%) passed crown clearance testall passed penetration resistance test

13 (81 ‘/0) met all performance standards14 (88°/0) passed electrical resistance test15 (94°/0) passed impact resistance test

for the 6 advertised as meeting ANSIstandard, 4 met aII performancestandards and passed penetrationresistance, electrical resistance, andself-extinguishing tests

21 (95°/0) passed Impact resistance test(only 1 of 24 samples fractured of themodel that failed)

21 (95°/0) passed frame impact test18 (82°/0) passed flammability tests

(failures were by small margin, judgednot to be major)all passed optical quality tests

all passed impact resistance test (16 of 17passed test at 5 times impact energyrequired by ANSI)

all passed frame and lens penetrationresistance tests

7 (41 ?/0) passed flammability tests(failures judged to present little dangerin workplace)

all passed optical quality tests

all passed impact resistance testsall passed penetration resistance tests48 (96%) passed “design test” that

estimated risk from particles enteringinside goggles through ventilationopening

32 (64°/0) passed flammability test33 (66%) did not meet ANSI optical

standards

13 (54%) passed impact resistance test16 (67°/0) passed frame impact testall passed flammability testall passed optical transmittance test

19 (20%) met all performance standardsmore than 90% passed ultraviolet,

infrared, and impact tests (whenappropriate)

76 (80°/0) passed visible-lighttransmittance tests

36 (97°/0) passed impact resistance test

36 (97°/0) passed penetration resistancetest

ail passed flammability test

11 (92%) passed electrical resistance test(model that failed electrical test waswithdrawn from market by manufacturer)

10 (84%) passed tensile strength




Table 8-3.—NIOSH Testing of Various Types of Personal Protection Equipment—Continued

Equipment type (reference) Number of models tested

Foot protectionMen’s safety-toe footwear (Cook (118)) 76 (random samples of

types in general use (71),

plus styles notrepresented in generalsamples (5))

Number (percent)meeting ANSI performance standards

ANSI analysis:a

49 (55°/0) passed impact resistance tests

60 (79°/0) passed compression tests43 (37°/0) passed overall testsStatistical analysis:28 (37°/0) passed impact resistance tests50 (60°/0) passed compression tests36-50 (48°/0-600/0) passed overall tests

confidence level that 9 out of 10 shoes would ANSI test (see text)

SOURCE Office of Technology Assessment from cited references

The impact resistance test is conducted for ver-tical impacts only. A member of the advisorypan el to this OTA assessment reports that NIOSH

also conducted nonvertical impact tests—with

disastrous results. Those results were not reported

by NIOSH.

Miners’ Helmets. —Miners are required to wear

helmets in un derground mines and in surfacemines where falling objects may create hazards.NIOSH characterized 15 of the 16 models of miners’ helmets as industrial helmets to which alamp an d a cord b racket for moun ting it havebeen added. Miners’ helmets, like “hard hats, ” canbe Class A, B, or C, depen ding up on th eir resis-tance to electricity.

The miners’ safety caps had better test resultsthan th e Class B hard h ats: 15 of 16 models passedthe impact resistance test; 14, the electrical resis-tance test. Manufacturers had drilled holes for usein attaching lamps to the 2 models that failed theelectrical tests; electrical shorts across the holescaused those models to fail. Overall, 13 modelsmet all the ANSI performance standards.

Oddly, of the five companies making bothminers’ helmets and Class B hard hats, four pro-duced a miners’ helmet that passed the the impactresistance test and at least one model of Class Bhard hat that failed it. By contrast, the producerof the min ers’ helmet that failed the imp act resis-

tance test made a Class B hard hat that passed.

Firefighters’ Helmets. -Firefighters’ helmets dif-fer in shape from hard hats and miners’ helmets,and th ey have a broad brim to carry water awayfrom the wearer’s face and neck. In addition to

Photo credit: E. /. du Pont de Nemours & Co.

These firefighters are using protective clothing,firefighters’ helmets, and self-contained

breathing apparatus

providing protection against impacts and electri-city, firefighters’ helmets must also be self-extinguishing. NIOSH used two different meth-ods to measure the transmission of impact forcesin testing firefighters’ helmets. An analysis showedthat the method they favored produced more con-sistent results; using that test, four of the sixmodels advertised as meeting the ANSI standardpassed the impact resistance test. All six modelspassed the tests for electrical resistance andpenetration resistance, and all were self-extin-guishing. NIOSH concluded that the two helmetsadvertised as meeting ANSI standards that failed

the impact resistance test suffered from poorquality control in the manufacture of the suspen-sion systems.

The agency suggested that the tests for thesedevices would more accurately reflect firefighters’




need s if an imp act resistance test at 300oCen-

tigrade (5720Fahrenheit) were added to the ANSI

standards. The severity of such a test reflects theconditions that firefighters and their equipmentface.

Comments on Head Protection.—The testsshowed significant performance variations fromANSI standards. The highest failure rates werefound in Class B hard hats, which are used in thegreatest numbers and manufactured by the largestnu mb er of firms. The min ers’ helmets, as a class,performed very well. The single failure in th e im-pact resistance test was associated with qualitycontrol during manufacture, and the electrical testfailures were related to holes being drilled in thehelmets.

Overall, the performance of protective head-

wear in tests comp leted in 1976 an d 1977 does no tproduce confidence that the devices work asclaimed. Furthermore, NIOSH drew attention tothe absence of tests of impact resistance for thefront, sides, and rear of helmets, highlighting whatapp ears to be a deficiency in th e tests. In th e re-port on m iners’ helmets, NIOSH noted th at thepresent ANSI standards d o not consider the ef-fects of projections into the interior of somehelmet models, which would tend to concentratethe force of any imp act from th e front, sides, orrear. After recommending that models with pro-trusions be avoided, NIOSH suggests a crud e test

to identify them:With the h elmet in p lace, a cautious series of

blows to th e perim eter of the helmet is sufficientto identify models with these protru sions.

The report on Class B helmets acknowledgedthat “It should be recognized that many lives havebeen saved through use of industrial helmets andsuch devices are a valuable adjunct to the over-all protection of workers. ” However, apparentlyin recognition of the deficiencies found in thosehelmets, the agency added, “NIOSH in tends topromulgate regulations in the immediate future

to establish th e legal basis for a testing and cer-tification program for industrial helmets. ” Thatwas 8 years ago.

Protective Eyewear

Protective eyewear (fig. 8-3) is the most com-

monly used personal equipment. In the work-place, this equipment provides protection againstparticles, sparks, and chemicals that migh t hit the

eye and/or protection against harmful ultraviolet,infrared, and too-intense visible light. ANSIspecifies that protective eyewear must not affectvisual acuity to the point where a worker’s per-formance is impaired and certainl y not to thepoint where the worker’s safety is affected by re-duced field or clarity of vision.

An obvious concern in safety eyewear is thatthe eyewear itself can present a hazard if it fails.A particle splintering the lens of spectacles maybe the cause of an accident, but the in jury maystem from fragments of the lens entering the eye.

Since 1972, all sp ectacles sold in the United Statesmust have impact-resistant lenses, but the levelof impact resistance in “street-wear” spectacles isfar below that required of safety eyewear used inthe workplace. To facilitate making a distinctionbetween lenses intended for street wear and thosefor ind ustrial u se, all the latter spectacles aremarked with the manu facturer’s name.

Piano Safety Spectacles.—Glass (or plastic)piano safety spectacles (“piano” means flat, non-corrective lens) are the “safety glasses” with whichmost people are familiar. They are intended tobe a barrier between the eye and foreign objectsand not to interfere with the wearer’s vision.

NIO SH tested 22 models of glass safety spec-tacles, one from each man ufacturer. All bu t onemodel passed the impact resistance test prescribedby ANSI. Twenty-four samples of each modelwere tested, and even in the model th at failed onlyone lens of the 24 fractured. All the models passedthe frame impact test, which requires the lens toremain in the frame after impacts on the side ortop.

The spectacles were also tested for resistance

to higher energy impacts, although the results of this test did not affect NIOSH’S decision on wheth-er a lens passed or failed the basic impact test.



Ch. 8–Personal Protective Equipment q 163

Figure 8.3.—Protective Eyewear

Service





Ch. 8—Personal Protective Equipment . 165

sign defects or poor quality control. An excep-tion to that generalization is the two m odels of flexible fitting goggles with design defects thatallowed particles to strike the eye from the side.

Face ProtectionNIOSH tested faceshields that were attached to

hard hats. All but 1 of 37 models (a “representa-tive sample” of those available) passed both the

impact and penetration tests. The same modelfailed both tests. NIOSH concluded th at the othershields performed in accordance with ANSI stand-ards, but warned, as do several manufacturers,that shields are not a substitute for eye protec-tion. Particles can pass around or under the shieldand cause injury if eye protection is not worn inconjunction with the face protection.

Linemen’s Rubber Gloves

Only three manufacturers make the 155 modelsof rubber gloves worn by electrical linemen toprovide protection against electrical shock.NIOSH tested 12 models considered to be repre-

sentative of all those available. Eleven modelspassed the ANSI specified electrical resistance test.The model that failed was, according to ANSI,withdrawn from the market by the manufacturer.

One of the two models that failed the tensilestrength test was advertised as meeting the ANSIstandard ; the other w as not. These two are theonly models not made from rubber and are in-tended for use in areas with very high voltages.NIOSH apparently sees the use of p lastic in p laceof rubber in these gloves as acceptable becausethey offer superior service qualities in the specific

uses for which they are sold.

Photo credit OSHA, Office of /n format/on and Consumer Affairs

Faceshields and safety glasses protect these workersfrom flying particles

Men’s Safety-Toe Footwear

Safety-toe footwear (more generally called“steel-toed sh oes”) are sub jected to two perform-ance tests. The impact resistance test measures thedeformation of the toe of the shoe when it is subjected to a sin gle hit w ith a falling object. Thecompression test measures the deformation dur-ing th e app lication of a steady squ eezing force.Safety-toe shoes are rated by the manufacturers

on the basis of the shoes being able to withstandan impact of 30, 50, or 75 foot-pounds and an

average compressive force of 1,000, 1,750, o r 2,500 pou nd s. The shoes are rated as Class 30,SO, and 75 respectively. NIOSH tested 76 different

models, a random sample of those available.

The ANSI stand ard is based on a pass/fail test.NIOSH analyzed its results on this basis as wellas on another statistical basis. The statistical anal-ysis considered how close each model came to fail-ing the test, and resulted in an estimate of the 95percent probability that at least 90 percent of all

shoes of that model would pass the test.Using the ANSI standard, 49 of 76 models

passed the impact tests; 60, the compression tests;only 43, both tests. The statistical test resulted in28 of 76 models passing the impact tests; 50, thecompression tests; 36-50 the overall tests.




Und er both m ethods of analysis, a significantproportion of the tested shoes did not conformto the ANSI stand ard. NIOSH concluded th atmanufacturers overrate the shoes. For instance,a shoe marketed as Class 75 provided only theprotection required of a Class 50 shoe. NIOSHalso noted, however, that some cases of failure,in wh ich the shoe deformed just past the fail mark,might n ot be associated with an injury in actualuse, and that safety shoes have afforded a sub-stantial degree of protection to workers.

Comments on NIOSH Testing of Personal Protective Equipment

Some types of safety equipment—notably spec-tacles, flexible goggles, miners’ helmets, linemen’srubber gloves, and face protection—were foundto conform to the AN SI standard against wh ich

Photo credit: E.I. du Pont de Nemours & Co

Protective clothing is frequently required for exposuresto toxic substances

they were manufactured. Others—safety-toeshoes, eyecup goggles, industrial safety helmets,firefighters’ helmets, and welding filter plates—often did not measure up to the ANSI standards.Furthermore, some deficiencies were foun d in th eANSI test standards, which do not measure someimportant properties such as resistance of hardhats to off-center impacts or of glass safety glassesto penetration.

NIOSH has not tested these safety devices sincethe pu blication of these reports in th e mid-to late-1970s. Furthermore, several items of personalsafety equipment, notably clothing and chemical-

resistant gloves, were not tested in the NIOSH

program. Whether design and quality control now

are better, about the same, or worse than w h e nNIOSH performed these tests is not known.

Tests of Gloves AgainstChemical Hazards

Manufacturers, in their literature, rate varioustypes of gloves as providing “excellent, good, fair,or poor” p rotection against w orkplace chemicals.There seems to be little reason for the generalassignments of resistance to chemicals. As isshown on table 8-4, man y chem icals penetrate“chemical-resistant” glove materials quite quickly.

Some workplace solvents, for instance halogen-ated ethanes (dichloroethanes and trichloro-

ethanes) and polychlorinated biphenyls (PCBs),have presented special problems because theypenetrate most gloves in m inutes or second s. Arelatively new m aterial, Vitron, developed by D uPont, provides excellent resistance to the halo-genated ethanes, however, and better resistanceto PCBs than any other tested material. This ex-ample illustrates how new developments in tech-nology find application in the protective devicesindustry. Yet Vitron gloves may not be used wide-ly because of the high cost—10 times as much asany other glove.

Involvement of Personal ProtectiveEquipment in Injuries

There are no field tests of personal protectiveequipment used for preventing injuries. It is prob-ably imp ossible to design such tests, and on ly




Table 8-4.—Comparison of Various Protective Garment Materials’ Capacity toResist Penetration by Chlorinated Ethanes and PCB

Number of minutes required for solvent to penetrate 1/1,000 inchof the protective material

1,2-di- 1,1,1-tri. 1,1 ,2-tri - polychlorinatedProtective material chloroethane chloroethane chloroethane biphenyl (PCB)

Butyl rubber . . . . . . . . . . . . . . . . . . . . . 6.4 2.7 2.3 0.1Neoprene rubber latex . . . . . . . . . . . . 0.9 2.0 0.3 0.02Nitrile rubber latex . . . . . . . . . . . . . . . 0.3 3.8 0.3 0.1Polyethylene . . . . . . . . . . . . . . . . . . . . . 1.2 1.5 1.8 0.4Surgical rubber latex. . . . . . . . . . . . . . 0.2 0.05 0.1 0.04Vitron . . . . . . . . . . . . . . . . . . . . . . . . . . . 82.0 >144.0 >144.0 6.0SOURCE Adapted from (456)

workers with a great deal of confidence in their

equipment wou ld submit to having their hard hats

or safety-toe shoes struck by a heavy weight while

their heads or feet were inside. In the absence of

such d ata, it is useful to in spect the Bureau of La-bor Statistics (BLS) reports of accidents involv-

ing different parts of the body.

BLS warns that its data do not allow any con-

clusions to be drawn about the incidence of in-

juries suffered by workers wearing and not wear-

ing protective equipment, for no informationabout exposure is available. For instance, the BLSdata do not reveal if workers wearing protectiveeyewear are exposed to more airborne particleswith the p otential of harming eyes than are work-ers who do not wear protective eyewear. Al-though the BLS data cannot reveal how many in-

juries personal protection devices prevented, theycan be used to learn about conditions that caused

failure of such devices and why personal protec-

tive devices were not worn.

The BLS data were collected over time periods

ranging from 2 to 5 months in 19 or 20 States (de-

pending on the injury studied). Employers’ reports

of injuries to State workers’ compensation agen-

cies were reviewed, and questionnaires were

mailed to workers in selected occup ations in allindustries except mining. In general, the surveyperiod ended w hen a certain nu mber of qu estion-naires were returned , and the results cannot b e

taken as representative of all injuries affecting thespecified part of the b ody.

Selected Data From the BLSSurvey of Head Inju ries

The head injuries suffered by workers wearinghard h ats were divided ab out equally among im-pacts sustained on the hard hat, on an unprotected

area, and both (600) (table 8-5). The shells of 37 percent of the helmets broke, and the suspensionsof 17 percent failed as a result of the accident. Aninju ry can resu lt, of course, from an imp act thatdoes n ot dam age the helm et. For instance, toomuch force can be transferred if the shell is pushedforcibly onto the worker’s head. The high failurerate reflected in shell and suspension breakageparallels NIOSH’s observations that only 33 per-cent of tested Class B industrial helmets passedthe ANSI impact resistance test.

Table 8-5 presents data on the reasons that hard

hats were not worn . The majority of workers whowere un protected were n ot supplied with p rotec-t ive equipment, not required to wear it, orthought it was unnecessary. Less than 20 percentof the injured workers who were not wearing headprotection said th at hard hats were un comfor-table, impossible to wear, or interfered with work.

The percentage of work ers usually wearinghard hats in their work is very close to the per-centage required to do so. Twenty-one percent of all workers who responded to the BLS question-naire are required to wear hard hats; 20 percent

wear hard h ats all or most of the time. Ninety-five percent of the workers wearing hard hats at




Photo credit: Department of Labor, Historical Office

Photo credit: Chemical Manufacturers Association

Worker dons full protective suit

the time of their accident were requiredthem.

Selected Data From BLS Survey of Eye

to wear

Injuries

The most important information for assessing

the effectiveness of eye protection would be toknow how many injuries were prevented by them.As with h ead inju ries, however, no data are avail-able to calculate that.

Although materials have changed since this photo wastaken, the basic purpose of protective clothing is stillto prevent worker contact with harmful substances

Table 8=5.—Selected Information From BLSSurvey of Head injuries

Number Percent

Workers’ reports of head Injuries while wearing hard hats: Total . . . . . . . . . . . . ... , . . . . . . . . . 169a

Struck on hard hat area only ., . . 53 31Struck on unprotected part of

head only , . . . . . . . . . . . . . . . . . . 60 36Struck on hard hat area and

unprotected part . . . . . . . . . . . . . 55 33Don’t know . . . . . . . . . . . . . . . . . . . 1 1

Helmet shell broken ordamaged , . . . . . . . . . . . . . . . . . . 40 37

Helmet suspension broken ordamaged . . . . . . . . . . . . . . . . . . . 18 17

Workers’ reports of masons for not wearing hard hats: a

Total . . . . . . . . . . . . . . ... , . . . . . . . 852

Thought it was not needed . . . . . 216 25Not available from employer . . . . 176 21Not normally used or not

practical . . . . . . . . . . . . . . . . . . . . 471 55Uncomfortable, did not fit with

other equipment, hard to workwith it on, or in bad

condition . . . . . . . . . . . . . . . . . . . 163 19Other . . . . . . . . . . . . . . . . . . . . . . . . 42 5

responses number of Injuries and sum of

100 because multiple responses could be given by single individual.

SOURCE:



.

Ch. 8—Personal Protective Equipment . 169

Table 8-6 lists the reasons w orkers thou ght p ro-tective eyewear failed to protect them (598). Themost frequently cited reason was that the objector chemical that caused th e injury w ent aroundor under the protection. NIOSH (94,133) hasdrawn attention to this p ossibil i ty in reports onpiano safety spectacles (which should be equippedwith sid e shields) and on face protection (wh ichshould not be used without eye protection).

Despite all the caveats that must be attachedto conclusions about the effectiveness of protec-tive eyewear, it can b e conclud ed th at few d evicesfailed because of characteristics for which ANSIhas testing standards. Only 4 percent of the injuries involved len s failures, and only 1 percentwere related to frame breakage.

The reasons given by injured unprotected work-

ers for not wearing eye protection are tabulatedin table 8-6. Twenty-two percent reported that pro-

tective eyewear was unavailable at the work site.

The other reasons given were either that theworker or the work er’s supervisor did n ot think

Table 8-6.—Selected Information From BLSSurvey of Eye injuries

Number Percent

Workers’ reports of reasons Injury occurred when eye protection was worn:

Total . . . . . . . . . . . . . . . . . . . . . . . . . 401 a

Object or chemical went under

or around protection . . . . . . 376 94Object went through lens or theshattered lens hit eye; lenswas knocked out of frame . . . 15 4

Frame broke and injuredworker . . . . , . . . . . . . . . . . . 4 1

Eye or face protection slid or fellout of place . . . . . . . . . . . . . . . . 16 4

Other . . . . . . . . . . . . . . . . . . . . . . . 28 7

Workers’ reports of reasons for not wearing eye protection.-

Total . . . . . . . . . . . . . . . . . . . . . . . . . 612

Eye or face protection lifted up;not in place . . . . . . . . 37 6

None available, not required, orworker thought none needed ornot normally used or 136 22impractical . . . . . . , . . . 402 66

Protection device reduced visionor device fogged up, or devicewas uncomfortable or in badcondition . . . . . . . . . . . . . . . . 293 39

Other . . . . . . . . . . . . . . . . . . . . . . . . 63 10

asorne resporlses exceed total number of Injuries and Sum Of Percentages

exceeds 100 because mult Iple responses could be given by single individual

SOURCE (598)

eye protection was necessary or that the eye pro-tection interfered with the worker’s vision.

There is no way to be certain that wearing eyeprotection would have reduced th e num ber of injuries to unprotected workers, but it is a safe

assumption that at least some injuries would havebeen p revented and th at the severity of otherswould have been reduced. Apparently greater useof protective eyewear would result from greatersupervisor attention and improved designs to re-duce interference with workers’ vision. Seventy-nin e percent of those wearing eye protection wererequired to; only 52 percent of all workers wererequired to.

Just over half (56 percent) of the injured work-ers who were wearing eye protection thought thatit reduced the severity of their injuries. Five per-

cent thought that the protection contributed tothe inju ry. The remain ing 39 percent did n ot havean opinion about the effect of the eye protectionor though t that it had h ad no effect.

Selected Data From the BLSSurvey of Face Injuries

Only 9 of 770 workers who were included inthe survey of face injuries reported that they hadbeen w earing face shields when th ey were hurt(599). How ever, about a third of the in jured work-ers had been wearing eye protection; about 20 per-cent of them thought the eye protection minimizedtheir injuries, and about 10 percent reported facialinjuries from broken frames or lenses.

Most workers who did not wear face protec-tion reported th at it was not required or w as notconsidered necessary. Only about 10 percent re-ported th at it was uncomfortable or interferedwith vision.

The on e face shield t ha t failed was split byfragments of an exploding cutting wheel, whichcaused multiple fractures. In five cases, the object or chemical that caused injury went around

or und er the face shield.

Selected Data From the BLSSurvey of Foot Injuries

Workers only infrequently wear safety foot-wear unless required by employers; “fewer than




a tenth of those n ot required to u se foot protec-tion were wearing safety shoes” (601). Eighty-fivepercent of the workers wearing safety shoes wereinjured in an unprotected part of the foot. Impor-tantly, given the ANSI emp hasis on test ing thestrength of the safety toe, only 7 percent of foot

injury accidents reported to BLS involved safetytoe failures.

As noted earlier, NIOSH (117) observed thatmanufacturers sometimes exaggerated the impactor compression resistance of the safety toe. Evi-dently users of safety shoes are seldom aware thatthe sh oes are rated on th ese features; 82 percentof workers wearing safety shoes did not knowwh at class of protection th e shoes p rovided. Fifty-seven percent of workers wearing safety shoesthought that the severity of their injuries had beenreduced; only 1 percent thou ght th at the shoes

contributed to injury.

Possible Conclusions From the BLS Surveys

The resu lts of the BLS Surveys are consistentwith the conclusion that the eq uipm ent works-inthat the failures the ANSI standards are to guardagainst occurred infrequently except in the caseof hard hats, which failed relatively often. Thatconclusion is necessarily limited. For instance, if the 7 percent of safety-toe shoes that failed on th e

job d id so b ecause th ey received an im pact of much greater force than the shoes were designed

to withstand, then the shoes performed u p to thestandard. On the other han d, if some fraction of the 7 percent failed at an impact less than theywere designed to resist, then the 7 percent failurerate is an underestimate.

Third= Party Laboratory Testing ofPersonal Protective Equipment

Manufacturers of personal protection devicesare not required to test their products. They maydo tests to assure themselves that the products

meet ANSI stand ards. However, the results of the(now dated) NIOSH evaluation of personal pro-tective equipm ent against ANSI standards p ro-vides no assurance that such tests are always doneor that quality control is sufficient to guaranteethat products coming off the assembly line meetthe standards.

The Industrial Safety Equipment Associationis the trade association of man ufacturers of per-sonal protective equipment. According to its presi-dent (672), the association had supported the ex-tension of NIOSH certification programs fromrespirators to other personal protective equip-

ment. In 1980, the association, upon deciding thatNIOSH was unlikely to be able to expand its cer-tification program, established as a separate en-tity the Safety Equipment Institute.

SEI is a testing and certification organization.It does not develop its own test standards; instead,as NIOSH did in the late 1970s, it tests equipm entagainst the ANSI standards. The tests are carriedout in laboratories under contract to SEI. The In-stitute so far has tested h ard hats m ade b y 95 per-cent of the manu facturers and eye an d face pro-tection mad e by 65 percent of the producers, and

it makes available lists of hard hats and eye andface protection that passed the ANSI standardsand were certified. Currently it is testing emer-gency eyewash and shower facilities.

Following the testing ph ase of the SEI certifica-tion procedure, the Institute, through an ind e-pendent consulting firm, arranges for quality as-surance audits of the manufactures of certifiedequipm ent on a b iannual basis. In addition, at 6-or 12-month intervals, SEI retests a number of each

certified model of personal protective equipment.

Upon retesting hard hats, SEI found that all the

tested green-colored hats of one model made byone manu facturer did not meet the AN SI standard s.Upon being notified of this fact, the manufacturer

withdrew that lot of green hats from the marketand informed all distributors that had purchasedthem that the h ats were below ANSI stand ards.

SEI has not been greeted by everyone as an in-dependent source of information about the effec-tiveness of personal protective equipment. Spring-ing as it did from the trade association, it is seenby some as under the control of the manufactur-ers. The In stitute has p artially add ressed this crit-

icism b y establishing a b oard of directors that hasonly one -member from the trade association. Itsbylaws also separate it from the trade association.

Although time will have to pass before the suc-cess of SEI’s program can be evalu ated, the p ro-gram is now well under way, and it offers third-




party certification of personal protective equip- purchaser of certified personal protective equip-

ment. SEI points out that it offers both an alter- ment that the equipment meets national consen-

native to self-certification and assurance to the sus standards for performance.

SUMMARY

The Federal Government does not certify that any types of personal protective equipment, ex-cept respirators, work. In the case of some other

items of personal protective equipment, the Amer-

ican National Standards Institute has drawn up

standards, and manufacturers advertise that their

products meet those standards.

The procedures used by NIOSH to certify respirators ar e dated, and there is a great deal of dis-

satisfaction with them. Even devices that pass the

tests may not work well in the field, and sincethere is only a p ass/fail evaluation, better respi-rators receive the same grade as ones that barelymeet the standards.

Few studies have measured the effectiveness of respirators in the workplace. High effectivenesshas been found only in workplaces that have well-developed respirator programs with careful main-tenance, education, and supervision.

NIOSH is currently drafting a revision of the

certification regulations, which reportedly will re-

quire that manufacturers test and certify their own

products. Not everyone supports self-certification.Labor unions are in favor of the government

maintaining a role in certification. An alternativeoffered b y some m anufacturers is the establish-ment of a testing laboratory, supported by indus-try fees, to carry ou t the certification tests . In -du stry is not un iformly behind the idea of athird-party laboratory, however, because the fa-cility, as proposed, wou ld h ave ties to some man -ufacturers. To opponents of the third-party lab-oratory, those ties mean that it too wou ld b e amethod of self-certification, and they favor

straightforward self-certification. Hearing conservation programs depend on

measuring the level of noise in the workplace,lowering it wh en p ossible by engineering controls,providing hearing protectors to workers exposedto noise above certain specified levels, and check-

ing workers’ hearing periodically to determine if hearing acuity has dropped below prescribed lev-els. All hearing protectors are labeled with a NoiseReduction Rating, which is supposed to give thepurchaser information about the amount of pro-tection provided by the protector.

There is almost un iversal agreement, and noevidence to the contrary, that the N RRs overstatethe amount of protection afforded by hearing pro-tectors. NRRs are required by a law adm inistered

by th e Environmen tal Protection Agency; becauseof bu dgetary cutbacks, however, EPA is no lon germon itoring th e accuracy of NRRs. Therefore,products bearing a Government-approved effi-ciency rating are known to be overrated, and thatsi tuation is un likely to change.

Field testing of hearing protection has yielded

evidence that noise attenuation achieved in theworkplace is much less than that expected fromthe NRRs. Some workers, even though they worehearing protectors, received no benefit in termsof noise reduction. On the other han d, a l imitedstudy of hearing acuity in a major chemical com-pany showed that hearing losses among its work-ers over a 5-year period were not related to noiselevels. Add itional, longer studies are n ecessary,however, before the success of these programs canbe fairly judged.

Analogous to the situation w ith respirators, theusefulness of hearing protectors depends on howthey are chosen and used. A continuous programof instruction, supervision, and maintenance isnecessary.

In the late 1970s, NIOSH tested several typesof personal protection equipment against the

ANSI standards. Since almost all the equipment

was manufactured by companies that claimed ad-

herence to ANSI standards, the NIOSH tests were

a measure of the quality assurance programs of




the manufacturers or of their ability to carry out

the ANSI tests.

Some types of safety equipment, notably spec-tacles, flexible goggles, miners’ helmets, linemen’s

rubber gloves, and face protection, were found

to conform to the ANSI standard against wh ichthey were manufactured. Others—safety-toeshoes, eyecup goggles, industrial sa fe ty helmets(hard hats), firefighters’ helmets, and welding filter plates—often did not measure up to the A N S Istandards. Furthermore, some deficiencies werefound in the ANSI test standards, wh ich d o notassess some important properties such as resis-tance of hard hats to off-center impacts or of glass

safety glasses to penetration.

The Bureau of Labor Statistics has collectedqu estionnaire data about some ind ustrial ac-

cidents. Their survey data about head injuriesshowed that hard hats frequently failed in acci-

den ts, which fits with NIOSH’s findings that manyhard hats did not meet ANSI standards. Other

Bureau reports found that other types of personalprotective equipment also failed under certain,sometimes very severe, cond itions. However, pro-tective equipmen t was seldom id entif ied as thecause of an accident. Althou gh it is imp ossible toknow how m any injuries were prevented b y per-sonal protective equipm ent, it is clear that its usedepend s on good design and supervision of its use.



9Hierarchy of Controls



Contents

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b.

q Q . . * . * * * * . , . * , * * * * C

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q * O . * . . . . e e * c * , c e o. q q q ~ 183

. . . . . . , . * , . *“ “ “ “ q q q q q q q q q

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1751751761771771781791791811$2

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Hierarchy of Controls

As explained in chapter 5, a generalized model

of the w orkplace environm ent looks at sou rcesof hazards, transmission of the hazard, an d work-

ers (see fig. 5-2 in ch. 5). Health and safety hazardsare controlled by interrupting the transmission of hazardous agents to workers. Controls can be intro-duced at several points: the source of the hazard,the workplace atmosphere (or transmission points),and the workers’ location(s). For health hazards,control at the source can include substitution of less toxic agents or substances, as well as processand engineering changes to reduce emissions of the h azardou s agents or sub stances. Control of transmission of the agent can be accomplished by

ventilation, isolation, dilu tion, or enclosure. Con-trol at the worker can include personal protec-

tive equipment, work practices, and administra-

tive procedures (see discussions in chs. 5 and 8).

This model can also be applied to inju ry haz-ards, al though mu ch of the safety research p ub -lished to date has followed other approaches. Forexample, control of electrical energy at the sourcemight involve grounding to prevent the buildupand inappropriate release of hazardous amountsof energy. Control of transmission could includeseparating workers from the hazard by, for exam-ple, placing physical barriers or guards betweenthe worker and the hazard, Personal protectiveequip ment, such as in sulated gloves, represents

a control applied on the worker.

DESCRIPTION OF HIERARCHY OF CONTROLS

Health and safety professionals have tradi-tionally ranked controls according to their relia-bility and efficacy in rem oving or controlling haz-ards. Put simply, the principle of the hierarchyof controls is to control th e hazard as close to the

source as possible. (This hierarchical approach ismost commonly discussed in relation to healthhazards and the methods of industrial hygiene.Although the principle can also be applied to safe-ty hazards, most of the discussion in this chapterwill focus on the control of health hazards. )

Expressed differently, the h ierarchy of controlsdescribes th e order that either should be followedor must be followed w hen choosing among op-tions for controlling health and safety hazards.In its sim plest form, the hierarchy of controlsspecifies that engineering controls (including sub-stitution, enclosure, isolation and ventilation) arepreferred to the use of personal protective equip-men t. Work p ractices are frequently ad ded to thisl ist between engineering controls and personalprotective equipment. Administrative controls,such as worker rotation, are also oftentimes in-

clud ed and generally constitute the “third ” line of defense, falling after engineering controls andwork practice controls and ahead of protectiveequipment. For some hazards, however, the Oc-cupational Safety and Health Administration

(OSH A) places adm inistrative controls on anequal basis with engineering controls. In addition,OSHA now usually groups engineering controlsand work practices together and assigns them thesame priority. Nevertheless, in all cases, personalprotective equipment is listed as the control of lastresort.

Views of Health Professionals

The hierarchy of controls is widely supportedin the professional community. Every current in-dustrial hygiene textbook endorses the idea of such a hierarchy and lists engineering controls asthe f irst priori ty and personal protective equip-ment as a last resort (455). It is often expressedin th e context of controlling exposu res to airbornecontaminants-fumes, dusts, and vapors-that

175




m ay enter th e w orker’s respiratory system. Elim-ination of the contamin ants by sub stitution of materials, enclosure of operations that generatefumes and vapors, dust suppression methods, ordilution of the contaminants by venti lat ion areall preferred over reliance on respirators. Leadersin this field and industrial hygiene texts all agreeon this point (129,173,199,362,369,423).

Excerpts from a 1947 textbook on industrial hy-

giene and from a 1980s text un derlin e the un -changing preference for engineering controls.

Obviously, the most su ccessful approach to theproblem of industrial atmospheric sanitation lies

in the design or alteration of plant and equipment so that the control features are engineered into thestructure a nd machinery (71, emph asis in original).

In man y instances, however, the redu ction of ex-posure [through engineering methods] is not suffi-cient to eliminate the ha zard , and other controlmeasures are need ed. . , . Respiratory protective de-vices have a d istinct place in the field of industrialhealth engineering. That they are a last Zinc of de-

fense can hardly be denied (71, emphasis added).

The newer text states:

If confinement or removal by ad equate proper-ly engineered and op erated ventilation systems isnot possible, personal pr otective equipm ent on atemporary basis should be considered . We stressthe word “ tempora ry” since respiratory protec-tion can seldom be relied on for long p eriods of

time in hazardou s exposures, unless highly u nu-sual control procedures are established and rig-orously enforced (172).

In 1963, the American Conference of Govern-mental Industrial Hygienists (ACGIH) and theAmerican Industrial Hygiene Association jointlyissued a comprehensive guide to respiratory pro-tection in the United States. The opening para-graph is clear on the p referred m ethods of con-trolling occupational hazards:

In the control of those occup ational diseasescaused by breathing air contaminated w ith harm-

ful du sts, fum es, mists, gases, or vapors, the pr i-mary objective should be to prevent the air frombecoming contaminated . This is accomplished a sfar as possible by accepted engineering controlmeasures; . . . (9).

Consensus Standards

The h ierarchy of controls is also foun d in th e“consen sus” standard s written by comm itteesmeeting under the auspices of the American Na-tional Standards Institute (ANSI) and its prede-

cessor, the American Standards Association. TheAssociation’s 1938 standard for protective equip-ment did not require any particular “hierarchy of controls, ” but the attached commentary noted:

It is obviously better to remove the hazard,when this is possible, than to protect the workeragainst it [using p ersonal protective equip ment].Thus, in granite cutting it is preferable to removethe dust by an exhaust system rather than to allowit to contaminate the air, and th en to protect thewor ker against breathing th e du st. . . . This codedoes not attemp t to specify how various indu s-tries shall be condu cted, with respect to avoiding

hazards, but points out the method of protectingthe worker w here the hazard has not been elimi-nated by other means (15).

In th e 1959 revision of this consensus stan dard,respirators were assigned a supplemental functionin th e actual text of the stand ard:

General Considerations. Respirators are usedto supplement other methods of control of air-borne contaminants rather than to substitute forthem. Every effort should be mad e to prevent thedissemination of contam inants into the breathingzones of the w orkers. In some instances, it is nec-

essary to use respirators only until these controlmeasu res have been taken; in others, such meas-ures are impracticable, and the continued use of respirators is n ecessary (16).

In 1969, ANSI issued a separate standard forrespiratory protection. The heading of the para-graph th at describes the app licable principles waschanged from “General Considerations” to “Per-missible Practice,” adding weight to the impor-tance of the control hierarchy. In addition, em-phasis was given to w hat was now viewed as the“primary objective” of workplace controls: pre-venting the contamination of th e workp lace at-

mosphere. In addit ion the word “feasible” wasused in connection w ith controls.

Permissible Practice. In the control of those oc-cupational d iseases caused by breathing a ir con-



. .——. ...—

Ch. 9—Hierarchy of Controls q 177

taminated with h arm ful dusts, fogs, fumes, mists,gases, smokes, sprays, or vap ors, the primary ob-

jective shall be to prevent atmospheric contamina-tion. This shall be accomp lished as far as feasibleby accepted engineering control measures (for ex-ample, enclosure or confinement of the operation,general and local ventilation, and su bstitution of less toxic materials). When effective engineeringcontrols are not feasible, or wh ile they are beinginstituted, app ropr iate respirators shall be used. . . (11, emphasis in original).

The 1980 revision of this ANSI standard is vir-

tually iden tical in w ording, although the ph rasebeginning with “the primary objective” is nolonger underscored. In addition, respirators arenow permitted “[w]hen effective engineering con-trols are not feasible, or while they are being in-stituted or evaluated . . . “ (12, emphasis added).

Government StandardsThe conclusions and practices of the profession-

al community and the consensus standards orga-nizations now have regulatory force. The startupstandards adopted by OSHA in 1971 under theauthority of section 6(a) of the OccupationalSafety and Health (OSH) Act (see ch. 12) included

three specific provisions concerning the hierarchy

of controls.

The applicable paragraph in OSHA’s standard

concerning respiratory p rotection (29 CFR 1910.134

(a)(l)) was taken, word for word , from the p aragraphin the 1969 ANSI standard quoted above, although the

one ph rase und erscored in the ANSI stand ard is not

und erscored in the OSHA stan dard. Second , theOSHA noise standard requires employers to com-ply with the permissible exposure limit throughthe u se of “feasible adm inistrative or engineeringcontrols” (29 CFR 1910.95(b)(l)).

Finally, OSHA ’s m ain requ irement for limiting ex-

posures to toxic substances (the Air Contaminants

standard) reads:

To achieve compliance with . , , this section,

administrative or engineering control must first be determined and implemented whenever feasi-ble. When such controls are n ot feasible to achievefull compliance, protective equipment or any

other p rotective measu res shall be used to keepthe exposure of employees to air contaminantswithin the limits prescribed . . . Any equ ipmentand/ or technical measures used for this purposemu st be approved for each particular use by acompetent industrial hygienist or other technicallyqualified p erson. Whenever respirators are used,their u se shall com ply w ith section 1910.134 [theOSHA respirator standard] (29 CFR 1910.1000(e), emphasis added).

In addition, in all of its substance-specific pro-ceedin gs that resulted in n ew or revised permissi-ble exposure limits, OSHA has maintained a pol-icy of first requiring em ployers to comp ly byimplementing “feasible” engineering and workpractice controls. Although the precise wordingof these requirements has differed slightly amongthese health standards, the basic outline is clear:

First, an emp loyer mu st institute feasible engi-neering and work p ractice controls to reduce em-loyee exposu res to or below the p ermissible ex-posure limit.

Second, even if the feasible engineering andwor k p ractice controls are insu fficient to achievecompliance with th e perm issible limit, the em-ployer is required to use them in order to redu ceexposures as low as possible before issuing per-sonal protective equipment.

Personal protective equipment, such as dust

masks, gas masks , an d other types of respirators,is to be used against airborne contaminan ts in

only four circumstances:q

q

q

q

du ring the t ime period n ecessary to instal lfeasible engineering and work practicecontrols,when engineering and work practice controlsare not feasible (includ ing m any repair andmaintenance activities),when engineering and work practice controlsare not su fficient to achieve compliance withthe permissible limits, andin emergencies.

Controls for Safety HazardsA similar priority system has been suggested

for the control of injury hazards. A clear exam-




ple can be foun d in the National Safety Council’s Accident Prevent ion Manu al (322), wh ich lists thefollowing “hierarchy”:

The basic measur es for preventing a ccidentalinjury, in order of effectiveness and preferenceare:

1.

2.

3.

4.

Eliminate the hazard from the machine,method, material, or plant structure.Control the hazard by enclosing or guardingit at its source.Train personnel to be aware of the hazardand to follow safe job p rocedures to avoidit.

Prescribe Personal prot ectiv e equipm ent forpersonnel to shield-them against the hazard.

Discussions about the hierarchy of controls inthese situations is often concerned with the rela-tive priorities to be placed on workplace and ma-chinery design as opposed to worker training. Em-ployee training and education will always be animp ortant adjun ct to any control techn ique. Butergonomics and safety research now stress the im-portance of design over primary reliance on theinculcation of certain “safe” work routinesthrough training. (See also discussions of safetyhazard identification, injury controls, ergonomics,and worker training in chs. 4,6,7, and 10).

Photo credit: NIOSH (photo provided by OSHA,

Office of Information and Consumer Affairs

Because respirators increase the effort required forbreathing and are uncomfortable, workers often do notwear them or wear them only intermittently. Engineeringcent rots can often eliminate the need to use respirators

ADVANTAGES AND DISADVANTAGES OF THEHIERARCHY OF CONTROLS

The preference for engineering methods for con- professionals, the National Institute for Occupa-trolling workplace hazards is sometimes ques- tional Safety and H ealth (NIOSH ), and OSHAt ioned . Why a re engineering contro ls p re fe rred ass igned persona l p rotect ive equipment to theand why is personal protective equipment ranked position of being only a ‘last line of defense”? Thelower than o ther methods? Why have nearly al l r easons can be d ivided in to those that dea l wi th



.


specific, often technical, problems of currently

available personal protective equipment and those

that address more general advantages of engineer-ing controls.

Problems with Personal

Protective Equipment

Many types of existing personal protective

equipment do not provide reliable, cons is ten t , and

adequate levels of protection. Indeed, research

conducted on the real-world or workplace, as op-

posed to laboratory, effectiveness of such equip-ment shows that the protection provided by these

devices is unequ al, highly variable, and substan-tially lower than that predicted from laboratorymeasu remen ts (see ch. 8). For example, it has been

estimated th at t he mean real-world attenuationof hearing p rotectors is only about on e-third their

laboratory attenuation (49). These shortcomingsoften make personal protective equipment inade-quate for worker protection.

Advantages of Engineering Controls

The problems specific to personal protectiveequip men t are sufficient to cause professionals torank engineering controls above them in the hier-archy of controls. Additionally, engineering con-trols have a number of advantages ranging fromthe relatively mundane and pragmatic to the morephilosophical.

In brief, engineering controls are inherentlymore reliable and provide more effective protec-tion than personal protective equipment and aremore likely to result in successful hazard control(see box G). Once installed and adequately main-tained, engineering controls provide reliable andconsistent performan ce, and, if designed correctly,adequate levels of protection.

Engineering controls work day after day, hourafter hour, without depen ding on hu man sup er-vision or intervention. Because they do not de-pend on a “good fit” with workers, they providethe same protection to all, and monitoring devicescan measure the protection afforded. Separatedfrom contact with the worker, engineering con-trols do not create add itional health or safetyproblems, Moreover, these controls, especially

those at the sou rce of a hazard, can sim ultan e-ously control several exposure routes, such as res-piratory and dermal exposure, while protectiveequipment is generally limited to protecting onlyone exposure route.

In addition, OTA has identified five other areasfor which en gineering controls have advantagesover personal protective equipment. First, manyemployer-provided personal protective programsare currently inadequate. Most discussions of therelative merits of engineering controls and per-

sonal protective equipment center on respiratoryhazards. For those hazards, it is argued that res-

pirator programs can be designed and imple-mented to provide protection equal to that af-

forded by engineering controls. Successful controlthrough the use of respirators has sometimes beenachieved by a few, usually large, employers whohave soph ist icated h ealth and safety programs.But not all employers have implemented such pro-grams or are capab le of doin g so.

Ind eed, failures in employer respirator pro-grams are the most frequent cause of OSHA cita-tions in h ealth insp ections, reinforcing the experi-ence of many indu strial hygienists and OSHAinspectors that most existing respirator programsare inadequate. More than one-third of all OSHAcitations for violations of health stan dard s in-volved the respirator program requirements,




wh ich were directly adopted from the 1969 ANSIconsensus standard (180).

Former OSHA inspectors have written that, in

their experience, for most cases of employee over-

exposure to air contaminants the employers’ res-pirator programs were inadequate (329,363). This

is supported by analysis of OSHA inspection data.OSHA inspectors cite violations of the respira-

tor program requirements in 40 to 70 percent of

the inspections in which employee overexposure

was m easured (402). A leading consultan t in thefield has summarized his experience:

having reviewed the respirator programs of hundreds of private companies, I can state thatI have not, w ith the exception of the nation’s verylargest corpora tions, ever observed a prop er andadequate use of respirators in the occupationalsetting (309).

Second , it is generally impossible to mak e peri-odic measurements of respirator efficiency, andit is very difficult to mon itor each in dividu al em-ployee as he/she cleans, dons, and uses his/herrespirator. Moreover, it is probably hu man n atureto be on one’s “best behavior” when someone is“watching. ” It is therefore difficult to be certainthat the use of equipment observed by a respira-tor program manager is representative of regularuse. Similarly, it is mu ch more d ifficult for OSH Ato monitor the use of masks and respirators dur-ing an inspection, wh ich are cond ucted infre-qu ently, and to be certain that the u se observed

then is representative of use on other d ays.

Third, in a hierarchical approach, with controlachieved close to the source of the h azard, thereis room for backup or supplemental controls. Forexample, if the p rimary control involves the useof process containment (“control at the source”),then this control can be supplemented by havingpersonal protective equipment available (“controlat the w orker”) for emergency use. If the prim arycontrol is protective equipment, the opportunityto provide for supplemental control is eliminatedbecause the control selected is already “at th e

worker”; that is, the last line of defense hasalready been u sed.

Fourth, primary reliance on engineering con-trols can sp ur th e advance of techn ology. TheOSH Act allows the agency to mandate “technol-

ogy-forcing” controls (see ch. 14). New controltechnology can be, and has been, accompaniedby other changes in plant and equ ipment that im-prove p rodu ctivity, as well as protecting work erhealth an d safety (see ch. 16). Relying on personalprotective equipm ent w ould reduce techn ologi-

cal development—in cluding the development of controls that may find application to otherhazards, as well as improvements in equipmentthat redu ce hazards and simu ltaneously raise pro-

ductivity. For example, if OSHA had permitted

the use of dust masks to comply with the cotton

dust standard, the installation of new technology

in the cotton textile industry would probably not

have taken place as rapidly as it did. Modernized

equipment has both dramatically improved pro-

ductivity and lowered worker exposures to cot-ton dust (413).

Finally, personal protective equipment is bur-densome on employees. It is usually uncomfortable,decreases mobility, and the w eight of many typ esof personal protective equipment increases em-ployees’ physical work loads. Negative-pressurerespirators, in addition to their discomfort, alsosignificantly increase the effort needed for breath-ing. This can create special difficulties for work-ers who have already suffered lung impairments.

Moreover, this equipment often impairs produc-tivity. In many cases workers are paid on a “piece-work” basis or are evaluated on how well they meet

emp loyer-set produ ctivity standards. If allowanceis not made for the decrease in productivity due tothe use of protective equipment, an economic bur-den may be borne by the employee.

The use of such equipment, especially respirators,also impairs communication and worker-to-workercontact. This may lead to additional safety prob-lems because employees wearing respirators will beun able to warn each other of potential safety haz-ards, while those wearing hearing protection maybe unable to hear instructions, warning signals, orchanges in the operations of plant equip ment. (How-

ever, one study has found decreases in accidentsafter implementation of a hearing conservation pro-gram (622).) In addition, reducing worker-to-workercommunication can increase a person’s sense of isolation and detract from the important social func-tions of work.




Lastly, workers required to use personal protec-

tive equipmen t may feel that they are n o longer be-

ing treated as persons, especially if they are not

allowed to participate in any decisions concerning

the use of equipment. People in this position may

feel that they are merely cogs in the workplace, simi-

lar to other m achines that require hood s, filters, andmasks.

Problems with Engineering Controls

Notwithstanding the advantages of engineer-

ing controls over personal protective equipment,

there are some drawbacks. First, although they

are less subject to human error and inherently

more reliable, engineering controls can fail. No

matter how well designed, a ventilation system

will fail to remove an airborne contaminant if the

fan stops. Although these failures can be kept toa minimum with adequate maintenance, respira-

tors mu st be available for u se in such em ergencies.

Even substitution does not eliminate the possi-

bility of a failure in hazard control. For example,

carbon tetrachloride, which had been used as a

substitute for petroleum naphtha, is now widelyrecognized as toxic itself. Some of the substitutes

for carbon tetrachloride (tricholoroethylene, per-

chlorethylene) are now suspected of having vari-ous previously unrecognized toxic effects.

Second, there are a number of situations for

which feasible control methods have not yet beenfully developed. In these situations, the best that

can be done is to require the use of personal pro-tective equipment while attempting to develop

feasible engineering controls. In addition, such

equipment will always be needed when engineer-

ing controls are insufficient to reduce exposures

to permissible levels and during the interim periodwhile engineering controls are being designed and

implemented.

These situations are widely recognized and are

provided for in OSHA’s hierarchy of controls.

There are, and will be, however, disputes aboutwhat kinds of controls are “technologically fea-

sible” in any given situation. This is particularly

true when OSHA issues a regulation that “forces”

technology, either by speeding development of

Photo credit OSHA Office of Information and Consumer Affairs

Engineering controls for occupational noise exposuresinclude the use of sound dampening enclosures

control techniques or by facilitating dissemina-tion of existing techniques.

Cost is the principal objection to requiring engi-

neering controls. Although a well-designed and

well-conducted respirator program can be expen-

sive, such programs are in many cases cheaperthan engineering controls and certainly capital

costs are lower. Sometimes the concern about the

costs of engineering controls arises because of the

belief that these costs would be infeasible for a

particular firm (leading to a plant closing) or for

an industry as a whole. Sometimes arguments are

based on the relative “cost-effectiveness” of controls.

Some emp loyers and economists have suggested

that employers should be allowed the flexibilityto choose among the available control methods,




rather than being required first to install feasibleengineerin g controls. This flexibility would allowemployers to choose the least-costly control method.

For example, in its reconsideration of the leadstandard, OSHA estimated the compliance costsfor a group of industries. If these industries were

required to use engineering controls, total annualCosts were estimated to be n early $130 million.

But if respirators were allowed, the costs would

be about $78 million (626).

A second example concerns compliance costsfor reducing asb estos exposu res from 2 fibers/

cubic centim eter to 0.5 fiber/ cubic centim eter. Thetotal annual costs for al l industries, in 1982dollars, are estimated to be about $134 million

if engineering controls are required and $54 mil-

lion if respirators are allowed. If the permissible

limit is set still low er, at 0.2 fiber/ cubic centi-

meter, the annual costs would be about $170 mil-lion for engineering controls and $56 million forcomplian ce through the u se of respirators (647).

For both examples, there are limitations to theaccuracy of these estimates. Moreover, in neithercase was OSHA able to estimate the potential re-duction in worker productivity due to the in-terference caused by respirators. But, as esti-

mated, the cost differences between these controlmethods appear, in many cases, to be substantial.

Many employers believe that the use of person-al protective equipment can provide adequate em-

ployee protection at reduced cost. This argumentis used with regard to both full 8-hour exposuresand for brief and intermittent exposures. Theseindustry representatives argue that if the degreeof protection offered by the equipment is equiva-lent to that provided by engineering controls, it

would be sensible to choose the least costly means.Unfortunately, as already n oted, many k inds of protective equipment have not been demonstratedto be effective in actual w orkplace conditions. Inaddit ion, there may b e add it ional ben efi ts fromrequiring engineering controls, such as increasesin productivity or relative decreases in absentee-ism. These economic benefits need to be consid-ered w hen jud ging the “cost-effectiveness” of dif-ferent control techniques.

The cost-effectiveness argument is also raisedin connection with the requirement that feasibleengineering controls be installed even when engi-neering and work practice controls are insufficientto achieve compliance. In these situations personalprotective equipment is needed for workers in or-der to meet permitted exposure levels. It is arguedthat in such cases expenditures for engineeringcontrols are wasted because personal protectiveequipment will still be required. But because per-sonal protective equipment often fails, reducingcontaminant levels through th e use of en gineer-ing controls minimizes the likely degree of workeroverexposure.

OSHA’S POLICY TOWARD THE HIERARCHY OF CONTROLS

Since its creation in 1971, OSHA has enforcedthe provisions of the startup standards requiringthe use of engineering controls. In addition, OSHAhas developed, through rulemaking proceedings,new or revised standards covering a num ber of toxic substances or hazardous physical agents.

In these proceedings, nearly every health and

safety professional, irrespective of whether theperson worked for an employer, a trade associa-tion, a labor un ion, a pu blic-interest group, auniversity, or the Government, agreed that engi-neering controls are preferable to the use of per-

sonal protective equipment. Many of these sameprofessionals, and other representatives of em-ployers’ and trade associations, would then ex-plain why this general policy did not apply to theirown workplaces or industries. Representativesfrom labor unions, public-interest groups, andGovernment would carefully argue in reply thatthe preference for engineering controls was nec-

essary to protect employee safety and health.

The requirement that regulatory agencies per-form “economic impact assessments” (see ch. 14)has resulted in economists becoming directly in-



Ch. 9—Hierarchy of Controls q 18 3

volved in discussions concerning health standards.

The Council on Wage and Price Stability advised

OSHA, on a number of occasions, to change its

policy and allow the use of personal protective

equipment in p lace of engin eering controls. Ineach proceeding on health standards before 1981,

OSHA rejected that advice and continued to re-quire engineering controls as the first line of de-fense for controlling exposures to air contaminants.

Actions by the Current Administration

In February 1983, OSHA published an AdvanceNotice of Proposed Rulemaking announcing that

it was condu cting a review of the hierarchy of con-

trols and requesting information and comments

from the public. OSHA stated that its objectiveswere to:

q

q

q

q

Explore whether a revised policy will allowemployers to institute more cost-effectivecompliance strategies.Investigate whether advances in respiratordesign, techn ology, and app lications maypermit increased reliance on respirators.Attempt to identify processes, operations,and circumstances appropriate for particu-lar compliance strategies.Assess actual workplace conditions and em-ployee health in industries and operationsemploying different compliance strategies(639).

During the comment period that followed this

announcement, OSHA received 132 separate com-

ments from the public, including employers, trade

associations, labor unions, and individuals. Em -ployers and their representatives supported a gen-eral change in OSHA’s policy, and asked that theagency allow the use of respirators to substitutefor engineering controls. There were some d iffer-ences among employers and trade associationsconcerning the precise circumstances under whichsuch a substitution should be permitted, butnearly all were in favor of allowing employers

flexibility to choose between engineering controlsand respirators. Labor unions, on the other hand,voiced support for the existing policy and objectedstrongly to any changes.

NIOSH, in its comments, supported the hierar-chy of contro ls:

Each element of the hierarchy: 1) preventingemissions at their source, 2) removing th e emis-sions from the pathway between the source andthe w orker, and 3) control at the recipient, should

be applied in d escend ing order to the extent fea-sible before the next lower element is applied(585).

Health and safety professionals working foruniversities and government agencies supportedthe preference for engineering controls. The twoassociations of professional industrial hygienists(the Am erican Conference of G overnmental In-dustrial Hygienists and the American IndustrialHygiene Association) supported the concept of first using engineering controls:

The elected Board of Directors of the [ACGIH]

. . . unanimously endorses continuation of thecurrent [OSHA] p olicy to require em ployers touse feasible engineering controls, work practices,and ad ministrative controls to prevent employeeexposures above perm issible levels. Personal pro-tective equipm ent, including r espirators, may beused as alternatives only when other m ethods arenot adequate, are not feasible, or have not yetbeen installed. Furthermore, we endorse engineer-ing controls as the preferred approach (125).

The AIHA wou ld like to go on record as statingthat the elimination of workplace hazards issup erior to the use of engineering controls, per-sonal protective equipment, and other control

strategies. Where elimination is not feasible, engi-neering and oth er control strategies should be theprim ary method s for redu cing or eliminating ex-posures in the workplace. However, personal pro-tective equipment may be necessary pending morelong-term solutions, We recognize that there aretimes where person al protective equipm ent is ul-timately the only feasible control. The decisionto recommend engineering controls, personal pro-tective equipm ent or other control strategies de-pends on the nature of the hazard in question andshould be based upon the professional judgmentof an industrial hygienist (375).

At this time, OSH A has not yet pu blicly an-nounced what course it will follow concerning thegeneral h ierarchy of controls policy. in light of OSHA's reconsideration of the hierarchy of con-




trols, the advisory panel for this OTA assessment asked to be recorded as endorsing the hierarchyof con t ro ls . To turn away from the hierarchy of

controls without careful verification of the level

of protection afforded by personal protective

equipment is likely to increase exposures to health

hazards.In several substance-specific standards, the cur-

rent administration h as both continued the tradi-tional policy and proposed changes. In its recon-sideration of the cotton dust standard, OSHAdecided to continue to require engineering con-trols, even in the face of objections from the O f-fice of Managem ent and Budget (OMB). This dis-pute between OSHA and OMB was, at leasttemporarily, resolved in OSHA’s favor and thepublished proposal reiterates the hierarchy of con-trols (641).

However, in a proposal concerning a newstandard for ethylene dibromide (EDB), OSHAproposed for the first time to make an importantexception to th e traditional h ierarchy of controls,although this exception would be limited to casesof intermittent exposure. The agency’s proposalwould al low em ployers to use respirators as the

primary means of control “where exposure to EDB. . . is intermittent [defined as an operation that

results in exposures occurring for 1 or 2 days atany one time] and occurs less than a total of 30days p er year” (642).

In its 1984 proposal for a new asbestos stand-ard, the agency proposed that employers be al-lowed to use respirators on a continuous basis asthe prim ary means to comp ly with a new , redu cedexposure limit. Emp loyers would still be req uiredto use feasible engineering and work practice con-trols to meet th e current existing limit (2 fibers/ cubic centim eter). But th ey wou ld b e allowed touse personal protective equ ipmen t on a continu-

ous basis to reduce exposures from the 2 fibers/ cubic centimeter limit to the new permissible ex-posure limit (either 0.5 or 0.2 fibers/cubic centi-meter) (647).

In its 1984 final rule redu cing the perm issibleexposure limit (measured as an 8-hour time-weightedaverage) for ethylene oxide exposures, OSHA re-quires employers to comply w ith the n ew p ermis-sible exposure limit through the use of feasibleengineering and work practice controls. OSHA

also concluded that most operations that gener-ated short-term exposures to ethylene oxide couldbe controlled with the use of engineering controls.Thu s, the agency did n ot, as it proposed for ethyl-ene d ibromide, al low the general use of respira-tors for all short-term operations with ethylene

oxide exposures (649). (However, because of objections from OMB, the agency did not issue anyshort-term exposure limit for ethylene oxide, butrequested public comments on the need for sucha limit and the feasibility of a short-term exposurelimit without the use of respirators.)

In addition, OSHA concluded that for some sit-uations, engineering controls to meet the 8-hourtime-weighted average for ethylene oxide were notfeasible and, for the first time in any health stand-ard, specifically lists those operations in the textof the regulation. For those situations, employers

are allowed to issue respirators as the primarymeans of control (649).

Moreover, the current administration has also

issued an administrative directive to OSHA in-spectors, ordering that no citations concerningOSHA’s permissible exposure limit for noise beissued to employers who h ad issued and requiredthe use of hearing protectors by employees ex-posed to levels up to 10 decibels (dB) above th epermissible limit (that is, exposures between 90dB to 100 dB) (646). Because of the logarithmic

nature of the decibel scale, this difference of 10

decibels is equal to a tenfold increase in permissi-

ble exposures. One researcher has estimated that

using hearing protectors instead of engineeringcontrols for noise exposures between 90 dB and100 dB will double the probability that an exposedworker will incur an occupational hearing loss(165).

Finally, OSHA first granted and then withdrewan experimental variance from the medical remov-al protection provisions of the lead standard. Thelead standard requires that emp loyees wh oseblood lead levels exceed certain specified limitsmust be transferred to jobs with little or no ex-posure to lead. The variance would have allowedone employer to issue respirators to several em-ployees with blood lead levels above the permittedlimits, who would then continue in lead-exposed jobs instead of being transferred to positions with-out lead exposures (243,338,349).



. —


CONCLUSION

In sum mary, OTA find s the h ierarchy of con-trols to be a well-found ed an d p rotective concept.Applicable to both health and safety hazards, thehierarchy is derived from the experience of health

and safety professionals and has been embodiedfor years in consensus standards, professionalpractice, and O SHA regulations. Engineering con-trols are more likely to meet the essential require-ments for hazard control , and personal protec-tive equipm ent is a last line of defense to be u sedwhen engineering controls are infeasible, insuffi-ciently protective, or not yet installed. The prob-lems of p ersonal p rotective equipm ent arise outof 1) limitations in performance, 2) difficulties inevaluating their performance, 3) problems asso-ciated with their use, and 4) the physical and other

burdens they create. Moreover, engineering con-t rols are preferred on more general grounds be-cause most personal protective equipment pro-grams are inadequate and because engineering

controls allow easier monitoring of performance

by employers, employees, and OSHA. In addi-

tion, these controls are inherently more reliable

and do not create employee burdens, and requir-

ing them enhances the development of n ew con-t rols and production technology.

OSHA’s reevaluation of its longstanding pol-icy favoring engineering controls for airborne con-taminan ts may ind icate a shift in th e agency’s ap-proach to the hierarchy of controls. That policyhas led to imp rovements in th e health of U.S.workers and has spurred, at least to some extent,the development of control technologies. Policychanges that allow greater use of personal pro-tective equip ment m ay endanger the h ealth an dwell-being of many American workers and reduce

the regulatory imperative to develop new and bet-ter production and control technologies.



10.

Training and Education for

Preventing Work-Related

Injury and Illness



Contents

Worker Training and Education . . . . . . . . . . . . . .Fun damentals Programs. . . . . . . . . . . . . . . . . . . .Recognition Program $ . . . . . . . . . . . . . . . . . . . . .Prob lem -Solvin g Program s . . . . . . . . . . . . . . . . .Emp owerm en t Program s . . . . . . . . . . . . . . . . . . .Evaluation of Worker Trainin g and Education

Occupational

ContinuingCurriculumPlanning. .

Safety and H ealth Professionals . .

Education . . . . . . . . . . . . . . . . . . . . . .Development and Dissemination .. . . . . .,..,, . . . . . . . 6... < . . . . . . . .

Trai nin g G ran ts. . . . . . . . . . . . . . . . . . . . . . . . . . .Edu cation al Resource Cen ters . . . . . . . . . . . . . . .

Programs . . . . . . . . . . . . . . . . . .

Other Tra in in g Program s for OSH Profession als . . . . . . . . . . . . . . . . . . . . . . . . .Engineers and Managers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........6

Educating Engineers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Tra in in g Busin ess Man ager s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Com pu ter N etw ork s as an Edu cational Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

NIOSH Use of Computer Networks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Privacy andTrade Secret Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .The Future of Computer Exchanges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,.,

Summary . . . . . . . . . . . . . . . . . . . . . . . .

Figure No.

Effect of Fun din g Changes on Nu mb ers of Gradu ate Degrees Gran ted1o-1.and Continuing Education Courses Provided by Both NIOSH andGran t Su pported Un iversi ties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page

189190191191191194195

195195197198198

198199199199200200201201

201

196

. .

.,





Since a comprehensive analysis of worker train-ing and education programs, their effectiveness,and the resources devoted to them is lackin g,OTA contracted with INFORM to survey 40

worker training and education programs. Re-spondents included 8 business firms and tradeassociations, 10 unions, 4 hospital-based pro-grams, 8 university-based programs, 6 Commit-tees (or Coalitions) for Occupational Safety andHealth (COSH groups), and 4 miscellaneous edu-cational programs.

Fundamentals Programs

“Fundamentals” worker training programs in-struct about known hazards in order to prevent

work-related illness and injury. Such training mayinstruct workers in:

* prevention of work-related injury and illnessthrough the p roper use and m aintenance of

q

q

q

.•

O f

potentially hazardous tools, equipment, andmaterials;emergency procedures;personal hygiene as related to use of hazard-

ous materials;the n eed for medical checkups or examina-tions; anduse of protective devices such as masks,respirators, safety goggles, or gloves duringnonroutine maintenance, where protectiveengineering methods have not yet been im-plemented, or during emergencies (227 andsee box H).

the five “fundamentals” programs in theINFORM survey, three were operated by businessfirms and two by trade associations. Four teachsupervisors, occupational safety and healthspecialists, or other “keypersons” to convey in-formation and skills to workers. In the fifth case,the health and safety staff of a compan y instructsboth w orkers and sup ervisors. The program ob-



Ch. 10—Training and Education for Preventing Work. Related Injury and Illness q 191

jective most frequently cited was to reduce costsof work-related injury and i l lness.

Recognition Programs

“Recognit ion” programs prepare workers to

participate in a broader range of worksite safet yan d

q

q

q

q

q

q

health activities through:

emphasizing awareness of the hazards pres-ent in the workplace;understanding different methods available forhazard elimination or control;und erstanding rights and responsibilitiesun der th e law, e.g. right-to-kn ow law s;collecting information about workplace haz-ards, e.g. chem ical iden tity of work place sub-stances, symptoms associated with ex-posures, exposure levels;

observing or informally inspecting the work-place for potential hazards; andreporting hazards or potential hazards toappropriate individuals or committees (227and see box I).

Of the 14 “recognition” programs in the sur-vey, 3 are conducted by businesses, 5 by unions,3 by universities, and 3 by hospitals; their majorobjective is to teach workers to recognize hazards.

Problem-Solving Programs

The general objective of “problem-solving” pro-grams is to provide workers with the informationand skills necessary to participate in hazard rec-ognition an d control. These programs prep areworkers to:

. help solve problems that may arise on theshop floor, in an on going, regular way, byuse of union and management resources andmechanisms; and

q exercise legal rights wh en n ecessary and prac-tical, to brin g outsid e agencies, especiallyOSHA and NIOSH , into the workp lace tohelp address hazards (see box J).

In order to be effective, workers must learn to:

q question work processes and materials toassess whether hazards have been adequatelyidentified; and

q judge the effectiveness of alternative meth-ods of control (227).

Of the 14 “problem-solving programs” includedin the survey, 5 are administered by unions, 5 byun iversi t ies, 1 by a h ospital, and 3 by indepen d-

ent edu cational programs. The major program objectives emphasize teaching workers to use partic-ular mechanisms to address workplace problems.

Empowerment Programs

“Empowerment” programs aim to teach work-

ers the broadest range of skills so as to involve

them in defend ing and expand ing their r ights toan illness- and injury-free workplace. The majorassumption underlying “empowerment” programsis that the goals of cleaning up hazardous work-sites and ensuring the health and safety of work-

ers requires a substantial transfer of political andeconomic power to workers and their unions. Tohelp educate workers to play a broad social andpolitical role, “empowerment” programs must ei-ther instruct workers in the entire range of skillsand knowledge offered by “fundamentals,” “rec-ognition, ” and “problem-solving programs’’—orthey must work to ensure that such training is pro-vided to workers by unions and/or management(See box K).

Although INFORM (227) did not collect infor-mation about employers’ responses to “empower-

ment” p rograms, it is expected that th ose pro-grams wou ld b e opposed . The transfer of politicaland economic power from employers and manag-ers in any area, including safety and health, wouldbe a dramatic shift.

Six of the seven “empowerment” programs inthe survey are condu cted b y Comm ittees or Coali-tions for Occup ational Safety and Health. Theother is conducted by a nonprofit educational pro-gram. The political focus of “empowerment” pro-grams is apparent in the following d escriptionsof program objectives listed by four groups from

th eq

q

survey:empow er workers to deal with problems atwork;build on hazard recognit ion and problem-solving skills to give safety committee mem-




— —



—.

Ch 10—Train/ng and Education for Preventing Work-Related Injury and Illness q 193 — .

IBPAT reports that its program has h ad a significant imp act on collective bargaining. Accordingto an IBPAT evaluation of its fiscal year 1982 activities, 5 out of 10 locals or d istrict councils th at completedthe IBPAT program prior to negotiations of their contracts secured provisions for health and safetycommittees. Among affiliates that did not receive IBPAT instruction, only 3 out of 10 secured suchcommittees.

The IBPAT program eva luation also showed th at 27percent of those affiliates that have comp letedthe program won provisions for training programs in their new contracts. This compares with only 10percent of affiliates that had not undertaken the program. (Both measures of success are complicatedbecause the affiliates who participated in the program may have already made significant commitmentsto safety and health. If that were so, participation and success in negotiations might be better characterizedas t w o successes stemming from overall commitment rather than any cause-effect relationship. )

Source: (227).

Box J.—Example of a Problem-Solving Program:Labor Occupational Health Program (LOHP) at the University of California, Berkeley

LOHP offers a variety of progra ms an d services, including:

.

1. formal edu cation and training courses;2. workshop s and conferences;3. plant w alk-throu ghs to assist in haza rd identification;4. off-site technical ad vice;5. legal ad vice;6. assistance in collective bargaining; and7. maintenance of a resour ce center for p ublic use.

In 1982, LOHP instructed m ore than 800 workers and union officials through courses, workshops,and conferences and provided educational and training materials to 4,000 workers and union officials.

In addition to providing instruction typical of “fundamentals” and “recognition” programs, LOHPplaces special emp hasis on teaching the problem-solving skills listed in the chart below:

Problem-solving programs convey information LOHP offers the following programs thatand skil ls to workers that enable them to: instruct workers and union officials in problem-

solving skills:

1. take an active role in seeking solutions to 1. training for participation in joint committeesproblems on the shop floor (such as an annual course for the Oil, Chem-

ical and Atomic Workers International Union ,and petrochemical companies in the Berkeleyarea)a conference on workers’ compensation forworkers and trade unionistsworkshops on “Collective Bargaining onHealth and Safety”steward training sessions in health and safety ‘

for unionsZ. exercise legal and contractual rights and 2. a conference on California right-to-know

ensure management compliance with laws law, attended by 150 union and managementand contractual agreements representatives, professionals, and students

small workshops to aid in the implementationof the state right-to-know law

Source: (227).



194 . preventing illness and Injury in the Workplace

q

q

bers and local un ion officials and stewardsskills in observing and interpreting air moni-toring and medical tests; track trade namesof potentially hazardous chemicals; deviseengineering control methods; negotiate effec-tive health and safety contract language;empower workers and their unions to win ill-ness- and in jury-free working conditions;have m ore control over their working con-ditions; andempower workers with the skills and the con-fidences they need to prevent work-relatedillness and injury in their workplaces throughcollective action (227).

Evaluation of Worker Training andEducation Programs

Ideally, effectiveness of worker education andtraining programs would be measured by reduced job-related injuries and illnesses. However, thedata currently available are often limited, espe-cially for illnesses (see ch. 2). In addition, evenwith the appropriate data, attribution of improve-men ts to one factor requires kn owled ge of allother factors that might have an effect. In prac-tice, effectiveness measures are generally indirectand in clude counting the nu mber of workerstrained or educated and surveying workers’ andman agement’s perceptions of the value of theprograms.



Ch. 10—Training and Education for Preventing Work-Related Injury and Illness . 195

OCCUPATIONAL SAFETY AND HEALTH PROFESSIONALS

Congress recognized the need for training acadre of occupational safety and health profes-sionals to reach the objectives of the Occupational

Safety and Health (OSH) Act of 1970. Section 20

of the Act designates NIOSH as th e agency to plan

for and carry out programs to assure an adequate

supply of professionals. NIOSH was given author-

it y to conduct programs for this purpose directly,

through grants, and through contracts.

Since 1971, NIOSH has conducted short-term

training programs for occupational health and

safety professionals, developed curricula and

training materials, and provided grants to univer-

sities. Through a grant program, it has established

Educational Resource Centers to train occupa-

tional safety and health professionals through

interdisciplinary programs, to provide consulta-

tion and training for workers and employers, and

to conduct research related to worker health and

safety. NIOSH has also provided financial sup-

port to students through training grants to qual-ified universities (588).

In add ition to NIOSH courses, large comp aniessometimes train their own professionals. A coop-erative agreement b etween G eneral Motors andthe United Auto Workers to train union safetystewards is described in chapter 15.

Continuing EducationNIOSH conducts technical training courses for

private-sector and Government professionals andtechnicians. The cost of the training courses is paidby reimbursements to NIOSH. Short-course top-ics include:

. industrial hygiene;

. occupational safety;

. ind ustrial toxicology;

q occup ational health n ursing; andq occupational medicine.

Special custom courses are produced to meetspecific training needs identified by Governmentand private sector groups. For example, in fiscalyear 1982, courses were p resented to th e U.S.Navy about analyzing asbestos samples taken dur-ing ship refit t ing; to the H ealth Departments of New Jersey and Arizona to train state officials in

the recognition of workplace hazards; to the MineSafety and Health Administration Training Acad-emy to provide information about industrial hy-

giene sampling and analysis for mine inspectors;and to Case Western University to train sciencedepartment faculty in preventing injuries in lab-oratories.

Between 1977 and 1981, continu ing edu cationenrollment increased from approximately 1,600to over 10,000 per year (fig. 10-1). At this rate,enrollment could eventually increase to 50,000 peryear if each specialist in the field attended one con-t inuing education program at least every otheryear. As figure 10-1 illustrates, the number of

attendees in continuing education courses in-creased with funding from 1976 to 1980.

However, a substantial redu ction in the n um -ber of attendees was projected, based on anassumption of a lack of Federal funding of ERCsin t he 1984 Presiden tial Bud get (102). In fact,fund ing was continued b y Congress and the num -ber of trainees is now estimated to be 14,000 peryear. The demand for continuing education in-creased dramatically as OSHA and NIOSH re-sources for disseminating information to profes-sionals were cut. This is partially becausegraduated professionals sought to update theirknowledge and skills. Funds have been available

to meet this demand due to the flexibility of ERCsin rebud geting fun ds intended for graduate train-ing, where enrollment has been declining.

Curriculum Development andDissemination

Refinement and modernization of curricula forshort-term and continuing education can improvethe effectiveness of occupational safety and healthtraining. One way N IOSH d isseminates recent re-search find ings that may help p revent work-related illness and injury among high-risk groups

is through the d evelopm ent of curricula. Gener-ally this approach consists of identifying groupswho have access to high-risk workers, develop-ing materials that will train these target groupsin recognition and means of prevention of harm,and conducting “training-the-trainer” programsso these groups can transfer the k nowledge.




Figure 10.1 .—Effect of Funding Changes on Numbers of Graduate Degrees Granted and Continuing EducationCourses Provided by Both NIOSH and Grant Supported Universities

747781

743 Based on ERCdirectors’ forecastand funds reinstated bycongress

800 -

Annual600

graduate 432degrees 400granted

217

200Based on ERCdirectors’ forecastand no federal funds

1976 1977 1978 1979 1980 1981 1982 1983 1984(est)

14,014

rEstimated following

12

10 -

8 “

6 “

4

2 “ 1.5

1976

reinstatement of

funds by congress10.5

9.8Annual number

of attendeesin continuing

educationcourses(thousands)

7.9

4.4

Based on ERCdirectors’ forecastand no federal funds

1983 1984(est)

1977 1978 1979

9.4

1980

12.9

1981

8.7

1982

1 2 -

10

8 -

6 “

42.9

0 ’1976

Reinstatedby congress

Annualtrainingfunds($ million)

7.0

President’s 1984 budget

1979 1980 1981 1982 1983 19841978



Ch. 10—Training and Education for Preventing Work-Related Injury and Illness q 197 —

An example of curriculum development is the

joint NIOSH-OSHA program for instructing vo-

cational education teachers how to teach skills inrecognition and control of workplace hazards. In-

troducing such concepts to new workers before

they are employed is especially important since

young workers are at the highest risk of traumaticinjury. Pilot programs were conducted with over

100 vocational education administrators and

teachers in Ohio, California, Minnesota, Arizona,

Florida, and New York. The program was de-

signed for flexibility so that its 17 units can be

taught over 3 days or over longer periods, depend-

ing on individual needs.

Another example of training-the-trainer was the

NIOSH program to increase the awareness of high

school science teachers about hazards in the work-ing environment. In a three-year period, over

100,000 teachers were trained through this pro-gram at a cost of little more than $1 per trainee.

This program also resulted in changes that de-scribed chemical hazards to workers in a recently

published high school science text.

Specific teaching m odu les have also been devel-

oped and made available to appropriate groups.For example, audiovisual presentations on safe

removal of asbestos from school buildings were

developed jointly by NIOSH, OSHA, the Envi-ronmental Protection Agency, and the National

Cancer Institute. Over 1,000 copies of these pro-

grams were distributed to train asbestos removalcontractors. In another case, videotape programs

were developed to instruct firefighters and other

workers in the techniques of maintaining and don-

ning self-contained breathing apparatus. These

tapes featured the latest findings from the testing

of these devices.

Planning

In 1977, NIOSH conducted a nationwide sur-

vey of governmental agencies and nonagricultural

firms with more than 100 workers to determine

the current number of employed occupational

safety and health professionals and to predictfuture demand. Based on nearly 3,300 survey re-

sponses, NIOSH estimated the nu mber of full-time

professionals to be between 104,360 and 110,840

and forecast 3,100 new positions a year would be

available by 1990. Growth in demand was con-

centrated in jobs that “inspect, interpret, in-

vestigate, and plan, ” such as industrial hygienists

and safety engineers (570).

The future supply of occupational safety and

health personnel was estimated in another NIOSH

survey by asking 112 programs in occupationalsafety and health education how many graduatesthey expected in the future. These results, com-

bined wi th es t imated numbers of personneltrained by insurance companies and by the Fed-

eral Government, showed that in 1977 the de-

mand exceeded supply of occupational safety

specialists, occupational health nurses, and oc-

cupational health physicians, but that the demand

equalled supply for industrial hygienists. Due tosurvey limitations, data collected at that time were

insufficient to predict adequacy of supply of oc-

cupational safety and health personnel by 1990

(570). A report that updates work force supplyand demand information has been completed(584); however, publication of the report awaits

OMB approval.

The NIOSH surveys of demand and supply,

like all such projections into the future, were based

on assumptions about conditions in the yearsahead. Because of the sagging economy in the

early 1980s, and probably also because of a re-du ced Federal presence in occup ational safety and

health, there have been few positions availablein this field. The Advisory Panel to this assess-

ment lamented the fact that occupational safetyand health professionals are often among the first

Photo credit E.I. du Pont de Nemours & Co

Measuring the concentrat ion of potentia l ly harmful

gases is one aspect of an industrial hygienist’s job




to be laid off from company and union jobs, bu t

could offer no suggestions to alter that condition.

Training Grants

NIOSH’s findings of shortages of trained oc-

cupational safety and h ealth graduates w ere citedin successful efforts to expand training grants pro-grams. On e part of this expansion was to intro-duce the concept of multidisaplinary educationalresource centers. The other part was growth of single-discipline training grants.

Single-discipline training project grants havebeen established in 28 universities, and over 100

different academic degree programs were in place

in 1980. Because of bu dget cutbacks, the nu mb erof programs was reduced to 60 in 1982. The num-

ber of professionals graduating from these and

ERC programs each year increased from 217 in1976 to 747 in 1980. As shown in figure 10-1, the

number of graduates increased as the funding in-

creased.

Educational Resource Centers

Congress authorized creation of up to 20 Educa-

tional Resource Centers for occupational safety

and health in 1976. Funding increased from $2.9million in 1977 to $12.9 million in 1980, and the

ERCs now number 15. These centers: 1) provide

continuing education to occupational health and

safety professionals; 2) combine medical, indus-trial hygiene, safety, and nursing training so that

graduates are better able to work effectively in

complex and diverse conditions; 3) conduct re-

search; and 4) conduct regional consultation serv-

ices. All ERCs but one are located in universities.

The centers are distributed as far as p ossible togive regional representation and to meet trainingneeds for all areas of the Nation. The Federal cost

of ERC education is approximately $7,000 foreach degree graduate and $70 for each attendeeat continuing education courses (102).

Recent budget cuts have reduced the current

level of funding for Educational Resource Centers

to $5.8 million, 55 per cent below the level in fiscalyear 1980. According to projections by the Asso-

ciation of University Programs for Occupational

Health and Safety, if Federal funding for ERCs

had been eliminated as proposed in the President’s

fiscal year 1984 budget, the number of graduates

completing their programs would have decreased

to approximately 338 (compared with about 781

in 1981) and only about 25 degree programs of

the 112 progr ams curr ently in existence could have

been expected to survive. Furthermore, there wasconcern that without Federal funds, multidisci-

plinary programs would revert to more narrow

and limited single-discipline programs.

While the President’s 1984 budget for NIOSH

contained no request for ERC funding, the Con-

gress added $8.8 million for the centers.

Other Training Programs forOSH Professionals

Other Federal agencies and private companiestrain occupational safety and health professionals

in special cases. OSHA maintains a training insti-

tute in Des Plaines, IL, primarily to give short-

term training to State and Federal compliance of-

ficers, and the institute also provides short coursesto some private sector groups (636). The Mine

Safety and Health Administration maintains a

Training Academy in Beckley, WV, to give short-term training to its inspectors (452).

Many short-term training courses for workersand occupational safety and health professionals

are sponsored in the private sector. The courses,

including a wide variety of specialized short-term

training in both illness and injury prevention, areannounced weekly in journals such as the Occupa-tional Safety and Health Reporter published by

the Bureau of National Affairs. The number of

private sector courses has grown substantially

since the passage of the OSH Act.



Ch. 10—Training and Education for Preventing Work-Related Injury and illness q 199

ENGINEERS AND MANAGERS

Although there appears to be a growing aware-ness in the business community of the costs of

work-related illness and injury (284), little infor-

mation is provided about prevention in business

schools (579). Furthermore, there is little evidencethat engineering schools treat the subject at anylevel, but there are some attempts to change this.Professional engin eering societies and trade asso-ciations have formed committees on occupationalsafety and h ealth, governm ental agencies are con-ducting training and information programs, andeducators are slowly becoming concerned.

Engineers and business managers are often un-aware of the potential for reducing work-relatedinjuries and illnesses either because the hazard re-main s to be iden tified or because information

about i t is new and inadequ ately disseminated.Even after a hazard is recognized, these businessdecisionmakers may lack access to informationon which to base plans for prevention.

Educating Engineers

The engineering curriculum is one of the fewthat prepares baccalaureate degree holders for aprofessional license. Because it provides both anundergraduate and a professional education, thecurriculum is a crowded one and under constantpressure to add new material. Occupational safetyand h ealth would be a useful addition or augmen-tation to currently scheduled lectures, but it is dif-ficult to squeeze it in.

Few people more fully recognize the difficultiesof the engineering curriculum than professionaleducators, yet they see some opportunities to in-crease safety and health instruction. For instan ce,industrial-hygiene-engineering educators recom-men d, in a recent report, presenting studen ts withinformation on recognition and control of work-related injury and illness hazards and making suchinformation available to practicing en gineers(587). They single out design engineers as a par-

ticularly imp ortant group b ecause the greatest op-portunity for change is in the planning stages of industrial processes. “All undergraduate engineer-ing curricula (particularly d esign courses) shouldinclude instruction on the responsibilities of engi-neers for occupational safety and health engineer-ing problems and solutions” (587). The report alsorecommends that academic programs in occupa-tional safety and health should be offered to prac-ticing engineers as continuing education. The Amer-ican Board of Engineering and Technology, whichaccredits programs in en gineering, finds it “desir-able” for engineering schools to teach safety (4).

Specific legal responsibilities require profes-sional engineers to protect workers and the pub-lic as well as their employers. Professional engi-

neers may b e required to act accordin g to theprevailing p ractice of the p rofession b y State law,but they may lack knowledge about local or Fed-eral regulations or penalties for noncompliance.Indeed, engineers have been held accountable forthe actions of untrained su bordin ates in somecases. In the case of workplace health and safetyregulations, trainin g may be absen t since fewschools of engineering have courses bearing onresponsibilities under the Occupational Safety andHealth Act.

Complicating problems for engineering schools

are current pressures to update curricula to meetrapidly changing technology, to respond to thesudden upsurge in enrollment, and to upgradefaculty and overcome critical staff sh ortages.Undergraduate enrollment exceeded 387,500 in theacademic year 1981-82. This was an all-time high

for the Nation’s 286 engineering schools (419).

Training Business Managers

According to a national survey of 217 schoolsof business management accredited by the Amer-ican Assembly of Collegiate Schools of Business



200 qPrevent ing I l lness and Injury In the Workplace

(a group representing a majority of business man-agement schools) that w as condu cted b y the N a-tional Safety Management Society, few specifysafety managemen t studies as a d egree requ ire-ment (311). It is not difficult to imagine that suchstudies would be of low priority in management

schools, but some companies argue that commit-ment of top managemen t is the single most nec-essary ingredient in safety and health p rograms(156).

ing programs in business schools. The project willbe publicized through a series of briefings givento administrators and faculty at selected businessschools. Audiovisual materials will be preparedand a case-study b ook assembled containing 50related occupational safety and health articles.

These materials will be designed so that they canbe u sed in classwork b y the bu siness educators(584).

NIOSH and OSHA have begun Project Minervato develop occupational safety and health train-

COMPUTER NETWORKS AS AN EDUCATIONAL TOOL

Improving the quali ty and quanti ty of infor-

mation available about preventing work-relatedinjury and illness depends upon finding solutionsand communicating the solutions to people whowill benefit from them. The traditional methodsof information exchange are jou rnal articles, pres-entations at professional meetings, and variouskinds of consultation. Computer conferences—formed by people who share common interestsand who “part icipate” in the conference by sen-ding and receiving messages in a central comput-er—are an experimental method of informationexchange. They h ave been tried on a lim ited scalefor the exchange of information about occupa-

tional safety and health and on a larger scalewithin companies to exchange technical informa-tion. It is unclear what their eventual value willbe, but they h ave been p raised b y some occup a-tional safety and health p rofessionals wh o haveused them.

NIOSH Use of Computer Networks

One of the duties of the Technical InformationDivision of NIOSH is to draft responses toOSHA-proposed rules. NIOSH used computerconferences to respond to two 1982 Advance No-

t ices of Proposed Ru lemaking from O SHA. Onenotice concerned “Hazard Communication” (the“labeling standard”), which details what informa-

tion is to be provided to workers about the chem-icals to which they are exposed. The other dealt

with OSHA’s regulation concerning Access to Em-

ployee Medical Records, which stipulates whatmedical records are to be retained by employers,for how lon g, and wh o has access to them. In bothcases, NIOSH arranged a conference that involvedabout 10NIO SH em ployees in scattered locations;there was little overlap in the membership of thetwo groups.

NIOSH participants consider the exchanges tohave b een a su ccess. The comp uter-time cost forthe h azard commu nication exchange was $2,500,about two-thirds as much as a 2-day meeting atNIOSH in Cincinn ati , wh ich w ould b e an al ter-

native method of gathering needed responses.A NIOSH-MIT exchange was organized differ-

ently. The Reader’s Digest computer data base,the Source, has software called PARTICIPATEthat permits its users to join in conferences. Threeprofessionals with expertise in computers andvideo display terminals posted a message on theSource invit ing commen ts and discussion. Overa dozen participants joined in; the discussions fol-lowed two paths—one concerning possible healtheffects from radiation and ergonomic considera-tions, the other stress and q uality of work.

Priest (377) sees the NIOSH-MIT exchange asa limited success. It attracted participan ts, but b e-cause it did not have a goal, such as producinga document or answering a question, the exchangestrayed, just as undirected conversations do.





208 . Preventing Illness and Injury In the Workplace

Workers cooperate in the training of union safetystewards in General Motors’ training programs.

NIOSH’s 15 Educational Resource Centers, lo-cated across the N ation, represent a dep arturefrom d isciplinary training for health and safetyprofessionals. They emphasize interdisciplinaryt raining of indu strial ph ysicians and nu rses, in-dustrial hygienists, and safety engineers. Unfor-tunately no solid evaluation of the programs hasbeen carried out, but the ERCs are well regardedby m ost professionals.

The stability, if not the very existence, of ERCsis threatened b y u ncertain Federal fundin g. Foreach of the last four years, the President’s bud-get has recommended no Fe&al funding. In eachyear, Congress restored funding. Nevertheless, thethreat to the ERCs has seen parallel decreases inthe number of graduate degrees awarded.

One of the surest ways to disseminate new in-formation is to gradu ate new p rofessionals andsend them into the work force. As enrollment ingraduate programs has declined, ERCs have in-creased attention to continuing education for prac-ticing health and safety specialists. The flexibility

of ERCs in providing both degree and continu-ing education programs is an argument for theircontinuation.

Evaluation of Federal education and trainingprograms has consisted largely of counting num-bers of graduates and hours of instruction. Whilethose measures provide an indication of howmuch education is going on, they provide no de-tails of the impact of the education. Carefulevaluation would aid in making funding decisions.



q

1 1 .

A Short History of Privateand Public Activities



Page

Voluntary Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

National Safety Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

American Occupational Medical Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

American National Standards Institute. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206

American Conference of Governmental Industrial Hygienists . . . . . . . . . . . . . . 206

Governmental Efforts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207Workers’ Compensation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

Progressive Era Aims.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

State Health and Safety Programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209

Early Federal Government Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210

Federal Research and Assistance in Occupational Safety and Health. . . . . . . . 211

Federal Legislation and Regulatory Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212



11 m

A Short Historyand Public

of PrivateActivities

Accompanying new methods of factory pro-

duction in th e 18th an d 19th centu ries were ex-posures to new working conditions and new h az-ards. As some associations between hazards andinjuries or illnesses were recognized, efforts w eremade to imp rove working condit ions and to re-duce or eliminate job hazards. Some of these

VOLUNTARY EFFORTS

The importance of workplace safety was rec-ognized by some large American firms around theturn of the century in the face of a rising numberof injuries associated with the installation of newindustrial machinery. One positive response wasthe creation of employer policies and practicesdirected at reducing the frequency of those injuries(box L). In add ition to compan y-specific efforts,

several voluntary organizations have been createdto promote occupational health and safety.

National Safety Council

The first national organization devoted entirely

to occupational safety, the National Safety Coun-cil (NSC), was established in 1912 as a respon seto the high ind ustrial accident rate. It popu larizedthe “Safety First” slogan that h ad b een u sed byU.S. Steel. The coun cil was govern ed b y a bu si-ness-dominated Board of Directors. It sought toachieve industry consensus for its recommenda-tions, and favored nonmandatory standards,training and education, and voluntary safety pro-grams (361) as the best method of improving safe-ty records. The NSC thus epitomizes the volun-

tary safety movement.Although the council h as now shifted i ts em-

phasis to automobile and home accidents, its safe-ty publications (and particularly Accident Facts(324)) are well known and widely disseminated.

originated in the p rivate sector; others, in theGovernmen t. Many of these efforts concerningoccupational conditions were intertwined with at-tempts to improve public health more generally.A number of programs were successful, resultingin improved working conditions, although prog-ress has often been strikingly slow (see, e.g., 218).

The council has worked extensively with the De-partment of Labor to provide safety trainingcourses and materials to industry. Industrial firmsthat belong to the NSC have been reported tohave “injury rates well below those of non-mem-bers” (249).The cause-and-effect relationship be-tween low injury rates and membership in theNSC is n ot clear. It is at least as likely that com-pan ies with low rates join the N SC as it is thatmemb ership in the NSC results in lower injuryrates.

American OccupationalMedical Association

Indu strial medicine originated in large comp a-nies that emp loyed surgeons to treat traum atic injuries. By 1915, enough physicians and surgeonswere engaged in ind ustrial health to lead to theorganization of the American Association of In-dustrial Physicians and Surgeons. Seventy-twophysicians attended the association’s first meetingin 1916. (In 1951, the association’s name changedto Ind ustrial Med ical Association and later toAmerican Occupational Medical Association. )Also in 1915, the American Medical Association

held its first symposium devoted to industrial hy-

giene and medicine. The American Occupational

Medical Association publishes a monthly journal,

th e Journal of Occupational Medicine.

205




rected at technical specifications for manufactur-ing, such as having common thread pitches forscrews, nuts, and b olts, some of the stand ardsissued b y ANSI are directed at imp roving occupa-tional safety (249).

The membership of ANSI consists of companies(company members) and trade associations, gov-ernment agencies, and private group s (memberbodies). Several un ions are also memb er bodiesof the organization. The “consensus” method usedby the institute is defined in its constitution as aposition “achieved according to the judgment of a duly appointed authority. Consensus impliesmuch more than the concept of a simple majoritybu t n ot necessari ly u nanim ity.”

ANSI standards are developed by standardscommit tees and are reviewed , sin ce 1969, by a

Board of Standards Review. The 15-person boardhas 9 industry members, 2 representatives fromthe Federal Government, 1 from m un icipal gov-ernment, 2 academic representatives, and 1 mem-ber from a consum er organization. The board isauthorized to decide w hen a standards commit-tee has reached consensus; this decision includescounting and weighting the votes of the commit-tee’s mem bers (249). The votes and weighting fac-tors are not mad e pub lic, although ANSI does cir-culate drafts to interested parties for commentthroughout the final consensus process. (TheANSI standards concerning occupational health

and safety that existed in early 1971 were adoptedas regulations by the O ccup ational Safety andHealth Adm inistration (OSHA) using the author-ity granted in sec. 6(a) of the Occupational Safetyand Health Act of 1970. See below and ch. 12. )

American Conference ofGovernmental Industrial Hygienists

The American Council of Governmental Indus-trial Hygienists (ACGIH) was founded in 1938 by

a grou p of indu strial hygienists from v arious levels

of government. The ACGIH is a professional or-ganization that issues “recommendations” that aredeveloped by a straight membership vote.

By 1968, ACGIH had adopted nearly 400Threshold Limit Values (TLVs) for hazardous sub-stances. The TLVs are 8-hour time-weighted aver-



.

Ch. 11—A Short History of Private and Public Activities q 207

age values that are suggested limits for workday

exposure; they are “gu ides for the control of health

hazard s” and were historically directed to the toxicrather th an th e carcinogenic, cytogenic, or muta-genic properties of chemical sub stances. In aspecial app end ix to the 1968 publication, ACGIH

recommended no exposure to a list of carcinogens.

ACGIH standards have been adopted by severalforeign governments and were incorporated in

GOVERNMENTAL EFFORTS

Workers’ Compensation

The first workers’ compensation program wasestablished in G ermany by Otto von Bismarck in1884, and other European countries soon adopted

their own programs (279), In the United States,

the most important early-20th-century activity of

State governments concerning occupational health

and safety was the creation of workers’ compen-

sation programs. A limited program was estab-

lished for Federal workers in 1908, and a num-

ber of States established commissions to study

possible programs at about that time. Interest inworkers’ compensation derived from severalsources.

The focus of these efforts was on the p erceiveddeficiencies of the U.S. legal system concernin g

compensat ion for industrial injuries, UnderAnglo-American common law, individuals cansue others for damages if a wrong has been com-mitted that causes harm. The basic duty of em-ployers was to act with d ue care for employeesafety, as a reasonably prudent p erson w ould, andto furnish a su fficient nu mb er of safe tools andequipment, as well as a sufficient number of qual-ified employees to do the work. Employers wereresponsible for issuing and enforcing rules forworkplace safety, rules that with ordinary carewould prevent reasonably foreseeable accidents.Finally, there was a duty to warn workers of un-usual hazards.

In theory, if the employer failed to live up tothis stand ard of cond uct, an inju red emp loyeecould sue for damages under the common law.This was not always easy, however. The first dif-ficulty was simply proving the employee’s case.

1969 by th e Bureau of Labor Standards of th e U.S.Department of Labor using the auth ority of theWalsh-Healey Act (described below ). Followin gits establishment in 1971, OSHA adopted theWalsh-Healey standards as its own, resulting inthe TLVs pub lished in 1968 by ACGIH b ecom-ing occupational health standards for all U.S. in-dustry (249) (see also ch. 12).

Other employees might be crucial witnesses, butin the 19th century, when there were few govern-mental or union job protections, anyone who tes-tified against an employer would risk being fired.

More importantly, the law also established threepowerful defenses that employers could useagainst lawsuits brought by employees. Thesewere:

q

q

q

negligen ce of other servants or co-work ers,knowledgeable assumption of risk by the em-ployee, andcontributory negligence by the injuredworker .

Progressive Era Aims

In the early 1900s a number of Progressive Era

hum anitarian efforts und erlined the plight of theinjured w orker and paved th e way for workers’compensation programs. Crystal Eastman con-ducted the now-famous “Pit tsburgh Survey” of 1907-08. She examined the economic conditionsof the families of workers who h ad b een kil ledor injured. In over h alf the cases, she foun d that“the emp loyers assumed ab solutely no sh are of the in evitable income loss. ” The costs of work ac-cidents fell “directly, almost wholly, and in like-l ihood finally, upon the injured workmen andtheir dependents. ” She concluded that a systemof compensation w as necessary to achieve equity,social expediency, and prevention (274).

At about the same time, a State commission inIllinois reported that most court awards for in-dustrial accidents were small, and that the fami-lies of the inju red w ere often forced to live oncharity. Moreover, for employers w ho h ad lia-



208 Preventing illness and Injury in the Workplace

bility insurance, only 42 percent of payments wentto medical care. The remaining 58 percent wentfor administration, claims investigation, and legalexpenses (100).

Employer< Attitudes

The apparently small awards made to mostworkers was not the only reason for dissatisfac-tion w ith legal remedies. Emp loyers, wh o as agroup supported workers’ compensation legisla-t ion before labor un ions did, also found ad van-tages in compensation p rograms. There is someevidence that just prior to the creation of work-ers’ comp ensation laws, inju red w orkers, at leastin some circumstances, won a substantial portionof lawsuits against their employers (100,130,234,316).

Moreover, workers’ compensation substituteda regular, fixed, and predictable compensationpayment for uncertain, potentially ruinous liabil-ity judgments (274). Employers also feared thatwithout a workers’ compensation system, thecourts wou ld start making more awards to injuredemp loyees, especially if a worker could sh ow th athis/her employer had violated one of the increas-ing number of State safety regulations (249).

Finally, employers advocated workers’ compen-sation in ord er to remove one source of hostilityfrom labor-management relations and possibly toprevent more fundamental changes in the worker-

employer relationship. They specifically opposedthe passage of liability law reforms that wouldhave eliminated the common law defenses of em-ployers. Some large companies h ad already estab-lished company benefit plans that provided p ay-ments for work injuries. Smaller manu facturersfavored creation of such plans, but lacked the re-sources to do so privately (667). Larger manufac-turers feared that if such plans were not created,legislators might act to change employer and em-ployee rights. In the absence of changes, it wasfeared that the n ascent un ions would be given aboost (100,667).

For these reasons, some of the in itial advocatesof workers’ compensation included groups like theNational Association of Manufacturers, the Na-

tional Civic Federation, the American Associa-tion for Labor Legislation, and a number of theleading ind ustrialists of the day.

Labor Union Reactions

Unions, on the other hand, ini t ial ly opposedworkers’ compensation. They generally wantedworkers to retain the right to sue employers andadvocated abolition of the three common law de-fenses. They held this position in part because theythought injured workers would receive larger pay-ments u nd er such a plan an d because, at the time,they generally mistrusted the government andfeared that governmental intervention wouldweaken unions (667).

Union opposition was also based on their per-ception that workers’ compensation was “pallia-

tive and n ot preventive” (279). The b elief thatworkers’ comp ensation could provide an econom -ic incentive for prevention was, according to Mac-Laury (279), important in changing labor’s posi-tion; it “seemed to tip the scales. ”

initial Legislation

The very first compensation acts, in Maryland,Montana, and New York, were ruled unconstitu-tional. The Federal Government enacted a law in1908, which covered only certain Federal employ-ees. The first State law to become effective and

remain so was p assed in Wisconsin in 1911. Fol-lowing this breakthrough and aided by the com-

bined support of reformers, business, and labor,

laws were passed rapidly. Four other States passed

laws in 1911. By 1925,24 jurisdictions had enacted

compensation, although it wasn’t until 1948 that

all the States had such laws (249,316,667).

In some cases, workers’ compensation was set

up to supplement rather than to replace the legal

liability system. Lubove states that “[w]here la-

bor had a major voice in shap ing compensationlegislation, as in Arizona, injured workers were

allowed a choice of remedy after injury.” It ap-pears that un ti l that choice was removed u nd erbusiness pressure a decade later, most injuredworkers chose the liability route (274).



Ch. II—A Short History of Private and Public Activities q 2 0 9

Extent of Coverage

The initial laws covered only accidental injuries.Some s t a t e legislatures had no intention of com-

pensating occupational diseases and specifically

excluded them from coverage. Three reasons for

this have b een suggested. First, workers’ compen-sation laws were created to sup plant common lawliability. Under the common law, workers wereconsistently d enied recovery for occupational d is-eases. Second , it was thou ght th at comp ensationfor disease would be so expensive that it wouldbest be hand led un der a general health or disa-bility in suran ce program. For examp le, it wasbelieved that complete coverage of certain occupa-tional d iseases, such as silicosis in fou nd ries,mines, or qu arries, would be extremely expen sivefor the compensation system and those part icu-lar indu stries (261).

It has also been suggested tha t some of the writ-

ers of the early workers’ compensation laws usedlanguage that would not alarm legislators, but

would be flexible enough to allow the courts to

extend coverage to occupational disease (46).

Massachusetts was the first State to compensate

disease when the courts acted in just this way. Butby 1928, only 10 States covered diseases. From

1931-39, 14 States added coverage, while 18 States

d id so in th e 1940s. The 7 remaining States addedcoverage between 1951 and 1967 (261). (See ch.

15 for a discussion of the current workers’ com-

pensation system. )

State Health and Safety Programs

Most early occupational health and safety ef-forts in th e United States occurred at the Statelevel. Occupational safety laws w ere enacted byvarious States during the 19th century. As seemsto be often the case, there appears to have beena tendency to direct the laws at what were, at thetime, new technologies. For instance, in 1852,

Massachusetts passed a law regulating steam en-gines and permitting State inspectors the “power

of closure” in situations of grave hazard (249).Twenty-five years later, in 1877, the same Statepassed the first factory-insp ection law that re-quired the installation of certain safety devices(guardin g of b elts, shafts, and gears), fire exits,and protection on elevators (279).

The early lead of Massachusetts in establish-ing regulations about workplace safety was fol-lowed elsewhere. By 1890, 22 States had passedregulations permittin g safety inspectors in mines,and 14 had factory and workshop inspectors.However, these early laws were rarely enforced,partly because inspectors, who were often politi-cal appointees, were too untrained to recognizeeven the most obvious safety hazards.

In th e first decades of this century, Alice Ham -ilton (box M) and other researchers actively pur-sued the w ork-relatedn ess of certain diseases.Their work was important in st imulating the in-terest of State governments in occupationalhealth. By 1913, programs were organized in Con-necticut, New York, and Ohio. The first impor-tant occup ational disease laws, the “lead law s, ”were passed in New Jersey, Oh io, and Pennsyl-

vania (373).

Despite the establishment of these State occupa-tional health and safety programs in the early partof this century, these programs were often defi-cient. A 1964 study reported that, on average,there was only one occupational health staff mem-ber for every 108,000 workers, and there were

fewer than 1,600 safety inspectors in the various

State programs combined (249).

A survey taken in 1968 foun d th at occup ational

health programs were in place in only 20 Statesand jurisdictions and th at most States had m oregame wardens than safety inspectors. State oc-cup ational safety programs, wh ich w ere muchmore highly developed than occupational healthprograms, covered only the mining portion of thework force in 4 States, and 1 State had no safetylegislation at all until 1967. State expenditures onoccupational safety ranged from 1 cent per em-

ployee in Wyoming to $2.70 per worker in O regon.In addition, as late as 1969, only 21 States gave

safety inspectors the right to shut down a work

area that presented an imminent hazard (249).

Moreover, even in th e States with occupationalhealth programs, the powers to develop and en-force occupational health laws and to inspectworksites were often diffused through severalagencies. The resulting fragmentation of powerscontribu ted to the d ifficulties of enforcing Stateoccupational health laws.




A final comp lication of separate State laws isillustrated by what happened when Pennsylvaniabanned the use, manufacture, storage, and han-dling of beta-nap hthy lamine, a carcinogen . Soonafter the ban, another facility in another Statebegan producing the chemical (249). This State-

by-State app roach w as also criticized by bu sinessrepresentatives. A keynote speaker at a trade asso-ciation m eeting in Washington in 1973 noted:

When . . . [there is] a proliferation of differentstate plans and state enforcement . . . Americanbusiness [has] great difficulty because most. . . companies . . . are multiproduct, multiplantcompanies. Having to live with . . . 40 or 50 dif-ferent approaches . . . as distinguished from asingle set of ru les . . . concerns me greatly (277a).

Thus, by the time Congress considered Federaloccupational health and safety legislation in the

late 1960s, there was widespread agreement that,as one historian has su mm arized it, “safety andhealth laws, historically left to the States, werepiecemeal, varied in quality, and often unen-forced” (124).

Early Federal Government Programs

As early as 1790, the First Congress appearedto take an interest in the safety of merchant sea-men by giving the crew of a ship at sea the rightto order th e vessel into the nearest por t if a ma-

jority of the seamen plus the first mate believedit unseaworthy (279). In 1798, the Marine Hos-pital Service, which evolved into the Public HealthService, was established to provide care to seamendisabled on the job. The Hospital was paid forthrough the first system of health insuran ce in th iscountry: a tax of 20 cents annually deducted fromall seamen ’s w ages (249). In the ear ly 19th cen-tury, the Marine Hospital’s physicians were pri-marily concerned with the control of epidemic dis-eases, such as cholera and yellow fever, wh ich w asmore in the realm of public health than wor kerhealth.

Federal employees benefited from several meas-ures passed in the 1800s: an 1833 law grantedcompensation to d isabled seamen; an 1868 lawlimited the w orkday of Federal emp loyees to 8hou rs; in 1908 and 1916, work ers’ comp ensation



Ch. 11—A Short History of Private and Public Activities . 211

was enacted for Federal railroad and other em-ployees. Several early attempts (1796, 1852) atFederal intervention in matters of public health(such as enforcement of maritime quarantine andState grants to establish asylums for the insane)were rebuffed by the States, which considered

public health their responsibility (249).

Federal Research and Assistancein Occupational Safety and Health

The Public Health Service (PHS) activities wereextended to the workplace in 1914 when the Of-fice of Industrial Hygiene and Sanitation was es-tablished in the Division of Scientific Research(249). During the next 20 years, the office engagedin research to identify occupational health hazardsand their effects. It studied lead poisoning, lookedat hazards in brass foundries and in the glass andchemical industries, and made sanitary surveysin war plants during World War I. It also con-ducted studies about the physiological effects of lighting, high temp eratur e, fatigue, and other en-vironmen tal cond itions in the w orkplace.

A stud y in 1924 followed up the d eaths of 20people who had been employed in the paintingof radium watch dials. Recommended controlmeasures subsequently ended radium poisoningin the watch ind ustry . Less spectacular, but bear-ing on the health of many m ore workers, was theOffice of Industrial Hygiene and Sanitation’s

stud y of the du sty trad es. Begun in 1923, this re-search show ed th e extent of health impairment as-sociated w ith the granite, pottery, cement, cot-ton textile, and m ining indu stries.

During this same early-20th-century period, theU.S. Bur eau of Labor, and its successor, the De-partment of Labor, also sponsored research on oc-cupa tional health and safety. Its reports includ edstudies of lead poisoning, phosphoru s-caused d is-ease, the dusty trades, and industrial accidents(124). A 1910 report on “ph ossy jaw,” pu blishedby the Bureau, was important in revealing the na-

ture of that occupational health problem. In thesecond decade of this century, the Bureau em-ployed Alice Hamilton to investigate occupationalhazards especially in the “dusty trades” and pub-lished the results of her studies (279).

The passage of the Social Security Act in 1935led to an expansion of PHS studies of occupationalhazard s and to the provision of grants to Statesfor public health work, includ ing indu strial hy-giene activities. During the 1930s, the PublicHealth Service studied the health effects of lead

in gasoline and of fumes of chromic acid and mer-cury in the wor kplace.

A 1937 reorganization of the PH S resulted inthe Scientific Research Division being consoli-dated with the National Institutes of Health (249).The Office of Industrial Hygiene and Sanitationalong with the Office of Dermatoses Investigationsbecame the Division of Indu strial Hygiene of theNational Institutes of H ealth. Seven years later,because of the marked increase in its work withStates, the Division was transferred to the Bureauof State Services.

In World War II, as in World War I, the PH Swas concerned with the protection of employeehealth in government-owned , privately operatedmu nitions plants. A dram atic illustration of thesuccess of these efforts is provided by mortalityassociated with TNT m anufacture in both wars.During 7 month s of World War I, 475 workersdied and 17,000 were disabled by fumes; in WorldWar II, there were 22 deaths in 35 month s. In ad -dition, stud ies w ere carried out in aviation m edi-cine an d on th e health effects of new chemicalsand metals, such as vanadium and beryllium,

newly introduced into airplane manufacture.Other reorganizations followed World War II.

In 1953, the Federal Secur ity Agency, w hich hadincluded the Public Health Service, was abolished,and the Department of Health, Education, andWelfare (HEW) w as established. The Division of Industrial Hygiene became the OccupationalHealth Program and remained in the Bureau of State Services until it was designated the Occupa-tional Health Program in the Bureau of DiseasePrevention and Control in 1966. Other organiza-tional moves within the Department followed,and it was renamed the Bureau of OccupationalSafety and Health (249).

The Occupational Safety and Health Act in1970 established the National Institute of Occupa-tional Safety and Health (NIOSH), and in 1973




NIOSH was tr ansferred to the Centers for Dis-ease Control of the PH S. During all the bu reau-cratic reorganizations since it began in the Pu b-lic Health Service, the occupational healthprogram has produced important studies aboutoccup ational health and, m ore recently, safety.

Federal Legislation andRegulatory Programs

Federal regulatory attention has historicallyfocused on several high-hazard industries, suchas mining, longshoring, railroading, and construc-tion. The coal mining indu stry prov ides an ex-ample of Federal efforts to control occupationalhazards in these industries.

Coal Mine Safety Legislation

In the wake of the Monongah, WV, coal minedisaster of 1907 that killed 362 miner s and otheraccidents that caused the loss of many lives, theBureau of Mines was established in 1910 withinthe Departm ent of Interior to prom ote mine safe-ty. Bureau personnel were specifically denied “anyright or authority in connection with the inspec-tion or supervision of mines.” Although the pow-erlessness of Bureau personnel was widely de-plored, it was not until 1941 that the Federal CoalMine Health and Safety Act, wh ich gran ted in-spection author ity to the Bur eau, was passed . Anexcerpt from the Hou se of Representatives report

accomp anying th e bill captu res the sense of Con-gress at the time:

Investigation reveals no common standard of safety among the States, no common regulations,and , in add ition to this, a lack of un iform enforce-men t of such [State] regu lations as are in effect. . . . In order to supp lement the w ork of theState agencies, the bill un der consideration ex-tends and enlarges the authority of the Federal Bu-reau of Mines. It is not regulatory in any sense.It merely authorizes the Bureau , through its rep-resentatives, to make inspections of the under-ground workings and publicize its findings and

recommend ations. These inspections , . . are tobe mad e in conjunction w ith the local State agen-cies so that there is no assumption of the Stateauthority (quoted in 249).

Later laws gradually increased Federal author-ity over coal mine hazards; in 1966, Bureau in-

spectors were permitted to close certain establish-ments op erated by em ployers guilty of repeatedserious violations.

A disastrous explosion in 1968 killed 78 minersin Farmington, WV. This crystallized public at-tention on mine safety. Citing the Federal Gov-ernm ent’s “fatalistic attitud e” and failure . . . “toact vigorously to change [the prevailing bad prac-tices], ” the 91st Congress passed the Coal MineHealth and Safety Act of 1969 (the Coal Act)(249).

Despite the increase in auth ority given to theFederal Govern men t by th e 1969 Coal Act, safetyand health conditions in the m ines continued tobe unacceptable to the Congress; in 1973, approx-imately one of every 1,500 miners, compared withone of every 12,400 workers in general ind ustr y,were reported to have been killed. In 1977, Con-

gress passed the Federal Mine Safety and HealthAmendments Act, the first Federal law to consoli-date jurisdiction over both coal and metal minesand all safety and h ealth matters (except trainingand research) in one executive department. TheDepartment of Labor was empowered by this Actto inspect mines, and to develop, prom ulgate, andenforce safety and health stand ard s app licable tomines (249).

Legislation for Other Industries

The New Deal. —Frances Perkins, selected by

Presiden t Franklin D . Roosevelt in 1983 to be th eSecretary of Labor, brought experience in occu-pational safety and health to that position. In1934, she created within the Department the Bu-reau of Labor Standards, the first permanent Fed-eral agency with a mand ate to promote safety andhealth for the entire w ork force. To a major ex-tent, the Bureau acted by aiding the States in theadm inistration of their workp lace health an d safe-ty laws and by promoting protective legislation.

Three New Deal-era laws contributed to agrowing Federal involvement in occupational safe-

ty and health. As noted above, the Social Secu-rity Act of 1935 provided for the Public HealthService’s funding of State industrial health pro-grams. In addition, the Fair Labor Standards Actof 1938 (the “minimum wage law”) allowed theLabor Department to bar employment of persons



Ch. 17—A Short History of Private and Public Activities 213 .

under 18 in dangerous jobs, while the Walsh-Healey Pu blic Contra cts Act of 1936 directed th eDepartment to ensure standards for safe work byFederal Government contractors and to “blacklist”contractors who did not comply with the stand-ards (279). This last act is of particular interest

because it created a Federal regulatory role con-cerning job safety and health and located thisfunction in the Departm ent of Labor.

Walsh-Healey Act.–This legislation covered allemployees working for employers who h ad con-tracts with the Federal Government that exceeded$10,000 in total value. The McNamara-O’HaraAct of 1966 and the Construction Safety Act of 1969 extend ed Fed eral regu lation to service con-tract emp loyers and Federally fund ed construc-tion emp loyers, respectively. Emp loyers were re-quired by the terms of their contracts to comply

with Walsh-Healey safety and health standard s,wh ich w ere recomm ended by the Bureau of La-bor Standard s of the Departm ent of Labor. TheBureau of Labor Stand ards w as also given the au-thority to inspect workplaces covered by theWalsh-Healey Act and had the pow er to prohibitemp loyers w ho violated the act from bidd ing onFederal contracts for a period of three years.

Federal involvement in setting safety and healthstandards intensified in the late 1950s. In 1958,an amendment to the Longshoremen’s and Har-bor Workers’ Compensation Act extended the

Federal role in protecting safety and health in thehazardous maritime trades. The amendment au-thorized the Labor Department to set standardsin those trades and to seek penalties against em-ployers who willfully violated safety and healthstandards, Compliance with the standards w asgood after enforcement began in 1960, and acci-dent rates in the maritime trades declined (279).

Acting on its own in December 1960, the La-bor Department issued a set of mandatory safetyand health standards u nder th e Walsh-Healey Act.How ever, objections w ere raised to the rigidityof the rules that the Federal Government requiredState occupational safety agencies to enforce whenthey inspected Federal-contract workplaces. Thecriticisms were h eeded by the Dep artment, andhearings about the Federal standards were heldin March 1964.

The Federa l Bur eau of Labor Stand ard s almostnever used its inspection and enforcement p owers;in 1969, only 5 percent of th e 75,000 firms cov-ered by Walsh-Healey were inspected. At the3,750 wor ksites inspected b y th e Bureau in 1969,a tota l of 33,000 violations of safety regu lations

were recorded, while only 34 formal complaintswere issued. Two companies were blacklisted(prohibited from bidding on Federal contracts) in1969, and three had been similarly treated in 1968(361).

The history of events under the Walsh-Healeyand other acts exemplifies the spor ad ic efforts of the Federal Government to control occupationalhazard s in the years before OSHA. H owever, apattern of increasing Federal involvement, suchas the pr ogression that occurred in mining, canbe seen, particularly in the extra-hazardous

trades—maritime, railroading, and construction.In each case, the first laws permitted Federal per-sonnel to inspect specific aspects of hazard ousoperations, such as m an-cages (person nel hoists)in mines, air brakes on trains, and shackles andother rigging components in longshoring. Thisfirst stage was gradually followed by Federalassumption of the responsibility for developingor recommending standards, helping employersto comply w ith them (and only rarely, in casesof grave danger, using the power of closure), andfinally enforcing them . In all cases, the creationof Federal agen cies with inspection and enforce-ment authorities required more than a half-cen-tur y from the time of initial congressional action(249).

The Occupational Safety and Health Act of 1970.—One result of the strong criticisms voicedbefore and during the 1964 Department of Laborhearings w as a decision of the Departm ent to ex-amine its safety and h ealth policy. A stud y by anindepend ent consultant characterized the LaborDepartment’s safety laws and program s as frag-mented (279). During this period of self-examina-tion, the environmental movement was attractingpu blic and congressional sup port in its bids forFederal laws to protect human health and the envi-ronment from the effects of pollution. The envi-ronm ental movement sp illed over into questionsof occupational h ealth because of the attent ion




paid to chemicals as risks to health and the rea-sonable extension of “environment” to include theworkplace.

The Public Health Service published Protectingthe H ealth of Eighty Million Americans (the “FryeReport”) in 1965, which dr ew atten tion to threatsto health from new technologies. Although ithighlighted the evidence that some chemicals wereassociated with cancer causation, it also empha-sized th at man y “old” occup ational health p rob-lems had not been remed ied. The report su ggestedan ap proach to improve occup ational health thatwou ld require a m ajor new effort from the PH S.The AFL-CIO urged President Lyndon Johnsonto respond to the PH S report’s recomm endations(279).

With the Pr esident expressing interest in occu-pational safety and health, both the Labor De-

partment and the Department of Health, Educa-tion, and Welfare began d evelopment of legis-lation for a Federal program in occupational safetyand health. The departments deadlocked on theissue of wh ich one w ould control the national pro-gram in late 1966, and the effort stalled (279).

A dramatic bureaucratic action led the Bureauof the Budget to accept the Department of Labor’srecomm endations for legislation rather than thoseof HEW. In 1967, it w as learned that ab norm allyhigh numbers of uranium miners were dying of lung cancer. Later that year, the Federal Radia-

tion Council, composed of representatives froma number of Federal agencies, met to consider pro-tective measures for uranium miners. They cameto an imp asse concerning the standard prop osedby the Atomic Energy Commission versus themore stringent standard proposed by the Depart-ment of Labor. Unhappy w ith their indecision,Secretary of Labor Willard Wirtz adopted the pro-posed Department of Labor standards under theprovisions of the Walsh-Healey Act the very nextday. This bold m ove was instrumental, accord-ing to M acLaur y (279), in the Bureau of the Bud-get accepting the Department of Labor’s recom-

mendations about legislation.

In January 1968, President Lyndon Johnsoncalled on Congress to pass job safety and healthlegislation closely modeled on the recommenda-tions of the Department of Labor. The proposal

gave the Secretary of Labor the responsibility of setting and enforcing standards to protect 50 mil-lion workers. The bill also had a general dutyclause requiring employers to “furnish employ-ment an d a place of employment w hich are safeand healthful. ” It gave insp ectors legal author ity

to enter workp laces without management’s per-mission or prior notice. Violators could be pun-ished with civil or criminal penalties. Interestedstates could develop their ow n occup ational healthand safety program s to replace the Federal one.The Departm ent of HEW w ould p rovide the La-bor Department with scientific information (279).

Although hearings w ere held, that bill did notreach the floor of either th e Hou se or the Senate.Part of the reason w as the opp osition of business,particularly the Chamber of Commerce, to be-stowing so m uch p ower on the Secretary of La-

bor and to un derm ining the role of the States inoccup ational safety and health. Also impor tantwere other events of 1968: Riots in the inner cit-ies, protests against the war in Vietnam, and Presi-den t Johnson ’s d ecision not to ru n for re-electioncompeted w ith occup ational safety and health forpublic and congressional attention.

In 1969, Congress passed the Coal Act (seeabove) and President Richard Nixon introdu ceda new version of an occup ational safety and healthlaw for all U.S. workers. His version skirted theissue of w hether the Depar tment of Labor or HEW

was to h ave the lead in the Federal program. Theduty of Labor was to inspect workplaces for com-pliance with standards. The role of HEW was tocarry out research. The important function of is-suing safety and health standards w ould be vestedin an independ ent, five-person standard s-settingboard. The Nixon prop osal also stressed th e useof existing State government program s and pri-vate industry efforts (279).

Objections to the Nixon bill were raised bymany Democratic and some Republican congress-men. Their concerns involved the independent

standards-setting board, because of the adminis-trative confusion it wou ld cause and its lack of political accoun tability. Labor un ions, in par ticu-lar, opp osed this board , preferring instead thatthe auth ority to set standard s be given to the Sec-retary of Labor. In addition, objections were





.-. .

,

1

. . .

2 m

Governmental ActivitiesConcerning Worker

Health and Safety





— —

12Governmental Activities Concerning

Worker Health and Safety

This chapter h as thr ee major sections. The first vialing pu blic education and services, and moni-describes the framew ork of U.S. Governmen t ac- toring the performance of State programs. Thetivities created by the O ccup ational Safety an d third section d escribes the activities of the N a-

Health (OSH) Act, wh ile the second d iscusses the tional Institute for Occupational Safety andmain activities of the Occupational Safety and Health (NIOSH) in hazard identification, researchHealth Administration (OSHA): setting stand- on controls, and information dissemination.ards, inspecting and enforcing regulations, pro-

CURRENT FEDERAL/STATE FRAMEWORK

In the Occupational Safety and Health Act of 1970, Congress au thorized the creation of thr eeagencies to set and enforce man datory h ealth an dsafety standards; to conduct research on occupa-tional hazards and their control; and to reviewcontested enforcement actions. The three agen -cies are OSHA, NIOSH, and the OccupationalSafety and Health Review Commission (OSHRC).

One other Federal agency, the Mine Safety andHealth Administration (MSHA) of the U.S. De-partment of Labor, specializes in worker healthand safety. It is responsible for the health and

safety of workers in coal mines, as well as in othermetal and nonm etal mines. It was created as a re-sult of the Metal and Non -Metallic Mine SafetyAct of 1966, the Coal M ine H ealth an d Safety Actof 1969, and th e Mine Safety and Health A ct of 1977 (333). Its activities are not described in detailin this assessment.

OSHA is a regulatory agency that sets and en-forces regulations concerning the control of healthand safety hazards. It began its operations onApr il 28, 1971. Part of the D epartm ent of Labor,it is headed by a Presidentially ap pointed Assist-ant Secretary of Labor for Occupational Safetyand Health, to whom the Secretary of Labor hasdelegated authority to ad minister the OSH Act.OSHA sets mand atory health and safety stand -ards, inspects workplaces to ensure compliance,

and proposes penalties and prescribes abatementplans for employers found violating the standard s.In add ition, OSHA provides for p ublic, worker,and employer education and consultation, mostlythrou gh gr ant activities. Finally, OSH A p artiallyfinances the operations of State agencies operat-ing “State plans” an d monitors their performance.

NIOSH is a research agency that is part of theCenters for Disease Control (CDC) of the U.S.Public Health Service, which is part of the De-partm ent of Health and Hu man Services (HH S).NIOSH is headed by a Director app ointed by the

Secretary of HHS for a term of six years. It wascreated from w hat had been the Bureau of Occu-pational Safety and Health and started operationsas N IOSH on June 30, 1971. Congress m and atedthat it conduct research and related activities ondeveloping criteria or recommendations to be usedby OSHA in setting stand ards, on identifying an devaluating workplace hazards, and on measure-ment techniques and control technologies, as wellas provide p rofessional edu cation an d disseminatehealth and safety information.

The OSHRC has three mem bers appointed bythe President, with the ad vice and consent of theSenate, for staggered terms of six years. Its dutiesare limited to reviewing and resolving disputesconcerning OSHA citations and penalties. In do-ing so, the Review Commission interprets the

219







T a b l e 1 2 . 1

. - - F a d e r a l S p e n d i n g f o r W o r k e r H e

a l t h a n d S a f e t y

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p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n

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p a t i o n a l S a f e t y

a n d H e a l t h

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p r o g

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d g e t a

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t o t h e S t a t e s b y F e d e r a l

F o r t h e y e a r s

t h i s t a b l e , t h e s e g r a n t s w e r e

f o r

p e r c e n t

t h e o p e r a t i n g

c o s t s o f t h e S t a t e p r o

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b y

a n d



Ch. 12—Governmental Activities Concerning Worker Health and Safety 223

Figure 12-3.—Percent Change in Appropriations forSelected Health.Reiated Agencies 1980-84

‘OSHA MSHA’ NIH ‘NIOSH’ CDC ‘ CDC(excluding

1 I I 1 1

1971 1973 1975 1977 1979 1981 1983 1985

Year

Figure 12-2.— NIOSH Budget 1971-85

Year

He also worked to improve the professional ex-per tise of OSHA staff, especially its inspectors,

wh o had been criticized for their inexperience.In 1977, Eula Bingham was named to head

OSHA. She had been a professor of toxicologyand had served on an OSHA ad visory commit-tee concerning the coke oven emissions standard.

Agencies NIOSH)

SOURCE Budget of the United States Government

Table 12-2.—OSHA Assistant Secretaries andNIOSH Directors

OSHA

1. George Guenther . . . . . .2. John Stender . . . . . . . . .3. Morton Corn . . . . . . . . . .4. Eula Bingham . . . . . . . . .5. Thorne Auchter . . . . . . .6. Robert Rowland . . . . . . .

NIOSH

1. Marcus Key . . . . . . . . . . .2. John Finklea. . . . . . . . . .3. Anthony Robbins . . . . . .4. J. Donald Miller . . . . . . .

April 1971-January 1973April 1973-July 1975December 1975-January 1977April 1977-January 1981March 1981-March 1984July 1984-Present

June 1971-September 1974September 1974-January 1978October 1978-May 1981June 1981-Present

SOURCE Office of Technology Assessment

She acted to eliminate a n um ber of the “nit-pick-ing” standards, for which OSHA had been criti-cized, and emphasized the development of healthstandards and “generic standards” (those thatwou ld cover exposures to a group of substances,such as carcinogens, or would provide worker ac-cess to information, such as employer records con-

cerning exposures, medical care, and chemicalsubstance identity). She also established the NewDirections grants program and increased the num -ber of OSHA-funded onsite consultative visits,especially for small businesses.

Theme Auchter, a construction firm m anager,

took office in 1981. He emphasized a ‘balanced”

app roach to OSHA activities and im proved m an-agement of agency operations, established a n ewapproach for “inspection targeting, ” and en-




couraged cooperation with em ployers, especiallyconcerning negotiations about citations, fines, andabatement. Auchter reconsidered a number of thestandard s issued in previous adm inistrations, re-du ced the fun ding for the New Directions Pro-gram, increased the funding for onsite consulta-

tion, and encouraged the developm ent of Stateprogr ams. He r esigned in March 1984.

In July 1984, Robert Rowland was nam ed tohead O SHA. An attorney, he had p racticed lawprivately before being ap pointed as the Chairmanof the Occupational Safety and Health ReviewCommission. He served in that position fromAugust 1981 until his appointment as AssistantSecretary for OSHA.

In June 1971, Secretary Richardson of the De-partm ent of Health, Education, and Welfare an-nounced the establishment of NIOSH. Marcus

Key, M. D., previously chief of the Bureau of Oc-cupational Safety and Health in the U.S. Public

Health Service, was appointed as the first NIOSHDirector. He focused on making NIOSH a func-tioning organ ization. Key stepp ed dow n in Sep-tember 1974, after 3 years of his 6-year appoint-ment. John Finklea became the second Directorof NIOSH in Septem ber 1974 and also served 3

years. He em phasized the p rodu ction of NIOSHcriteria docum ents to be d elivered to OSHA.

Anthony Robbins, a former Commissioner forPublic Health in Vermont an d Colorado, becamethe third Director in October 1978. He deem-ph asized criteria documents an d focused on healthhazard evaluations and epidemiological fieldstudies. He, too, did not complete a 6-year term,but was fired by HHS Secretary Schweiker in1981. J. Dona ld Millar took office as the fou rthNIOSH Director in June 1981. Millar has takenseveral steps to im prove the quality of NIOSHresearch.

THE OCCUPATIONAL HEALTH AND SAFETY ADMINISTRATION

Figure 12-4 presents the organization of OSHA.The m ain activities of its national office in W ash-ington, DC, are perform ed by seven directorates,which specialize in developing health and safetystandards, coordinating operations of OSHA’s in-spectors, providing ed ucational and service pr o-grams, monitoring State plans, and furnishingadm inistrative and technical supp ort. However,the m ajority of OSHA staff, includ ing its insp ec-tors, are assigned to area offices that are groupedinto 10 different regions.

OSHA Standard-Setting

Section 5(a)(1) of the OSH Act, the “generalduty clause,“ imposes a general requirement thatworkplaces must be kept safe and healthful. Itprov ides that each employer:

. . . shall furn ish to each of his emp loyees em-ployment and a place of employment which arefree from recognized hazards that ar e causing orare likely to cause death or serious physical harmto his em ployees; . . .

The purp ose of the general du ty clause is to pro-vide employee protection from some of thehazards that are not currently addressed byOSHA’s more d etailed regu lations. The interpre-tation of the “general duty clause” is complex andcontroversial (see brief discussion later in thischapter).

Section 5(a)(2), the “specific duty clause, ” re-quires employers to comp ly with the m ore de-tailed stand ards issued by O SHA. These stand -ards are Federal regu lations that, for example,require employers to observe certain precautions,condu ct their operations in specified w ays, or in-stall and use certain kinds of equipment. The OSHAct provided OSHA, in sections 6(a), 6(b), and6(c), with th ree d ifferent meth ods to issue healthand safety standards. The standards issued underthese three methods have been termed interim,

new or p ermanent, and emergency temporarystandards (333,408). But many of the “interim”standards have not been changed since OSHAbegan. At the same time, OSHA has taken ac-tions to change some of the “perman ent” stand-



Ch. 12–Governmental Activities Concerning Worker Health and Safety q 225




ards. Mintz (307) suggests that OSHA standardsbe termed: startup standards, standards issuedafter rulemaking, and emergency temporarystandards.

Startup Standards

Congress mand ated that OSHA adopt, w ith-out additional rulemaking

l, those health and

safety standard s that had already been establishedby Federal agencies or had been adopted as na-tional consensus standards (OSH Act, section6(a)). This authority was limited to the first 2years after the act went into effect (April 1971 toApril 1973).

The established Federal standards had beenadopted by the Department of Labor using pro-cedu res that includ ed p ublication of the proposed

requirements and provided the public with an op-portunity to comment. The national consensusstandards, issued by groups such as the Ameri-can National Standards Institute (ANSI) and theNational Fire Protection Association, were definedby the OSH Act as stand ards created in way s thatallowed the consideration of diverse points of view and the formation of a substantial consen-sus or agreement by interested persons (Section3(9)). Durin g hearings before the passage of the

OSH Act, industry representatives had arguedthat the consensus standards were already widelyaccepted by industry (300).

Congress concluded that because these estab-lished Federal standard s and national consensusstandard s w ere already in effect or rep resented avoluntary consensus, there was no need for fur-ther ru lemaking. Rather, the existing standardscould be u sed to provide a m inimum level of pro-tection un til OSHA could issue its own stand ards.

Many believe that the new agency, how ever,acted more quickly than required, by completingwork on these standard s in only 2 months. Un-fortunately, a number of the national consensusstandards adopted by OSHA were outdated, un-

necessarily sp ecific, or un related to occup ationalhealth and safety. These included a regulation thatproh ibited th e use of ice in drinking w ater and

1“Rulemaking” refers to the procedures that Federal regulatoryagencies use for adopting regulations.

a regulation that m and ated a sp ecific shape fortoilet seats (406). In 1978, under Eula Bingham,OSHA rescinded abou t 600 of these “nit-picking”prov isions that app lied to general ind ustry andabout 300 that ap plied to several special indu s-tries. However, the process of revising the start-up standards continues.

Of more serious consequence, man y types of hazards are not adequately addressed by the star-tup stand ards. A Presiden tial task force in 1976estimated that the OSHA machine-guardingstandard s (which had been adop ted in 1971) cov-ered only 15 percent of the types of machines inuse (276). As of 1984, tha t standard had not yetbeen revised or expand ed. In many cases the orga-nizations that wrote the standards ad opted byOSHA in 1971 have revised their standards.OSHA, however, cannot incorporate these changes

without going through rulemaking.

Moreover, many of the startup stand ards sp eci-fied in great d etail the kind s of equip men t neces-sary for compliance. As pointed out by the 1976task force, this can hinder the development of im-proved control techniques and lead to unneces-sarily costly expenditures for compliance. Thistask force recommended, and OSHA has ac-cepted, the goal of dev eloping performance stand-ards that requ ire employers to control workplacehazards without specifying the details of equip-ment design. (The task force also recommended

that OSHA publish nonmandatory appendixes toprovide information on d esigns that OSHA con-siders acceptable to meet its performance standards. )

The startup standard s w ere almost exclusivelysafety standa rd s. Most of the relatively few start-up health standards h ad originated in Federalstandards adopted under the Walsh-Healey Actprior to the creation of OSHA. These includ edthe Threshold Limit Values for nearly 400 sub-stances that had been set by the American Con-ference of Governm ental Indu strial Hygienists(ACGIH) in 1968. In addition, OSHA adopted

about 20 ANSI consensus standards that set ex-posure levels for toxic substances. After eliminat-ing the overlap betw een these two lists, the start-up permissible exposure limits covered nearly 400toxic substances. Since 1971, the agency hasadopted new or revised stand ards for 23 sub-stances and one physical agent (discussed in the



q

Ch. 12–Governmental Activities Concerning Worker Health and Safety 227

next section). Some of these were revisions of OSHA’s startup standards. Thus the total num-ber of OSHA-regulated substances stands todayat about 410.

The latest Registry of the Toxic Effects of

Chemical Substances (586) compiled by NIOSH(as discussed later in this chapter) lists nearly60,000 separate chemical substan ces. Not all th e60,000 are found in the w orkp lace and not all aretoxic, but there is uncertainty concerning howmany hazardous substances are missing from theOSHA list of regulated chemicals. Most of the ex-posu re limits adop ted by OSHA have not beenrevised, and many are now ou tdated d ue to in-creased knowledge about the hazards posed byparticular substances. Furthermore, all the start-up standard s set only a perm issible exposure limit.None includes ad ditional requirements for expo-

sure monitoring, medical surveillance, employeetraining and education, record keeping, or warn-ning labels and signs. (In the mid-1970s, OSHA andNIOSH started actions to ad d these requirementsin what was called the “standards completionproject.” No regu latory actions were ever com-pleted un der that p roject and it is now “d ormant.”The only resu lt of that effort is a series of NIOSHpublications with recommendations concerninguse, monitoring, surveillance, and protectiveequipment for workers exposed to these sub-stances. )

Standards Issued After Rulemaking

OSHA also has the authority to issue newstandard s and to mod ify or revoke existing onesthrough informal rulemaking. This is authorizedby section 6(b) of the OSH Act, wh ich p rovid esfor a multistep process. This may start with th ereceipt of a criteria docum ent from N IOSH, withreports from employers, labor unions, or aca-dem ics concerning a hazard , or with a petitionfor a stand ard from an interested group.

ONH A may convene an ad hoc advisory com-

mittee for recommendations. If appointed, sucha comm ittee must have an equ al number of rep-resentatives from labor and management, as wellas at least one rep resentative from State healthand safety agencies. In ad dition, other personswith p rofessional expertise may be app ointed tothe committee. For standards affecting the con-

struction indu stry, OSHA has adop ted a regu la-tion r equiring consultation w ith a stand ing Con-struction Safety Ad visory Com mittee. Except forconstruction standards, OSHA has not used advi-sory committees to assist in d eveloping stand ardssince the mid-1970s.

In some cases, OSHA publishes an “AdvanceNotice of Proposed Rulemaking” in the Federal

Register to solicit information from the p ublic.This step, however, is not required.

The first mandatory step is to publish a “Noticeof Proposed Rulemaking” that describes the p ro-posed new ru le, mod ification to existing rules, orrevocation of existing rule, and that gives inter-ested persons and organizations time in which tocomment. An informal, adm inistrative hearingwill often take p lace, which any interested per-son or organization can attend to present testi-mony and to cross-examine other witnesses. Theagency may later receive written, posthearingcomments. After the final decisions h ave beenmad e, the agency pu blishes the text of the stand -ard and a statement of reasons in the Federal

Register.

A standard typically has staggered startup datesand deadlines. Some provisions go into effectshortly after publication, while others are delayedto allow employers time to plan for compliance.Standards that involve the installation of engineer-ing controls generally allow employers a year or

more to complete installation. For example, theOSHA lead standard allows some industries upto 10 years to comply with the requirements forengineering controls.

The agency is also required to develop an eco-nom ic analysis of the expected effects of the stan d-ard. This analysis and the content of the p roposedand final regulations are now subject to reviewby the Office of Managem ent and Bud get priorto publication by OSHA. In addition, after finalpublication by OSHA, a major standard is almostinvariably the subject of review by one of the U.S.

Courts of Appeals after an interested party chal-lenges its validity. One major issue in the legalchallenges to 6(b) rulemaking actions has con-cerned the interpretation of “feasibility” under theOSH Act, includ ing the extent to wh ich the agen -cy could or m ust consider employer costs wh ensetting standards (see ch. 14).




Emergency Temporary Standards

OSHA is au thorized by section 6(c) of the OSHAct to issue emergency temporary standards(ETS) that require employers to take immediatesteps to redu ce a workplace hazard. As outlined

by the OSH Act, an ETS can be issued afterOSHA determines that employees are exposed toa “grave danger” and that an emergency standardis “necessary to protect employees from such d an-ger.” An ETS, issued w ithout p roviding an op-portun ity for comments or for a pu blic hearing,goes into effect imm ediately up on p ublication inthe Federal Register. The ETS also initiates theprocess of setting a standard under section 6(b),with the published ETS generally serving as theprop osed standard . The act mandates that a finalstand ard be issued w ithin 6 mon ths of pu blica-tion of the emergency standard .

Major OSHA Rulemaking Actions

Table 12-3 lists the major health standardsissued by OSHA since 1971. Through 1984,OSHA issued 18 separate health standards afterrulemaking, or about 3 rules every 2 years. The

Table 12-3.—OSHA Health Standards

FinalOSHA regulation standard

1. Asbestosa b

. . . . . . . . . . . . . . . ., ... , , ... , .,2. Fourteen carcinogens . . . . . . . . . . . . . . . . . .3. Vinyl chloridea . . . . . . . . . . . . . . . . . . . . . . . . .4. Coke oven emissions . . . . . . . . . . . . . . . . . . .5. Benzenea. . . . . . . . . . . . . . . . . . . . . ., . . . . . . .6, DBCPac . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7. Inorganic arsenic. , . . . . . . . . . . . . . . . . . . . . .8. Cotton dust/cotton gins . . . . . . . . . . . . . . . . .9. Acrylonitrilea . . . . . . . . . . . . . . . . . . . . . . . . . .

10. Lead. . . . . . . . . . . . . . . . . . . . . ., . . . . . . . , . . .11. Cancer policy. , . . . . . . . . . . . . . . . . . . . . . . . .12. Access to employee exposure and medical

records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13. Occupational noise exposure/hearing

conservation. . . . . . . . . . . . . . . . . . . . . . . . . . .14. Lead—reconsideration of respirator fit-

testing requirements . . . . . . . . . . . . . . . . . . .15. Coal tar pitch volatiles—modification of

interpretation , . . . . . . . . . . . . . . . . . . . . . . . . .16. Hearing conservation-reconsideration . . .17. Hazard communication (labeling) . . . . . . . . .18. Ethylene oxide . . . . . . . . . . . . . . . . . . . . . . . . .

6/07/72

1/29/7410/04/7410/22/762/10/783/1 71785/051786/23/78

10/03/7811/14/78

1/22/80

5/23/80

1/16/81

11/12/82

1/21/833108/831/25/836122184

%bject of an Emergency TemporaW Standard,bEmeroencv atandarda were issued for aabeatos h 1971 and 1~cl ,adi~romo.~hloropropane,NOTE: Additional details on these standards can be found in table A-1 of

appendix A.

SOURCE: Off Ice of Technology Asaesament.

average time required from first announcementof proposed rulemaking un til final publicationamou nts to a little more than 2 years, althoughthe time for particular stand ards varied from 6months to 6 years. (This does not includ e add i-tional time for resolution of legal challenges after

pu blication of a final rule, nor d oes it considerthe standards th at OSHA h as begun to d evelopbut has not issued in final form.)

Ten of OSHA’s final actions on health stand-ards established new Permissible Exposure Limits(PELs) and other requirements for monitoring andmedical surveillance (asbestos, vinyl chloride,coke oven emissions, benzene, DBCP, arsenic,cotton dust, acrylonitrile, lead, and ethylene ox-ide). Two others did not institute or change a PEL:the“14 carcinogens” standard created new re-quirements for w ork p ractices and medical sur-

veillance for a group of carcinogens, w hile thehearing conservation amendment modified an ex-isting standard with requirements concerningnoise monitoring, audiom etric testing, hearingprotection, employee training, and record keeping.

Thus 12 separate proceedings resulted in newor revised requirements concerning 24 specificsubstances and 1 physical agent. How ever, thehearing conservation am endm ent, the 1978 stand-ard for benzene, and the requ irements for one of the 14 carcinogens have been ruled invalid by thecourts. (As described in table A-1 in app. A, some

of these standards are still under judicial reviewand several are being reconsidered by OSHA. Theapp lication of some requirem ents in several in-du stries has also been d elayed by OSHA or th ecourts. )

Three regulatory proceedings established new“generic” requ irements. The access to recordsstandard created requirements concerning thekeeping of exposure and med ical records an d forproviding employee access to those records, whilethe hazard communication standard requires thathazardous substances be labeled and informationprovided to employees about the substances andthe p recautions to be taken , The cancer policy seta general OSHA policy concerning future stand-ards regu lating carcinogens. Finally, three pr o-ceedings reconsidered and then modified existingrequiremen ts (respirator fit-testing for lead ex-posure, coal tar pitch volatiles, and hearing con-servation).



. .

Ch. 12–Governmental Activities Concerning Worker Health and Safety 229

Table 12-4 lists the safety standards issued byOSHA after ru lemaking. In O SHA ’s first 13 yearsthere were 26 such regulations. Many of thesesafety standard s have involved rew riting regu la-tions adopted as startup standards, while twoproceedings have revoked a n um ber of specific

provisions and advisory language that OSHA in-herited from th e consensus standard s adop ted in1971. In general, these changes in safety stand-ards did not impose large increases in costs toemployers. Most of them can be group ed by su b- ject: electrical, mechanical, fire p rotection, con-struction, or m aritime safety.

Tables 12-3 and 12-4 also ind icate the hazar d sand substances for wh ich OSHA has pu blishedemergency temporary stand ards. In all, there havebeen seven separate emergency actions concern-ing 19 specific substances, one ETS concerning an

activity (diving), and an attempt to regulate a

group of 21 pesticides with an emergency stand-ard. (It should be noted that asbestos has beenthe subject of an ETS tw ice-in 1971 and in 1983. )Of the 11 completed pr oceedings on sp ecific sub-stances, six began with the issuance of an ETS.But because an ETS requires employers to take

action before giving them an opportunity to filecomments or objections, these emergency actionshave often been controversial and several of themhave been ruled invalid by reviewing courts.OSHA’s successes with emergency standards havebeen those cases in which labor, management, andprofessionals all agreed that a problem existed andthat swift action was appropriate. But in thosecases challenged by emp loyers, the courts h avebeen reluctant to allow OSHA to imp ose an ETS.

Box N outlines OSHA’s regulation of vinylchloride monomer. See Ashford (30), Kelman

(245), and McCaffrey (290) for short histories of

Table 12-4.--OSHA Safety Standards

FinalOSHA regulation Standard

1.

2,3.4.5.6.7.8.9.

10.11.12.13.14.15.16.17.18.19.20.

21.22.23,24.25.26.

Miscellaneous amendments for construction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2/17/72Cranes/derricks (load indicators) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7/14/72Roll-over protective structures (construction) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4/05/72Miscellaneous amendments for construction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11/16/72Power transmission and distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11/23/72Scaffolding, pump jack scaffolding, and roof catch platforms . . . . . . . . . . . . . . . 12/02/72Lavatories for industrial employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5/03/73Trucks, cranes, derricks, and indoor general storage . . . . . . . . . . . . . . . . . . . . . . . 6/01/73Temporary flooring—skeleton steel construction . . . . . . . . . . . . . . . . . . . . . . . . . . 7/02/74Mechanical power presses–(”no hands in dies”) . . . . . . . . . . . . . . . . . . . . . . . . . 12/03/74Telecommunications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3/26/75Roll-over protective structures for agricultural tractors . . . . . . . . . . . . . . . . . . . . . 4/25/75Industrial slings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6/27/75Guarding of farm field equipment, farmstead equipment, and cotton gins . . . . 3/09/76Ground-fault protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12/21/76Commercial diving operations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7/21/77Standards revocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10/24/78Servicing multi-piece rim wheels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1/29/80Fire protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9/12/80Guarding of low-pitched roof perimeters during the performance of built-uproofing work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11/14/80Design safety standards for electrical standards . . . . . . . . . . . . . . . . . . . . . . . . . . 1/16/81Latch-open devices (on gasoline pumps) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9/07/82Diving exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11/26/82Marine terminals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7/05/83Servicing of single-piece and multi-piece rim wheels . . . . . . . . . . . . . . . . . . . . . . 2/03/84Revocation of advisory “should” and repetitive standards . . . . . . . . . . . . . . . . . . 2/10/84

asubject of an Emergency Temporary standard

NOTE: Addltlonal details on these standards can be found in table A-2 In appendix A.

SOURCE” Off Ice of Technology Assessment.






.-

,

.

.

-+

1,





some of OSHA’s standar ds. Mintz (307) provid esa number of excerpts of the formal documentsconcerning man y of these standard s.

Enforcement

Inspections and enforcement are the heart of the regulatory scheme in the OSH Act. Congresscreated an agency that is predom inantly an en-forcement agency cond ucting unan nounced in-spections and levying penalties for the “first in-stances” of violations, as well as for repeatedviolations.

The goals of enforcement are both to correctidentified hazard ous conditions in inspected plantsand to provide an incentive for un inspected p lantsto eliminate or reduce hazards. This second goalhas often been called “voluntary compliance,” al-

though it is misleading to label as “voluntary” ac-tions taken by emp loyers in the face of mand atorystandard s w ith the p otential threat of inspectionand civil penalties. “Reinsp ection compliance” isperhaps a better term (408). In practice, the in-centive for preinspection compliance is actuallyquite small, because of both the low probabilityof inspection an d the low level of pena lties (seediscussion later in this section).

Inspection Types and Priorities

OSHA condu cts a num ber of different kind s of

inspections. The first basic division is between in-

spections for safety hazards and those for healthhazar ds (table 12-5). The percentage of h ealth in-spections increased from abou t 6 percent in theearly 1970s to a peak of about 19 percent in fiscalyear 1979. This has fallen slightly to a range of 17 to 18 per cent in the last three fiscal years. (Thedecline w ould be larger, to about 15 percent, if “records review” safety inspections were includedin the totals on table 12-5. )

OSHA also classifies its inspections by priority.It attempts to investigate first those hazards pos-ing the greatest threat to employee health andsafety. The order of priority is:

q Imminent dangerq Catastrophe and fatality investigationsq Employee complaintsq Special inspection p rogram sq

Programed inspections.Imminent danger inspections are conducted

when OSHA learns of a hazard that can be ex-pected to cause death or serious ph ysical harmbefore it could be eliminated throu gh n ormal en-forcement a ctivity. Catastrophe an d fatality in-vestigations, second on the list, are spurred byreports of fatal occupational injuries or of in-ciden ts that result in the hosp italization of fiveor more employees.

The third priority is employee complaints.Under section 8(f) of the Act, employees and their

representatives w ho believe that an em ployer is

Table 12-5.--Federal OSHA Safety and Health Inspections

Establishment Safety Safety Health Health

Federal OSHA Inspections Inspections Inspections Inspections Inspect ions

fiscal year (number) (number) (percent) (number) (percent)

1973 . . . . . . . . . 48,409 45,225 93.4 3,184 6.6

1974 . . . . . . . . . 77,142 73,189 94.9 3,953 5.1

1975 . . . . . . . . . 80,978 75,459 93,2 5,519 6.8

1976 . . . . . . . . . 90,482 82,885 91.6 7,597 8.4

1977 . . . . . . . . . 60,004 50,892 84,8 9,112 15.2

1978 . . . . . . . . . 57,278 46,621 81.4 10,657 18.6

1979 . . . . . . . . 57,734 46,657 80.8 11,077 19.2

1980 . . . . . . . . . 63,404 51,565 81.3 11,839 18.7

1981 . . . . . . . . . 56,99446,236

81.110,758 18.9

1982 . . . . . . . . . 52,8188 43,609 82.6 9,209 17.4

1983 . . . . . . . . . 58,516b 48,269 82.5 10,247 17.5

1984 (first sixmonths) . . . . 30,606’ 25,086 82.0 5,520 18.0

Total. . . . . . . 734,365 635,693 86.6 98,672 13.4

aDogg not Include 8,444 “Records Review” lnsfMCtiOns.

b~g not Include 10,402 “Records Review” inspections.c~~ not Include 4,9S3 “Records Review” iIWeCtiOnS.

SOURCE Office of Technology Assessment, based on data supplied by OSHA.



Ch . 12–Governmental Activities Concerning Worker Healfh and Safety . 233

violating a health and safety standard may requ estan insp ection. OSHA schedu les insp ections to re-spond to wh at it determines are valid comp laints.The fourth priority-special inspection programs—includes programs to give special attention to cer-tain designated hazard s and ind ustries. Over thelast decade, the agency has ann ounced severalsuch progr ams: the Target Indu stries Program,the Target Health Hazard Program , and the Na-tional Emphasis Program. Currently, OSHA isgiving special attention to the construction indus-try, oil-well d rilling, and grain elevators.

The lowest priority inspections, but by far themost frequent, are programed ones. (In the past,these have been termed “general schedu le” inspec-tions. ) Although sometimes called “random in-spections, ” they now focus on indu stries with highinjury rates or those with know n health hazard s.

Over the p ast 12 years, OSHA has u sed a seriesof different scheduling systems. For safety inspec-tions, industries are ranked using injury rate in-formation from the Bureau of Labor Statistics(BLS) Annual Survey. Only industries with injuryrates above the national average for the privatesector are now selected for safety inspections. Forhealth inspections, OSHA now selects industriesbased on the last 5 years of OSHA health insp ec-tions. Ind ustries are ranked based on their respec-tive violation rates. Individual establishments areselected by u sing comm ercially available lists of employers to identify the establishments with 10or mor e employees in these selected ind ustries(635).

One other inspection category should be noted.Follow-up inspections can be condu cted at anytime to d etermine if workplace conditions havechanged following an inspection. In particular,OSHA is interested in verifying that abatementof a hazard has taken place by a schedu led date.(For informa tion on th e types of inspections, see307,333,408,635. )

OSHA has, through policy changes, varied the

distribution of inspection activity amon g thesecategories. For example, the proportion of inspec-tions triggered by employee complaints increasedfrom abou t 10 percent in fiscal year 1976 to over30 percent in fiscal year 1977, In recent years thepercentage of complaint inspections and follow-

up inspections has declined, while the percentagedevoted to program ed insp ections has increased(see table A-5 in app. A).

Enforcement Procedures

The conduct of all these inspections follows thesame general outline. The inspector (formally, theCom pliance Safety and Health Officer) arrives atthe workplace, almost always without advancewarning, presents his or her credentials, andspeaks with the employer, manager, or other per-son in charge. An opening conference is held withthe emp loyer (and a u nion representative, if any)to d escribe the purp ose of the visit. The inspec-tor asks to see any em ployer-maintained recordsthat m ight be r elevant (logs of injuries and ill-nesses, exposure and medical surveillance records,etc. ).

Then the inspector conducts a “walk-around ,”visiting all or p art of the w orkp lace. Both th e em-ployer and an emp loyee representative have theright to accompany the inspector on this tour. Theinspector observes workp lace conditions and takesnotes, ph otographs, and exposure samp les as maybe appropriate. After the walk-around, a closingconference is held (either jointly w ith both em-ployer and employee representatives, or sepa-rately), at which time apparent violations of OSHA standards are discussed. Norm ally, cita-tions are not issued at this closing conference, but

are m ailed later. This is to allow consu ltation be-tween the inspector and th e area director and toobtain the results of laboratory analysis of ex-posure samp les.

The Fourth Amend ment to the U.S. Constitu-tion generally protects persons from “unreason-able searches and seizures” by government offi-cials. There are certain circumstances in whichpolice are allowed to search withou t consent, butin general a warr ant mu st be obtained for sucha search. The question of whether OSHA is alsosubject to these requirements in cond ucting its

inspections of workplaces was raised most prom-inently in a 1976 case concerning an Idaho em-ployer, Barlow’s Incorporated. The case was ul-timately ap pealed to the Supr eme Court, w hichruled that OSHA had the constitutional author-ity to conduct inspections, but that if the employer



2.34 q Preventing Illness and Injury in the Workplace

did not voluntarily consent to the inspection, theagency w ould n eed to obtain a court-issued w ar-rant (see 307,333,408).

Although Congress has never amended theOSH Act, it has limited OSHA insp ection activ-

ity by attaching restrictions to OSHA’s appropria-tions. Currently OSHA is p rohibited from con-ducting programed safe ty inspections inestablishm ents w ith 10 or fewer em ployees in anindustry w ith a led-workday rate lower than thenational averag e; from assessing p enalties for the“first instances” of nonserious v iolations (u nless10 or more total violations are cited); from assess-ing penalties against an employer with 10 or feweremployees who had requested an onsite consulta-tion and is acting to elimina te id entified haz ard s;from issuing or enforcing standards for smallfarming op erations (10 or fewer emp loyees); and

from activities that would affect recreational hunt-ing, shooting, or fishing. There are also restric-tions on visits designed to monitor State program sand on OSHA activities on the Ou ter Continen-tal Shelf (489a).

Current Inspection Targeting

A new procedure for safety inspections w as in-stituted on October 1, 1981. Since then, OSHAinspectors conducting programed safety inspec-tions have also examined the injury and employ-ment records of the employer and calculated an

average lost-workday case rate for the previous2 years (or 3 years, for establishmen ts w ith 10 to20 employees). If the lost-workd ay case rate is lessthan the national average rate for manufacturing,the inspection is terminated. The national aver-age injury rate is derived from the BLS AnnualSurvey and currently is 4.2 cases per 100 full-timeemp loyees (644). (In table 12-5, these visits ar etermed “records review. ” Termination of inspec-tion because of a below-average injury recorddoes not currently apply to safety inspections inthe construction industry, nor does it apply tohealth inspections in any industry.)

In theory, th is policy of end ing insp ections for“low-hazard” establishments can create an incen-tive for employers to take steps to reduce injuryrates. It also may h elp OSHA to u se its scarce in-spection resources efficiently by concentrating at-tention on establishments with higher-than-aver-

age injury rates. There is concern, however, thatthis policy may also serve as an incentive for sys-tematic underrecording of the number of injuries,although inspectors are instructed to verify theaccuracy of emp loyer injury records.

Compliance with Standard s and theGeneral Duty Clause

Unless they have obtained a varian ce, emp loy-ers are required by section 5(a)(2) of the OSHAAct (the specific du ty clause) to comp ly with theterms of OSHA standard s and regulations. Dur-ing inspections, inspectors look for any violations,following the procedures and interpretationsissued by OSHA in its Field Operations Manual,

Industrial Hygiene Manual, and programdirectives.

Emp loyers mu st also comp ly with section S(a)(1) of the act–the general duty clause. This hasbeen used to cover hazards not treated by OSHA’smore specific standards. There has been contro-versy concerning the interp retation of this clauseand its application to employers by OSHA.

To prove a violation of the general duty clause,OSHA m ust d emonstrate that the em ployer failedto render the workplace free of a “recognized” haz-ard that w as causing or was likely to cause deathor serious physical harm . OSHA an d th e courtshave held th at a hazard is recognized if the em-ployer had knowledge of the hazard or if it is of common knowledge in the industry in questionand detectable by the senses or by techniques gen-erally know n an d accepted by the ind ustry (307,333,408). OSHA uses a num ber of d ifferent sou rcesof information to demonstrate that a hazard is“recognized,” including voluntary standards,statements of industry experts, implementation of abatement programs by other companies in thesame industry, manufacturers’ warnings, orstudies conducted by the industry, its employees,the governm ent, or insu rance compan ies (203).

The Role of OSHRC

An employer who disagrees with OSHA con-cerning a citation, a proposed penalty, or the datefor abatement of the h azard can file a notice of contest. Emp loyees also have an ind epend ent rightto contest the reasonableness of the length of the



--—

Ch. 12–Governmental Activities Concerning Worker Health and Safety q 23 5

prop osed period of time for abatement of a haz-ard. Unless contested within 15 days, an OSHAcitation becomes final. When contested, a hear-ing is held before an Adm inistrative Law Jud ge(ALJ), wh o is an emp loyee of the OSHRC, an in-dependent review body.

At the h earing before the ALJ, both OSHA an dthe employer present their sides of the case. Af-fected emp loyees and their representatives havea right to participate in these proceedings. Dur-ing the period when the citation is under contest,no abatement is required.

The ALJ examines the evidence and decideswhether to affirm, vacate, or modify OSHA’s cita-tion and proposed penalties. After this decision,any p arty can petition th e Occup ational Safetyand Health Review Commission to review the

decision of the ALJ. The Com mission can g ran tsuch review either upon request or by its ownchoice. Unless it is ordered to be reviewed within30 days by a member of OSHRC, the ALJ deci-sion becomes a final ord er of the Comm ission.Any adversely affected person can then petitiona U.S. Court of Appeals for judicial review(307,333,408).

Informal Conferences

Current OSHA policy encourages the use of in-formal conferences between employers and OSHA’s

area d irectors to reach settlements concerning cita-tions. Using su ch conferences to settle citationsmight facilitate prompt abatement of hazard s andimprove employee health and safety, as well asreduce the time spent by government p ersonnel,employers, employees, and their representativesresolving contested citations. The first directiveon th is was issued by Eula Bingham in 1980.

Assistant Secretary Theme Au chter stronglyencouraged the use of these settlements byOSHA’s Area Directors. During his tenu re as headof OSHA, the n um ber of inform al settlement s in-

creased dramatically. But there have been sugges-tions that some of these settlements m ay not su f-ficiently protect worker health and safety (440).Moreover, if the settlement agreement providesfor eliminating penalties, or reducing them to verylow levels, the incentive for preinspection compli-ance is virtually eliminated.

Recent cour t decisions limit the righ ts of em-ployees and unions to object to settlements thatthey view as insufficiently protective. If the em-ployer is no longer contesting the citation, therights of employees and unions to object is limitedto the “reasonableness of the abatement p eriod. ”

(In addition, OSHA enforces the provisions of the OSH Act that proh ibit emp loyers from d is-criminating against employees who exercise anyof the rights p rovided by the OSH Act. See ch.15 for a discussion of this protection and otheremployee rights. )

Incentives for OSHA Compliance

In th eory, OSHA’s enforcemen t activities w illlead emp loyers to comp ly with OSHA regulationsand to improve em ployee health and safety. But

in practice OSHA has never had the resources toinspect more than a relative hand ful of the Na-tion’s workplaces. In addition, the averagepenalties levied for violations u ncovered in the“initial” visits to workplaces are very small, espe-cially when compared with the costs of manytypes of controls (see box T in ch. 15). Thus, thereis only a weak incentive for employers to complyprior to an OSHA inspection.

In fiscal year 1983, OSHA conducted about58,500 establishment inspections an d abou t 10,400“records review” visits, The various State pro-grams conducted an additional 104,000 establish-ment inspections and about 2,500 “records re-view” v isits. This makes for a Fed eral-State totalof about 162,000 establishment inspections and13,000 “records review” visits. As there are about4.6 million private sector establishm ents in theUnited States (553), OSHA and the State pro-grams can inspect less than 4 percent of U.S.establishments.

The probability of a health inspection is sub-stantially less than the p robability of a safety in-spection. Of all fiscal 1983 inspections, about21,000 were health inspections. Thus, of each

1,000 establishments, about 31 receive a safety in-spection, 3 receive a “records review” visit (wh ichcovers only safety), and fewer than 5 receive ahealth inspection.

OSHA and the States do, however, concentratetheir activities on certain industries. For example,




in fiscal year 1983 the agency condu cted abou t58 percent of its establishment inspections in con-struction and about 33 percent in manufacturing.This wou ld imp ly about 54,000 establishmen t in-spections in th e ap pr oximately 321,000 man ufac-turing establishments n ationwid e (assum ing that

the State plans conduct the same proportion of inspections in manufacturing as does OSHA).Therefore, OSHA and the State programs are cur-rently able to inspect a maximum of about 17 per-cent of manufacturing establishments (assumingone inspection per establishment in any givenyear).

At this rate of inspection, OSHA and the Stateprograms can inspect each establishment in man-ufacturing on ly once every six years. The insp ec-tion rate for most other industries with fixedestablishmen ts—transportation, wh olesale and

retail trade, finance, services, and agriculture—is substan tially less than this. (Because of the limitsof available statistics, it is difficult to estima te theprobability of inspections at construction sites.)

Even if an establishment is inspected, the penal-ties for violations are quite low. The average pro-posed penalty for a “serious” violation (one thatcreates a “substan tial probability [of] death or seri-ous p hysical harm ”) for OSHA and the State pro-grams in fiscal year 1983 was about $172. Of course, this is only for violations that are actuallydiscovered and cited, and does not include thepenalties levied for “other than serious,” “willful,”“failure to abate,” and “repeat” violations. In fiscalyear 1983, OSHA and the State programs pro-posed penalties totaling abou t $13.4 million forall violations in the 162,000 establishment inspec-tions that were conducted, an average penalty of about $83 per inspection.

As discussed in chapter 14, employers makingdecisions to maximize p rofits will tend to choosethe least costly alternative. Thus the employerfaces a choice of spending a certain sum to con-trol a hazard and comp ly with OSHA stand ards,or not controlling a hazard and possibly being in-spected and penalized for noncompliance. Thedecision will be based on a nu mb er of factors, in-cluding the probability of inspection and the likelypenalties if an inspection takes place and the haz-ard is detected.

As discussed above, for establishments in man-ufacturing, the p robability of inspection is onlyabout one in six, while the average proposed p en-alty for “serious” v iolations w as abou t $172. Adecision based purely on a desire to maximize prof-its wou ld be to spend on controls only when th e

ann ual cost of controls is less than the an nu al ex-pected costs of noncompliance. If it is assumedthat th e inspection will detect the violation, theexpected costs for each serious violation equalsone-sixth of $172 or abou t $29. The average pr o-posed penalty for all violations was $39. With aone in six probability of inspection, this impliesan expected penalty for noncompliance of about$6.50. (See 64,127,287, and 685 for similar esti-mates based on older d ata.)

Of course, employers may take actions out of altruistic concern about the health and safety of

their workers or because of the other incentivesdescribed in chapter 15. In addition, for employerswho have been inspected recently, there is thethreat of a rep eat inspection. In th ese cases, thefines for “failure to abate” an identified hazardcan be very su bstantial. Thu s the incentives forcompliance are much larger after an OSHA in-spection. What is clear, how ever, is that the eco-nom ic incentive for preinspection compliance issmall.

In fiscal year 1983, compared with fiscal year1980, OSHA issued 40 percent fewer seriou s viola-tions, 55 percent fewer repeat violations, and 85percent fewer willful violations. Consequen tly,the total penalties it has proposed declined bynearly 60 percent (see tables A-8 and A-10 in app.A). This change has also been accomp anied bya decline in the number of inspections with con-tested citations (from nearly 12 percent of inspec-tions to less than 2’ percent) and may lead toprom pt abatement of hazards in firms that h avebeen inspected. However, the reduction in penal-ties also significantly weakens the small economicincentive for employers to comply w ith OSHAstandards.

At least one commentator has suggested that“OSHA will not be a meaningful deterrent u ntilthe cost of noncompliance becomes greater thanthe cost of compliance” (406). Violations of somerequirements for pollution control have been





238 . Preventing Illness and injury in the Workplace

consultant, although employers m ay voluntarilyturn that information over to employees. Thisprogram has increased substantially from 1975 totoday. In fiscal year 1983, OSHA funded about28,000 onsite visits, a t a cost of $23.4 million (seetab le 12-6).

In 1978, the General Accounting Office (GAO)issued a report criticizing OSHA’s managementof the consultation program, suggesting thatOSHA’s policies were not sufficient to ensure pro-tection of worker health and safety (505). Changesin the program have been made since then, buta continuing controversy concerns the relative em-phasis of enforcement versus consultation, whichparallels the debate about th e relative merits of mand atory standards versus voluntary efforts.Many think that Government shou ld engage inconsultation in order to assist well-meaning but

ignorant employers to improve health and safety.Others suggest that such an approach is largelyineffective and tend s to divert resou rces from en-forcement activities that require, rather thanmerely encourage, health and safety improvements.

In 1982, OSHA began an experimental programin two regions to grant employers a one-year ex-emption from p rogramed inspections if they applyfor and receive a health and safety consultation.In 1984 that program was made permanent andextended nationally. Now emp loyers wh o agreeto a comp rehensive onsite consultation, correct

all hazards d etected d uring th e consultation, andimplement th e “core elements of an effective safetyand health p rogram” can be given a on e-year ex-emption from programed inspections (355, 648).How ever, given the low p robability of an insp ec-tion, this one-year exemption may not representa very large incentive to participate in thisprogram.

OSHA h as also mod ified its policy concerningthe pr ovision of onsite information by agen cy in-spectors. OSHA still issues citations for appar-ent violations, but insp ectors are now requiredto provide “general assistance” to employers inidentifying abatement methods for alleged viola-

tions (629). In addition, OSHA has recently an-nou nced plans to create “fu ll-service area offices. ”The goal is the creation of “resource centers” thatemployers can use to obtain information on occu-pational safety and health and on compliance withOSHA standards.

New Directions Program

The New Directions program was establishedby OSHA in 1978 to prov ide gran ts to emp loyee,employer, educational, and nonprofit organiza-tions for the purpose of providing workplace

health and safety training, resources, and serv-ices for employers and employees. Grantees haveused these fun ds to d evelop ed ucational materials,conduct training sessions, provide technical assist-ance concerning health and safety hazards, andhire technical staff. OSHA has p rovided the bu lk of the funds for this program, and additionalmoney has come from the National Cancer Insti-tute, NIOSH, the Federal Emergency ManagementAgency, and the National Institute of MentalHealth (636).

The program has recently been cut back sub-

stantially, from $13.9 million in fiscal year 1981,to $6.8 million for fiscal years 1982 and 1983.(This does not, however, include funds from theNational Cancer Institute that are also includedin this program. ) Similarly, the number of orga-nizations receiving grants has declined from 156in fiscal year 1980 and 142 in fiscal year 1981 to100 in fiscal year 1983 (34).






employers mu st therefore comp ly with both Fed-eral and State stand ards. (Any tim e after initialapproval, however, as soon as the State is “oper-ational, ” OSHA may su spend its concurrent en-forcement jurisdiction throu gh an “op erationalstatus agreement.”) After all developmental stepsare comp leted and app roved, OSHA can issue acertification of the plan . If the State m eets all of OSHA’s requirements, it becomes eligible for“final approval” 1 year after certification. Evenafter “final approval, ” Federal OSHA still moni-tors the State program.

The requirement that States maintain a pro-gram “at least as effective” as OSHA’s means thatif OSHA issues new or revised r egulations, Stateagencies mu st follow suit by adop ting the change,issuing an equ ivalent chan ge, or mak ing the casethat, for local reasons, there is no need to alter

the regu lation. (For examp le, a State withou t tex-tile mills need n ot adop t the OSHA cotton d uststandard. )

There are also procedu res for OSHA to w ith-draw ap proval and/ or reintroduce Federal en-forcement for a State that does not comply withOSHA’s requirements (307,333,408). In all stagesof its operation, OSHA m onitors the qu ality of the State program. Monitoring may involve “spotchecks” (inspections by Federal p ersonn el after aState-cond ucted inspection) or “accomp anied”monitoring visits in which Federal personnel

observe a State inspector du ring an insp ection.(More recently, a computerized data system hasreplaced much of this onsite monitoring. )

History of State Programs Under the OSH Act

The policies of OSHA toward State programshave varied-sometimes permitting State pro-grams to operate relatively free from oversight,while at other times setting high standards forState programs. OSHA’s efforts to allow and en-courage or disallow and discourage State pro-grams have also been subjects of litigation

(249,307).From 1978 to 1983, 24 State programs were in

operation—21 States plus Puerto Rico and theVirgin Islands covered private and public employ-ment and one program (Connecticut’s) coveredonly p ublic emp loyment. In 1984, N ew York be-

came the 25th State program, although it appliesonly to State and local government employees(table 12-7). “Final approval” had not beengranted to any jurisdiction until 1984, when theVirgin Islands, Hawaii, and Alaska received thisdesignation.

An important issue for OSHA policy concern-ing State programs has been a continuing disputeconcerning the level of fund ing and the nu mberof comp liance personnel a State mu st have to meetthe requirements of the OSH Act. In the mid-1970s OSHA had interpreted this to mean thatState staff levels need on ly be equivalent to th oseof OSHA, even though OSHA’s staffing levelswer e not considered op timal. The AFL-CIO suedOSHA on th is issue.

In a m ajor d ecision in 1978 (AFL-CIO v . Mar-

shall), the reviewing court agreed with the AFL-CIO. According to its opin ion, the “at least as ef-fective” requirement applies only to the standards

issued by the State program. For staffing andfunding, the court ruled that Congress intendedthat OSHA could use “current Federal levels of personnel and funds as benchmarks for State pro-grams, provided they are part of a coherent pro-gram to realize a fully effective enforcement ef-fort at some point in the foreseeable future.” Thuswh ile curren t Federal levels, described by OSHAitself as only “a percentage of what is reallyneeded, ” were deemed to be adequate as interim

benchmarks, they were not adequate as goals for“fully effective” State p rograms (307).

Table 12-7.–State Programs (1984)

Jurisdlctions with approved plans: Alaska North CarolinaArizona OregonCalifornia Puerto RicoHawaii South CarolinaIndiana TennesseeIowa UtahKentucky Vermont

Maryland Virgin IslandsMichigan VirginiaMinnesota WashingtonNevada WyomingNew Mexico

Plans cover/rigonly pub//c employees: Connecticut New YorkSOURCE: (408).



Ch. 12–Governmental Activities Concerning Worker Health and Safety . 241

In 1980, with the concurrence of the AFL-CIO,OSHA submitted to the court staffing-level “bench-marks” designed to achieve the goal of Stateprograms becoming “fully effective” rather thanonly “at least as effective” as Federal op erations.This plan wou ld hav e required th e jurisdictions

with ap proved State programs to increase the totalnumber of safety inspectors from 849 to 1,154within 5 years and of health inspectors from 332to 1,683 (subject to an ann ual r eassessment of th eavailability of qualified health personnel). Theagency also released a “benchm ark m odel” thatcould be u sed to gen erate or revise staffing levelsas necessary. The mod el considered the hazar drank of various indu stry sectors and the n um berof establishments of each rank in each State whencalculating th e nu mber of p rogramed inspections,the factor that ultimately d etermines State healthand safety staffing requirements.

Since then, OSHA has taken steps to changethese requ ired benchmark levels. Beginning in1981, it has sought congressional approval to pro-hibit the spending of any funds to achieve Statestaffing levels that are greater than current Fed-eral levels. Although enacted in two continuingresolutions concerning ap prop riations in fiscalyears 1982 and 1983, this langu age w as not in-cluded in the final appropriations actions for thoseyears (34). In 1984, it was reported that OSHAis no longer seeking this appropriations language(350). In 1982, OSHA also formally prop osed to

recalculate the benchmark form ula. One result of this would be the lowering of the required Statestaffing levels (249).

Pros and Cons of State Programs

A nu mber of arguments have been mad e forand against State takeover of OSHA respon-sibilities. Proponents of State programs argue thatthey can ad apt to local needs better, are more ef-ficient and more fairly enforced, and continue thetrad itional State and local roles in occup ationalhealth and safety regulation. Opponents arguethat, compared with OSHA, these programs areless effective, understaffed, underfunded, ineffi-cient, less evenly enforced, and mor e susceptibleto local political influence (408).

Organized labor, especially at the nationallevel, is principally concerned that man y State

programs devote insufficient resources to healthand safety and are ineffective. Althou gh m anypeop le in the business comm un ities of affectedStates support such programs, large businesseswith establishm ents in more th an one State oftenexpress a desire for regulatory consistency-some-

thing th at is hard to achieve with a variety of dif-ferent State standards. Recent employer supportfor an OSHA “labeling” stan dar d, for example,derives in p art from a d esire to preemp t State andlocal laws on this subject.

Local control over job safety and health couldbe desirable in its own right, and the use of Stateprograms can create a combined Federal and Stateeffort that is larger than the Federal effort alonecould be. But most States do not have the researchcapability needed to set standard s, nor would itbe efficient to hav e each cond ucting the sam e re-search for standards development (30). However,because they can simply adop t Federal standard sverbatim, it is usually not necessary for them tohave such a capability (34).

But the p ossibility exists that States m ay com-pete with each other in order to attract newbusinesses by relaxing the enforcement of h ealthand safety standards. In theory, this should berestricted by the requirement that State programsbe “as effective as” Feder al OSHA. Examinationof inspection data shows that, on average, Stateprograms issue fewer serious violations and, forthis reason, propose lower penalties overall than

OSHA does. Moreover, the States with programs,as a group, devote a smaller fraction of their in-spection resources to health inspections than doesOSHA (see tables A-l to A-11 in ap p. A). On th eother hand, State programs conduct proportion-ately more inspections than OSHA d oes and someStates have proportionately larger enforcementstaffs, particularly in safety (34). In 1976, theGAO criticized OSHA’s policies toward the de-velopm ent of State programs and expressed con-cern that these policies w ere not su fficient to en-sure employee health and safety (500).

The friction over benchmarks, final approval,and Federal monitoring of State programs reflectsthe un derlying tension between th e national andthe State governments, which historically hadbeen respon sible for job safety and health. Fed-eral policies concerning State programs have re-




spond ed to those tensions, as well as to more gen-eral views concerning the rightful role of theFederal Government.

For examp le, the 1973 President’s Repor t on Oc-cupational Safety and Health referred to the ap-pr oval of 20 State program s in 1973 as a step th at

moves the United States closer to the “Fed-eral/ State occupational safety and h ealth p artner-ship intended by Congress. ” Assistant SecretaryBingham took a very different view, stating that“[t]he Federal agency is given a leadership rolewhich does not lend itself to a traditional part-nership of equality as I believe a number of Statesdesire.” Thorne Auchter returned to an earlier pol-icy of actively encouraging State programs. In hiswords, “It is my belief—and the belief of thisadministration —that in the last analysis, localproblems are best addressed by those closest tothem” (249).

Other Federal Agencies

Although OSHA and the State programs aredirectly responsible for ensuring the health andsafety of most private sector workers in the UnitedStates, some workers are the responsibility of other agencies. The OSH Act does not ap ply to

“working conditions” for which other Federalagencies and certain State agencies “pr escribe orenforce standards or regulations affecting occupa-tional safety or health” (OSH Act, Section 4). Forexample, the health an d safety of coal miners isregulated by the Mine Safety and Health Adm in-

istration, while protection of certain railroad em -ployees is provid ed by the Federal Railroad Ad -ministration.

Health and safety cond itions for most pu blicsector workers are not directly regulated byOSHA. State and local employees, however, arecovered by State programs in the 25 States withapproved plans. The heads of Federal agencies arerequired by the OSH Act to provide their employ-ees with an occupat ional safety and h ealth pro-gram that is “consistent with” OSHA stand ards.Three different Executive Orders have been issuedconcerning h ealth and safety protections for Fed-eral Government employees.

Lastly, the regulations issued by several otherFederal agencies also affect job safety and health,even though workp lace conditions are not the p ri-mary focus of these agencies. The constellationof governmental bodies with workp lace safety andhealth responsibilities is summarized in table A-12 in app end ix A.

THE NATIONAL INSTITUTE FOROCCUPATIONAL SAFETY AND HEALTH

The need to p rovide for research to id entify, Welfare) to carry out r esearch and related activi-evaluate, and control wor k-related illness and in- ties. Congress listed several ma jor activities for

jury, to disseminate information to workers, em- NIOSH:ployers, and health professionals, and to train oc-cupational safety and health professionals did not q

provoke much controversy during the debateabou t passag e of the OSH Act. All parties agreed q

there was overwhelming evidence that scientificknowledge abou t w ork-related injury and illness q

was lacking, that the su pp ly of trained personnel

was inad equate, and that meaningful statisticaldata were unavailable. oq

The OSH Act established the National Institutefor Occupational Safety and Health within the De-

develop criteria for recomm ended occup a-tional safety and health standards;conduct educational programs to provide anadequate supply of qualified personnel;conduct informational programs on the im-portan ce of the use of adequ ate safety andhealth equipment;condu ct Health Hazar d Evaluations; andcondu ct ind ustr y-wide stu dies of the effectsof chronic or low-level exposures.

partment of Health and Human Services (then In contrast to OSHA, most N IOSH p ersonnelcalled the Department of Health, Education, and wor k in on ly two locations, at the N IOSH facil-



Ch. 12—Governmental Activities Concerning Worker Health and Safety 243

ities in Cincinatti, OH, and Morgantown, WV.As mentioned earlier in this chapter, NIOSHheadquarters are now in Atlanta, GA. There are

also very small staffs, usu ally two to th ree, in the10 HHS regional offices (located in the same cit-ies as OSHA r egional offices).

NIOSH’s organization reflects the various top-ics of its research an d dissemination p rogram.These activities are cond ucted by NIOSH’s sevendivisions, each of which conducts research con-cerning a particular aspect of occupational health

and safety or provid es for the d issemination of informat ion or tra ining an d ed ucation (fig. 12-5).

For this description, OTA divides NIOSH activ-ities

q

q

q

into three major program areas:

Identification of occupational health andsafety problems;

Development of controls to prevent work-related illnesses and injuries; and Dissemination of findings and recommenda-tions and p rovision of Professional Train-ing and Education .

2

itself divides its activities into five areas: identification,evaluation, control, dissemination, and administration (s79). Th efirst three appear to have derived from the language of industrial

Figure 12-5.—National

The funding for the three activities is not,equal.Identification now receives the largest share of NIOSH’s budget, with information disseminationand control technology research receiving su b-stantially less fund ing. In ad dition, although itsmandate extends to both health and safety,

NIOSH has concentrated almost exclusively onquestions of occup ational health.

Identification

Identifying work-related illness and injury and

understanding the mechanisms of disease and injury causation involve using the skills of medi-cine, industrial hygiene, safety engineering, epi-demiology, toxicology, and statistics. It is the first

step tow ard prevention (chs. 3 and 4). The spe-cific NIOSH activities directed toward iden tifica-tion include illness and injury surveillance sys-

hygiene, which refers to recognition, evaluation, and control. OTAhas grouped what NIOSH calls identification and evaluation intoone category, largely because there really are no clear boundariesbetween these two activities, and both depend on a variety of pro-fessional skills. Moreover, the term “evaluation” is commonly usedin the Federal Government to refer to the process of assessing theadministration and impacts of particular programs. Administration,the fifth NIOSH program area, is not a research area and is not dis-cussed in detail in this chapter.

Institute for Occupational Safety and Health




terns, Health Hazard Evaluations, and NIOSH’stoxicologic and epidemiologic research programs.

Surveillance

NIOSH surveillance systems identify workplacehazards and work-related injuries, diseases,disabilities, or deaths, and generate hypothesesconcerning the possible relationships betweenworkplace exposures and adverse effects. NIOSHconducts work-related illness and injury surveil-lance in several ways. For illnesses, NIOSH’sactivities have included two large surveys of working conditions and the Health Hazard Evalu-ation prog ram (discussed in d etail below).

Until relatively recently, NIOSH did very lit-tle on th e identification of the causes of injur ies.Now it collaborates with the Bureau of Labor Sta-tistics and OSHA in conducting work injury sur-

veys, which are special-topic mail surveys of injured wor kers. Epid emiologic meth ods for injur yinvestigation are being d eveloped. N ational work-related injury data are being collected in conjunc-tion with the Consum er Produ ct Safety Comm is-sion’s National Electronic Injury SurveillanceSystem.

National occupational hazard and exposure sur-veys.—The first NIOSH survey of working con-ditions, called the National Occupationa l HazardSurvey (NOHS), was completed in 1974. Pres-ently, a major task of N IOSH’s surv eillance pro-gram is analysis of data collected in the secondnational inventory of potentially hazardou s ex-posures to workplace agents, the National Occu-pational Exposure Survey (NOES).

3The data for

both of these surveys were collected through visitsto a random sample of workplaces. Potentialexposures to workplace hazards were observedand recorded du ring comp rehensive tours of thesewor ksites. The surveyors collected informationon the natu re of the potential hazards, the num -ber of workers at risk, and the controls in placeto protect them.

3The word “hazard” in the title of the NOHS survey was changed

to “exposure” in the second survey in part because employers’ rep-resentatives argued th at the survey was really an inven tory of allpotential exposures, of which h azardous ones w ere only a part.

These surveys represent a large effort. The re-cent survey, patterned after the first one, covereda random sample of nearly 5,000 worksites in 67major metropolitan areas over a 2-year periodstarting in 1981. Potential exposure estimates forthe Nation are based on the pr obability samp le

in which over 9,000 chemicals and physical agentswere observed in industrial use. These observa-tions includ ed exposu res of workers in 450 sepa-rate occupational classifications.

The results of these two su rveys can providenational estimates of poten tial exposur e to work-place hazards by industry and occupationalgroups that can be useful for research planning,for estimating the impact of proposed stand ards,and for plann ing OSHA’s enforcemen t activities.For instance, occup ational safety and health p ro-fessionals have used the 1974 NOHS to identify

group s of workers exposed to various hazards orcombinations of hazards. One finding from N OHSwas that over 22 million of the 38 million work-ers in the survey u niverse were exposed to at leastone potential hazard.

Trade-name chemical prod ucts (produ cts w itha commercial name but often lacking informationabout the identity or properties of the chemicalconstituents on th eir containers) are pr evalent inthe w orkplace. Analysis of the NOHS d ata showedthat p otentially toxic substan ces are frequentlypresent in them. About 70 percent of 86,000 prod-ucts identified in NOHS (made by 10,500 manu-facturers) had trade names. NIOSH requestedinformation about the composition of theseapproximately 60,000 separate trade-name prod-ucts from the 10,500 manufacturers. The manu-facturers supplied information on 45,000 trade-nam e prod ucts. Of these, 40 percent contained atleast one OSHA-regulated substance and over 400of these trade-name products contained at leastone of the OSHA-regulated carcinogens.

How ever, while NOH S estimates are the onlynational base of information on exposure to po-tential workp lace hazard s, they have been qu es-

tioned for their accuracy, for being nonquan-titative, and for their validity. NOH S estimatesfor agents for which there is a high degree of awareness (such as asbestos) sometimes appear



Ch. 12—Governmental Activities Concerning Worker Health and Safety q 245

at odd s with figures put forward by others. Esti-mates of the num bers of people exposed to low-toxicity substances, such as sodium chloride,dom inate some parts of the d ata base, leaving acasual observer with the impression that the dataare weak for determining exposure to m ore haz-

ardous substances. Many users have wished forquantitative estimates of actual exposure levels,since these would strengthen the d ata and increaseits usefulness. Collecting actual exposure d ata,while theoretically possible, would be expensivesince accuracy and validity would depend on col-lection and chemical analysis of a large numberof samples taken over sufficient time to make surethe results were representative of workplace con-ditions.

The usefulness of NOH S is reflected by requestsfor it and r eports d eveloped from the collected

data. In fiscal year 1982 alone, there were over5,000 requests for data from NOHS. Further anal-ysis of potential exposures to hazardous sub-stances, includ ing analysis of trend s, will be pos-sible wh en ana lysis of NO ES, the second surv ey,is comp leted. A similar NIOSH environm entalsurvey focusing on the m ining ind ustry is plannedto comp ly with the m ining surveillance mand ateof the Mine Safety and Health Act of 1977.

Health hazard evaluation and technical assist-ance program s. —The identification program areaalso includes the H ealth H azard Evaluation (HH E)

and Technical Assistance (TA) programs. TheHHE program responds to employee and employ-er requests from t he pr ivate sector for evaluationof specific hazards, while the TA program re-sponds to requests from government agencies.

How ever, the techn ical aspects of HH Es andTAs are the same. The pu rpose of both of theseprog ram s is to “d etermine toxic effects of chemi-cal, biological, or physical agents . . . in theworkp lace” throu gh med ical, epidemiologic, andindustrial hygiene investigations of the worksiteof concern. Upon completion of an evaluation,

NIOSH rep orts the results back to the w orker andto the employer. If the substance proves to betoxic as it is used and exposur e is not covered byany standard, NIOSH is required to report itsfind ings to OSHA.

In fiscal year 1981, NIOSH received 513 re-quests for m ining and general ind ustry H HEs, a10 per cent increase over 1980. Twenty -one per -cent of these requests came from employers, 55percent from employees or unions, 23 percentfrom Government agencies, and 4 percent from

other sources. Twenty percent of these requestscame from establishm ents w ith fewer than 100employees. NIOSH investigators made over 600site visits and p roduced 234 final reports d ocu-menting HHEs conducted.

In 1978, the General Accounting Office criti-cized the administration of the HHE program(503). GAO suggested th at NOSH n eeded to pu b-licize the program more, issue HHE reports morequickly, establish an evaluation program, anddisseminate HHE reports more widely, When An-thony Robbins was its Director, NIOSH quad ru-

pled the nu mber of evaluations (465). This rapidgrowth of the HHE program created some con-cern in the business community. It has also beensuggested that the the HHE program has reachedtoo few workers, that the investigations take toolong, that NIOSH has attempted to reach conclu-sions about toxicity based on too few d ata, andthat the program h as not found many new work-related illnesses and injur ies, especially when com-pared with the expense of condu cting the stud ies.

In some cases, the data gathered by an HHEare insufficient to identify a particular cause forworker health complaints. For instance, individ-ual HH Es concerning health problems from u n-known sources of ind oor air p ollution have sel-dom identified a causal agent. The accumulatedfindings from these studies, however, havepointed to lack of ventilation as a comm on fac-tor. Frequently, reported illnesses disappear afterimprovements in ventilation.

State surveillance programs.—NIOSH is nowattempting to involve State health departmentsin surveillance programs for identifying work-related illness and injury . After su rveying State

Health Officers to learn abou t their curren t ca-pabilities for carrying ou t su rveillance and pre-vention p rograms, NIOSH established agreementsto cooperate w ith five States. NIOSH is d evisingmethods to assign Epidemic Intelligence Service




Officers to State Health Dep artm ents for generalepidemiological du ties related to prevent ing work-related illness and injury.

Epidemiologic and Toxicologic Studies

The goal of epidemiologic and toxicologic

studies is to und erstand th e causes of occup ationalhealth and safety problems and thus reveal areasfor preventive actions. Since 1971, NIOSH hassponsored a nu mber of stud ies through its re-search grants programs and NIOSH staff havethemselves conducted important studies.

NIOSH describes its current research efforts byreferring to its list of 10 leading w ork-related d is-eases and injuries. These are occupational lungdiseases; musculoskeletal injuries; occupationalcancers; amp utations, fractures, eye loss, lacera-tions, and traumatic deaths; cardiovascular dis-eases; reproductive disorders; neurotoxic dis-orders; noise-induced hearing loss; dermatoses;and psychologic disorders. As examp les of cur-rent NIOSH activities, a few studies of lung dis-ease, cancer, and reproductive health are dis-cussed.

Work-related lung disease. -Lung disease isthe highest priority work-related health problemand includ es a num ber of debilitating d iseases.The health and safety HH S pr evention objectives(see d iscussion below ) set a goal of virtually nonew cases of asbestosis, byssinosis, silicosis, andcoal workers’ pneumoconiosis. NIOSH efforts

concerning lung disease focus on these four dis-eases plus lung cancers and occupational asthma.

NIOSH studies in this area include animaltesting to study the carcinogenicity of shortasbestos fibers, those less than 5 um in length. Thestudy lasted 2 years, at which time the animals’lungs were examined. Asbestos fibers were foundin the lung, but fibrosis, lung tumors, and otherlesions were absent. The researchers concludedthat although short asbestos fibers did not bythemselves appear to cause tumors, there is stilla need for furth er stud y of the possible interac-

tions between short asbestos fibers and other sub-stances that cause cancer.

NIOSH researchers have sponsored the d evel-opm ent of criteria for the p athologic diagnosis of pleuro-pulmonary disease associated with as-

bestos dust exposure and a method for gradingdisease severity. An expert committee of pul-monary pathologists assembled in cooperationwith the College of American Pathologists re-viewed surigical and autopsy evidence and reacheda consensus as to what the criteria should be.

There have also been investigations of the im-munologic aspects of work-related lung diseaseto examine the natural d efense systems of the lun gand potential ways they are stressed by w ork-related exposures. For instance, the effect of cer-tain particulate matter often found in the w ork-place was tested on the interferon system in alaboratory experiment. One finding was an associ-ation of inhibition of interferon production withincreasing coal rank (coal, that is, with higher car-bon content such as anthracite). The growth of influenza virus, introduced into a treatment sys-tem, increased more among those treated with

coal par ticulate than among controls.

Work-related cancer. —Both laboratory andepidemiologic studies are condu cted to d eterminethe carcinogenic potential of workplace exposures.In cooperation with the National Toxicology Pro-gram, NIOSH sponsors carcinogenicity assays forworkplace chemicals.

As an example of epidemiologic studies, aNIOSH retrospective cohort mortality stud y of paper and pu lp workers found a suggestive in-crease in lymphatic disease, although associationswith exposure to workplace agents includingwood du st, formaldehyd e, sulfur compou nd s, andother chemicals were unclear. A proportionalmortality study of automotive workers suggestedthat makers of wood d ies and mod els suffer moreoften than expected from fatal colorectal cancer,leukemia, and other cancers.

NIOSH has d eveloped a registry of workers ex-posed to dioxins that contaminate certain chemi-cals. Follow-up studies of the members of theregistry w ill, it is hop ed, p rovid e clarifying infor-mation about the possible carcinogenicity of di-oxin. Although information about the exposure

levels of these “dioxin workers” is limited, at leastsome of them w ere exposed to mu ch higher levelsthan any “environm ental” exposure through air,wat er, or soil. Therefore, the registry will be im-portan t in th e d ioxin controversy. This activity






Table 12-8.—NIOSH Budget for Control Technology

Nonstaff TotalPerson (dollars in (dollars in

Program area Projects years thousands) thousands) Percent

Control systems. ... , . . 10 29.0 542.9 1,535.8 20.86Respirator research ., . . 10 16.7 462.6 1,000.0 13.58

Other PPE . . . . . . . . . . . . 3 4.8 99.3 253.7 3.45

Sampling/analysis . . . . . 12 36.9 1,500.8 2,751.8 37.38Method development, . . 6 24.2 272.8 1,090.5 14.81Respirator testing . . . . . 4 15.7 224.2 729.4 9.91

Totals . . . . . . . . . . . . . . 45 127.3 3,102.6 7,361.2 100.00

SOURCE (584)

Table 12-9.—Control Technology AssessmentsPerformed by NIOSH in Fiscal Year 1982

Completed: Seals and fittings in chemical processing technologyNonferrous metals production including aluminum

reduction and nonferrous smeltersFire buildingFoundries

Spray paintingPesticide manufactureDry cleaning

Ongoing:Dust control in dusty unit operationsChemical processing unit operationsUnit processes used in general manufacturing

SOURCE: (584)

trol of the suspected carcinogen formaldehyde(both in its manufacture and as it is found inadh esives du ring hot-press wood veneering) andcontrol of worker exposure to styrene, an agentthat can cause dermatitis and neurotoxic illness,

in boat building plants.NIOSH is also conducting control technology

research in selected petroleum-refining operations.Although m ost processes in this industry are con-tained, workers may be exposed to toxic sub-stances through leaks, during equipment failureor maintenance, while collecting quality controlsamp les, wh ile loading or un loading materials,and during waste treatment. NIOSH investigatedengineering and work practices at a hydrogenfluoride acid alkylation unit, at a benzene-loadingfacility, and during other processes in petroleumrefining.

CTAs have been condu cted in some u nit proc-esses. In the pharmaceutical industry, for exam-ple, the substances used to manufacture contra-ceptives are capable of causing gynamastia orenlarged breasts among both exposed female and

male workers, and m enstrual irregularity amongexposed female workers. Because the batches of these products are relatively small, the process hasnot been mechanized and there are man y oppor-tunities for worker exposures. Good engineeringcontrols used in these situations included isola-tion, highly efficient local exhaust ventilation and,

as an additional safeguard, the use of supplied-air suits.

Other assessments have been mad e in industriesexpected to grow in future years. These includehazardou s waste disposal, semicondu ctor man u-facturing, and fermentation processes. The studiesof waste disposal included investigations of wasteincinerators and automated drum handling.

Toxic materials used or found in the manufac-tur e of microelectronic comp onents includ e lead,arsine, phosphine, boron trifluoride, carbontetrafluoride, phosphorou s oxychloride, and hy -

drofluoric acid. In many cases, NIOSH foundwell-designed a nd effective engineering contr olsand ventilation systems for these hazards, but alsodiscovered on e previously un identified exposureproblem—arsenic off-gassing of silicon w afers im-pregnated with arsenic.

Fermentation processes are expected to be usedmore frequently in biotechnology. NIOSH is in-vestigating th e enzyme p rodu ction indu stry tolearn which control technologies are most effec-tive in containing potentially hazardous biologicalmaterial (582).

Respirator Certification and Research

NIOSH, in conjunction with the Mine Safetyand Health Administration, tests and certifiesrespirators. During fiscal year 1982, 44 new res-



Ch. 12—Governmental Activities Concerning Worker Health and Safety q 249

pirators were evaluated for approval and 60 wereevaluated for extension of ap proval. Aud its wereconducted of 33 off-the-shelf respirators to ensurethat certified respirator s continue to m eet test re-quirements. Respirator quality-control programsare also reviewed to make sure that certified

respirators continue to meet requirements. Asdetailed in chapter 8, however, there are manycomp laints about respirators and about N IOSH’sinability to publish new regulations concerningrespirator-testing requirements.

Field testing is condu cted to m easure certifiedrespirator performance in actual working condi-tions. Research is under way on sorbent efficiencyfor organic vapor respirators, filter efficiency andoptim um flow rates for aerosol air-pu rifying res-pirators, the effects of filter resistance and effi-ciency on pr otection factors and r edu ced air flow

use in pow ered air-pu rifying respirators, and thephysiological effects of using respirators simul-taneously with protective clothing.

Other Personal Protective Equipm ent Research

Chapter 8 outlines NIOSH investigations of various types of p ersonal protective equipment,includ ing head p rotection (hard hats), eye pro-tection (protective glasses), face protection (faceshields),

-foot protection (steel-toed shoes and

metatarsal guards), hand protection (protectivegloves), motion restraints, and protective cloth-ing. All of those studies were done in the late1970s. Currently, resource constraints have lim-ited research in th is area to chemical protectiveclothing. The absence of assurance that personalprotective equipment w orks as advertised couldbe add ressed by N IOSH, with sufficient funds andeffort, or by NIOSH in cooperation with otherorganizations.

Sampling and Analysis

Analysis of chemical samples is necessary forman y indu strial hygiene and med ical studies. Infiscal year 1982, 17,200 exposu re sam ples were

analyzed for 42,000 determinations. About one-quarter of the samp les were d one in NIOSH lab-oratories and th ree-qua rters on contract.

NIOSH also has a role in laboratory qualitycontrol. Approximately 375 private and govern-

ment industrial hygiene analytical labs participatein the NIOSH P roficiency Analytical Testing p ro-gram, which periodically sends out referencesamp les for analysis. For examp le, a sample of airborne lead d ust wou ld be analyzed by each lab-oratory, NIOSH then collates results from all of

the participating laboratories and r eports themback in sum mar y so each lab can see how closelyits results match th ose of other laboratories. Par-ticipating in this program and performing analy-ses within the quality control boundaries for thetested substances is required for maintaining lab-oratory certification by the American IndustrialHygiene Association.

Samp ling an d Analytical Methods Developm ent

To facilitate accurate and precise assessment of worker exposure to chemical hazards, NIOSH

develops and refines methods for sampling andanalysis. In 1981, it published the seventh volumeof the Manual of Analytical Methods, whichadded 21 methods for monitoring chemicalhazards.

NIOSH has also participated in the develop-men t of new samp ling dev ices. In 1981, it devel-oped performance specifications, testing protocol,and evaluation criteria for passive monitors,wh ich are devices requiring only the natur al mo-tion of contam inant m olecules in air, thus sav-ing the costs of sampling pu mp s. NIOSH and the

Bur eau of Mines collaborated in a com par ison of X-ray d iffraction an d infrared sp ectroscopy foranalyzing qua rtz or crystalline silica. These testswere d one to help r efine reliable, low-cost ana-lytical method s. Other samp ling research has ledto real-time, direct-reading samp ling method s.Such d evices, while costing mor e at the outset,will redu ce the overall cost of mon itoring chemi-cal workplace hazards by eliminating the costs,risk of error, and delays in obtaining results thatare associated w ith laboratory analysis.

Dissemination

NIOSH disseminates its research findings throughcriteria documents, reports, and published papersinforming professionals and the public of identi-fied p roblems and solutions, as well as throughHealth Hazard Evalution reports. Efforts are now




being made to d isseminate HH E findings to hard -to-reach aud iences. For examp le, a finding thatirritating vapors from duplicating machines wereaffecting teachers’ aides an d that an easy wa y tocontrol the exposure was available was dissem-inated through teachers’ organizations.

The OSH Act provides that N IOSH shall makerecommendations to OSHA concerning healthand safety standards. Since 1971, NIOSH hastransmitted to OSHA over 100 “criteria docu-merits, ” which contain extensive bibliographies of available scientific literatu re on th e chemical orprocess in question, followed by an analysis andassessment of the substance’s toxicity and a rec-omm endation to OSHA for a potential standard .The criteria documentation process has coveredabout 151 substances since 1970. Priority for thesubstances for which criteria documents were

written was based in p art on estimates of the nu m-ber of workers exposed , the volume of produc-tion of the su bstance, and the severity of toxicity.

The third NIOSH Director, Anthony Robbins,deemphasized the production of criteria docu-ments in part because many of them “w ere mostlytoxicological reviews” that “ . . . did not conta in

a great deal of epidemiology, which isneeded. They were inconsistent” (482). In ad-

dition, as discussed in chap ter 13, OSH A has notissued standards for most of the hazards addressedby N IOSH criteria docum ents.

Few criteria docum ents are being developednow, but from time to time N IOSH has prep aredother kinds of reports, transmitting them toOSHA, as w ell as disseminating them to the pu b-lic. These include Occupational Hazard Assess-ments, wh ich contain recommend ations but thatare less thorough and less specific than criteriadocuments. In addition, NIOSH prepares Current

Intelligence Bulletins, which contain n ew findingsabout w orkplace hazard s, are also pu blished an dtransmitted to OSHA, to w orker and employerrepresentatives, and to health and safety profes-sionals. NIOSH also participates in the public

hearings that are part of OSHA’s standard-settingprocess and provides recommend ations concern-ing the standard under consideration.

NIOSH technical publications are widely dis-seminated . In fiscal year 1982, for exam ple, one

research division-the Division of Surveillance,Hazard Evaluation, and Field Studies—submittedover 300 reports on industrial hygiene and m edi-cal studies to th e Na tional Technical InformationService, published 63 articles in technical journals,pu blished 3 articles on research findings d escrib-

ing hazards and means for reducing them in in-dustry and labor trade journals, had 6 articles inth e Morbidity and Mortality W eekly R eport, pub-lished 2 sum mar ies of app roximately 80 recentlycompleted HH Es, and provided over 200 reportsto people requesting information from N OH S.

The OSH Act requires that MOSH publish an-nually a list of all known toxic substances orgroups of toxic substances, their observed effects,and the concentrations at which they occurred .In compliance with this requirement, NIOSH pu b-lishes th e Registry of the Toxic Effects of Chemi-

cal Substances. The current edition contains218,746 listings of chemical names, of which59,224 are different chemicals (the rest of thenames are synonyms). The listings are extractedfrom the published literature, including journalspublished abroad, but are not evaluated for qual-ity, accuracy, or reproducibility, The substancenam e is given, followed by its synony ms, chemi-cal da ta, and toxicity data by the gener al catego-ries of irritation, mutation, reproductive effects,tumorigenic effects, and general toxicity. The cita-tion for each toxic effect reported is included sothat th e orginal article can be found for furth er

detail.

NIOSH is also becoming involved in educationto prevent work-related illness and injury. Ahealth motivation working grou p h as been formedto examine ways in wh ich NIOSH’s research couldbe applied to combine health protection (controlof work-related illness and injury) and healthpromotion (improvement of personal healthbehaviors).

In addition, NIOSH has responsibility for theeducation of occupational safety and health pro-

fessionals through both direct short-term train-ing and academ ic program s, It is estimated thatover 5,000 professionals have received trainingthrou gh th ese NIOSH progr ams. (These activi-ties are described in detail in ch. 10. ) Traininggrants for Educational Resource Centers have




been successful in establishing coordinated multi-disciplinary p rograms. They have received someattention recently because of proposals by the cur-rent administration to eliminate their Federalfunding (102).

NIOSH Priorities

Setting priorities for preventing work-relatedillness and injur y has b een a challenge to NIOSHmanagement. During John Finklea’s tenure as Di-rector, NIOSH activity was concentrated on theprod uction of recommend ations to OSHA con-cerning health and safety standards-NIOSH’s“criteria documents. ” He believed that the criteriadocuments should be the primary product of NIOSH and that once published w ould be con-sidered pu blic health p olicy documents that w ould

force OSHA into setting and revising healthstandards.

Anthon y Robbins, the next N IOSH Director,reemphasized criteria documents and focusedNIOSH activity on health hazard evaluations andepidemiologic studies (465,482). The fourthNIOSH Director, Donald Millar, has set specialemphasis on efforts to assure high-quality researchand focus research on the most imp ortant work-related p roblems. H e is also w orking to expandthe participation of State and local health agen-cies and to increase workplace health promotion

efforts (584).Present research priorities are influenced by the

HH S Prevention Objectives for the Nation, theNIOSH list of 10 leading work-related healthproblems, and the HHS National Toxicology Pro-gram . These are used to identify subjects for cri-teria docum ent development an d to set prioritiesfor research on hazard assessment an d control.

The Prevention Objectives include 20 objectivesfor preventing work-related injury and illness.Thirteen of these have been designated priority

objectives. The Prevention Objectives, shown inBox

q

q

q

q

q

O, are divided into several categories:

Improved health stat us (measured by fewerdeaths, injuries, and illnesses);

Reduced risk factors (by implementing haz-ard controls);

Improved public/professional awareness (asreflected by increased worker, employer, andprofessional knowledge about occup ationalhazards);

Improved s ervi ces/protection (through theuse of generic standards and increasedNIOSH activity in studying hazard s); and

Improved surveillance/evahation (includingcreation of coding systems and enhancing ex-isting efforts to include occupational factors)(556).

The NIOSH list of 10 leading work-related

health p roblems (see table 5 in ch. 3) was com-piled by NIOSH’s division directors. Frequencyof occurrence, severity, and amenability to p re-vention of the work-related injury and illness werethe criteria used for selection (583). This prioritylist is u sed by NIOSH to identify subjects for cri-teria docum ent development an d to set prioritiesfor research for hazard assessment and control.It was also published to encourage discussionamong occup ational safety and health p rofession-als and to a ssist them in setting their control pri-orities. NIOSH intends to collect d ata on the 10and periodically u pd ate it as cond itions change

(581).

The National Toxicology Program coordinatesthe Federal Government’s testing of chemicals forpossible human health hazards. Two of its activ-ites are impor tant for N IOSH. First, it carries outthe testing of substances that NIOSH identifies aspossible concerns, and NIOSH contributes to thecosts of those tests. Second, the results of testsrequested by other agencies are also provided, soNIOSH can evaluate the p otential workplace haz-ards presented by these substances.



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Ch. 72—Governmenta Activities Concerning Worker Health and Safety 253

’16.

17.

By 1990, generic stand ards and -other forms of technology tran sfer shou ld be established, wherepossible, for standardized employer attention to such major common problems as: chronic lunghazards, neurological hazards, carcinogenic hazards, mutagenic hazards, teratogenic hazards,and medical monitoring requirements.

By 1990, the num ber of health hazard evaluations being performed annu ally should increase ten-fold, and the nu mber of indu stry-wide stud ies being formed ann ually should increase three-fold. (In 1979, NIOSH performed app roximately 450 health h azard evaluations; 50 indu stry-widestudies were performed.)

Improved surveillance/evaluation:

-18.

19.

20.

By 1985, an ongoing occup ational health hazard / illness/ injury coding system, survey, andsurveillance capability should be developed, including identification of workplace hazards andrelated health effects, including cancer, coronary heart disease, and reproductive effects. Thissystem should include adequate measurem ents of the severity of work-related d isabling injuries.By 1985, at least one question about lifetime work history and known exposures to hazardoussubstances should be ad ded to all approp riate existing health data reporting systems, e.g., cancerregistries, hospital discharge abstracts, and death certificates.By 1985, a program should be developed to: 1) follow u p ind ividual findings from h ealth hazardand health evaluations, reports from unions and management, and other existing surveillancesources of clinical and epidem iological data, and 2) use the findings to d etermine the etiology,natural history, and mechanisms of suspected occupational disease and injury.

“Priority objectives of NIOSH.

SOURCE: (556).

SUMMARY

OSHA and NIOSH were created by th e Occu-pational Safety and Health Act of 1970 and bothbegan op erations in 1971. The separation of reg-ulatory activities from research may help ensurethe objectivity of the research, bu t it has a lso beencriticized because oftentimes the tw o agencieshave not coordinated their activities. After aperiod of growth during th e 1970s, the bud getsfor both OSHA and NIOSH have d eclined in re-cent years. After ad justing for inflation, OSHA’shas d ecreased nearly 13 percent since its peak in1979. NIOSH’s has d eclined 42 percent since apeak in 1980 and is now lower, in real terms, thanany NIOSH budget since 1973.

OSHA’s main activities are setting occupationalhealth and safety standards, conducting work-place inspections to ensure compliance with thosestandards, monitoring State programs, and pro-viding for several different types of educationaland service programs. Although many of OSHA’s

startup standard s have provided some workerprotection, there were many problems with thesestandards and OSHA has been slow in revisingthem . Since 1971, OSHA has com pleted 18 sepa-rate proceedings for setting health standards and26 proceedings for safety standards. However, thescope of some of these standards has been verylimited, and several involved only a rewriting of requirements that had been issued earlier byOSHA. Those that involved major changes havefrequently been the subjects of judicial review.OSHA h as also published nine emergency tempo-rary standards, but the courts have been reluc-tant to support these standards.

OSHA inspection activity has generated a greatdeal of controversy because employers can becompelled to install health and safety control tech-nology. Together, Federal OSHA and the Stateprograms operating under the OSH Act con-ducted about 162,000 establishment inspections




and 13,000 “records review” visits in fiscal year1983. However, for most workplaces, the threatof an inspection is quite low. On average, OSHApen alties are also low, often lower than the costsof many controls.

OSHA’s public education and service activitiesinclude its consultation program, New Directionsgrants pr ogram, and Voluntary Protection Pro-grams. All these programs attempt to approachhealth and safety in a w ay that is more coopera-tive than OSHA citations and penalties. But therehave been concerns expressed about OSHA’smanagement of funds in these areas, the qualityof the work performed, and the relationship of these activities to OSHA’s inspections.

Federal OSHA also monitors the 25 jurisdic-tions that have assumed responsibility for thehealth an d safety of all or som e of the work force

within their bord ers. These State prog rams canpotentially meet local needs better than a cen-tralized Federal agency and can enhance the totalgovernmental resources devoted to worker healthand safety. But there has been controversy heretoo, especially concerning app ropriate staffinglevels for these operations.

NIOSH a ctivities are chiefly related to hazar didentification, research on control technology,and providing for information dissemination and

professional education. The largest share of theNIOSH budget is now devoted to identificationof hazards. This includes a large survey of workplaces to determine the extent of potentialexposur es to toxic substan ces, the Health Hazar dEvaluation p rogram, and NIOSH research in ep i-

demiology and toxicology.Control technology receives a relatively small

portion of the N IOSH bud get. This research in-cludes Control Technology Assessments, respira-tor certification and research, research on othertypes of personal protective equipment, as wellas d eveloping sam pling and analytical techniquesand performing laboratory analysis of exposuresamples. Information dissemination includes theprepar ation of reports on Health Hazard Evalua-tion, industry-wide studies, Control TechnologyAssessmen ts, and guid es to good pr actice. Sever-

al NIOSH publications are standard referencesources for industrial hygiene, and the Registryof t he Toxic Effects of Chemical Subst ances is acomprehensive listing of the literature about thetoxicity of over 59,000 different chemicals. NIOSHhas also prepared Criteria Documents containingrecomm endations to OSHA concerning new orrevised health and safety standards. Finally,NIOSH grant programs h ave provided for theeducation of a nu mber of health and safety pro-fessionals.



1 3 .

Assessment of OSHA and NIOSHActivities

\



Contents

Comp arison of Recommend ations and Standard s. . . . . . . . . . . . . . . . . . . . . . . . . . .Methodology for Comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Resu lts . ....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Discussion . . . . . . . . . . . . . . . . . . ................... . . . . . . . . . . . . . . . . . . . .

Impacts of OSHA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Cost of OSHA Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

OSHA’s Impact on Injury Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Trends in Exposu re Levels. .Conclusions About OSHA’s

Impacts of NIOSH . . . . . . . . . .Summ ary . . . . . . . . . . . . . . . . . .

Table

13-1.

13-2.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LIST OF TABLES

Comparison of Protective LevelsMcGraw HillSafety . . . . . .

Survey of Capital. . . . . . . . . . . . . . . .

for selected substances. . . . . . . . . . . . . . .Spending for Worker Health and. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page

257

258259

260262

262

26426a

269

270

Page

259

263



.—.

Assessment of OSHA and NIOSHActivities

This chapter presents a discussion of several as-pects of the activities of the Occupational Safetyand Health Adm inistration (OSHA) and the Na-tional Institute for Occupational Safety andHealth (N IOSH). It is not a comp lete assessmen tof Federal and State activities concerning occupa-tional health and safety, but only a relatively brief treatment of several imp ortant areas. First is apresentation of the results of an OTA comparisonof the standards and recommendations of OSHA,

NIOSH, and the Am erican Conference of Gov-ernmental Industrial Hygienists (ACGIH). Secondis a d iscussion of estimates of employer invest-ments in health and safety, followed by a su m-mary of the research on the effectiveness of OSHAin reducing injury rates and toxic exposures.Finally, there is a short discussion of the dif-ficulties in assessing the results of NIOSHactivities.

COMPARISON OF RECOMMENDATIONS AND STANDARDS

This section discusses an OTA comparison of current OSHA standard s for certain toxic and haz-ardous substances with NIOSH Recomm endedStandards and with the Threshold Limit Values(TLVs) recommended by the American Confer-ence of Governmental Industrial Hygienists. Thiscomparison provides an analysis of the stringencyof OSHA standards, and NIOSH and ACGIH rec-ommendations. In most cases, OSHA standards

for chemical exposure appear to be less stringent.When there is more than one required or rec-

ommended level, engineers and designers can findthemselves in a qu and ary as they seek to designa productive process and a system for the pro-tection of worker health. Obviously, the designersmust comply with the OSHA standard and can-not choose to comply only with a less protectiverecommendation from another organization.

But w hen the r ecomm endations of NIOSH orACGIH are m ore protective than OSHA stand -ards, it wou ld be d esirable, from a health stand-

point, for companies to adh ere to these more pro-tective recommendations. This is especially truewhen building new facilities or rebuilding oldplants, when it is possible to increase worker pro-tection and to take advan tage of the reduced costsof controls introdu ced as part of the d esign. At

the current time, however, this is not requ ired.(As discussed in ch. 16, one op tion might be toencourage companies to meet more protectivelimits w hen u nd ergoing “reind ustrialization. ”)

OSHA curr ently has stand ards for about 410chemical substances. In most cases, OSHA sp eci-fies the maximu m levels for emp loyee exposur es(the Permissible Exposure Limits, or PELs). As de-scribed in chapter 12, nearly 400 of these stand-

ards w ere adopted in 1971 by OSHA un der sec-tion 6(a) and consisted of consensus standard s andestablished Federal standards. In addition, OSHAhas issued 18 separate health standard s. Twelveof these covered 24 specific substances and on ephysical agent. Among these 12 standards, therewere 10 that set new or revised Permissible Ex-posure Limits.

Each y ear the ACGIH p ublishes a list of TLVs.These are recomm ended to the ACGIH m ember-ship by the TLV Airborne Contaminant Comm it-tee—17 members and 9 nonvoting consultants

wh o represent comp anies and other countries.ACGIH h as a second committee that considersrecommendations for physical agents. Althoughqua lified technical consultants from u nions hav ebeen and are sought by ACGIH (244), unionshave not participated on either of these commit-

257




tees in recent years because they believe thatstandard setting should be a Government activ-ity. The committee members are unpaid and maymeet tw o to four times each year to deliberate.New TLVs that are accepted by the membershipat the annual business meeting are placed on a

list of “intended changes” for at least 2 years, dur-ing which comm ents and ad ditional data are re-quested . At the end of this period the member-ship votes on w hether to ad d the TLVs to the listof Threshold Limit Values.

The 1983-84 TLV list contains recomm end edexposure limits for 615 chemical substances andmineral dusts. In May 1984, ACGIH adoptedTLVs for 15 substances, and proposed to addTLVs for 7 substances not currently on their listas well as to revise the TLVs for 21 other sub-stances (352). Changes in ACGIH TLVs are n ot

autom atically incorporated by OSHA, even forthe PELs originally based on t he 1968 ACGIH list.

As outlined in the Occupational” Safety andHealth (OSH) Act, NIOSH makes recommenda-tions, in th e form of Criteria Docum ents or otherdocuments, to OSHA concerning health and safe-ty standards. It was apparently intended thatOSHA would issue mandatory standards after re-ceiving recommend ations from N IOSH.

A NIOSH list, Recommendations for Occupa-tional Health St andards, details the proposalsmade to OSHA since 1971 for exposures to 163

hazardous substances and working conditions.Five of these concern hazardous working condi-tions: logging, hot environments, coal gasifica-tion, confined spaces, and emergency egress fromelevated work stations. None of these five hasresulted in a comp leted OSHA ru lemaking.

1

Ten recommendations concern exposures tocategories of hazard ous su bstances or to harm-ful ph ysical agents (benzidene d yes, chrysene,coke oven emissions, fluorocarbon decompositionproducts, ethylene thiourea, kepone, noise, pes-ticides, ultraviolet radiation, waste anesthetic

gases). Only two of these, coke oven emissionsand noise, have resulted in any regu latory action

K)ne other NIOSH recommendation, concerning underwater div-ing operations, is not included in th e NIOSH list. This recommen-dation w as issued in August 1976 after OSHA had already issuedan Emergency Temporary Standard on diving operations. OSHA’S

final standard was published in July 1977.

by OSHA. For coke oven em issions, a stand ardwas issued in 1976. For noise, OSHA issued aHearing Conservation Amendment in 1981 andrevised it in 1983. For both version s of the H ear-ing Conservation Amendment, however, the pub-lished provisions covered only monitoring, audio-

metric testing, hearing p rotection, training,warning signs, and record keeping. The NIOSHrecommendation to lower the Permissible Expo-sure Limit from an 8-hour time-weighted averageof 90 decibels to 85 decibels has not been actedon. (The ACGIH TLV for continu ous noise is also85 decibels for an 8-hou r exposu re. )

Finally, NIOSH has made recommendationsconcerning 148 specific chemical substances. Butonly 123 of those recommendations include aspecified numerical exposure limit.

Methodology for ComparisonOTA’s analysis comp ares the p rotective levels

either recommended or required by NIOSH,ACGIH, and OSHA, for the 123 specific sub-stances included on th e NIOSH list. The use of the N IOSH d ata set as a basis for comparison d oesnot m ean that th e NIOSH exposure levels are themost important. The NIOSH data are simply aconvenient source for analysis. (See app. A fora discussion of the selection of substances and themajor points of inconsistency among these orga-nizations. )

Unfortunately, OSHA, NIOSH, and ACGIHuse different terminology for describing theirstandards and recommendations. OSHA refers tothe basic requiremen t of its health standard s asa “Permissible Exposure Limit. ” This is the re-quirement that employee exposures be kept belowa specified numerical limit. NIOSH prepares “Cri-teria for Recommended Standards” and transmitsthose recommendations to OSHA. ACGIH usesthe term Threshold Limit Values for its recom-mend ed exposure limits.

For these comp arisons, OTA has used the term

“Protective Level” to refer to the standards, rec-ommendations, and TLVs. Protective Levels canbe specified in two basic ways:

q time-weighted averages (TWAs), andq ceiling limits, short-term limits, or peak

levels.






organizations have identical TWAs or ceilinglimits is included in the following discussion. )

Overall, NIOSH recommendations are morestrict than the OSHA standard s. Even w hen theProtective Levels are separa ted into TWA and

Ceiling Limits, OSHA generally permits higherexposur es. Only 28 TWA PELs set by OSHA a remore stringent than NIOSH’s. In all but 2 of thosecases (lead and carbon dioxide) the TWAs usedby OSHA ap pear to be more stringent becauseNIOSH d id not set a TWA bu t only set a CeilingLimit. In many cases (22 of the 28), this NIOSHCeiling Limit is lower than or equal to the TWAused by OSHA.

There are, how ever, 5 instances in wh ich th eOSHA Ceiling Limit is more strict than the N IOSHone, althoug h in each case this is because N IOSHhas not recommended a Ceiling Limit. There are33 instances (27 percent) where OSHA PELs areequal to N IOSH recomm endations, either in theTWA or Ceiling or both. Of these, 22 representsituations in which both the TWA and CeilingProtective Levels are identical.

As mention ed, ACGIH up dat es its TLVs everyyear bu t OSHA’s PELs remain v irtually frozen atthe levels adopted by ACGIH in 1968. Obviously,then, OSHA PELs and ACGIH TLVs will be equalin those cases in which ACGIH has not changedits 1968 levels (15 instan ces). It is notew orthy thatACGIH now has TLVs for over 600 toxic and haz-

ardous su bstances—some 200 substances morethan OSHA regu lates.

OSHA standards are stricter overall than ACGIHTLVs in 10 cases (8 percent). ACGIH has no rec-ommendation for 4 of those substances: acetylene,DBCP, ethylene d ibromide, and petroleum sol-vents. OSHA’s TWAs are stricter than ACGIHTLVs in 11 cases (9 percent) and OSHA’s CeilingLimits are stricter than ACGIH’s in 12 cases (10percent). In all but 6 of these, if the TWA usedby ACGIH is weaker than OSHA’s, then theACGIH C eiling Limit is stricter than OSHA’s (or

vice versa). On the whole, instances where OSHAis more strict occur because ACGIH has not madeany recommend ation at all.

NIOSH recommendations are stricter thanACGIH TLVs for 28 substances (23 percent) out

this is because ACGIH has not set any TLVs forthese substan ces. NIOSH has stricter TWAs th anACGIH in 35 cases (28 percent) and stricter Ceil-ings in so cases (41 percent). NIOSH recomm en-dations and ACGIH TLVs are equal in 15 cases(12 percent). Sometimes one set of Protective

Levels, such as the TWA, is equivalent an d theother is not (33 cases), For example, the TWAsfor xylene are the same for both NIOSH andACGIH, but ACGIH’s Ceiling is stricter thanNIOSH’s. There is only one chemical with anOSHA PEL and an ACGIH TLV for w hich NIOSHhas not set an exposure limit (boron trifluoride).

Discussion

These three organizations u se different formal

decision ru les w hen setting their stand ards an drecommend ations. However, in practice, manymore informal factors enter into the decisions, in-clud ing the experience of the individuals involved,their professional judgments on what is protec-tive of wor ker health, and the values and goalsfor public policy that are held by these individualsand their organizations.

For OSHA and NIOSH, the formal guidelinesfor recomm endations and standard s derive fromthe OSH Act, which app ears to distinguish be-tween the “criteria” developed by N IOSH an d the

“standard s” set by OSHA. NIOSH is required todevelop “criteria” solely on health and safetygrounds, without consideration of the feasibilityof the “criteria. ” OSHA, on the other hand, isdirected to set standard s that are “reasonably nec-essary or appropriate” and, in the case of healthstandards, to protect employee health “to the ex-tent feasible. ” (For a d iscussion of OSHA d eci-sionm aking , see ch. 14. )

ACGIH sets its TLVs at levels “un der wh ich itis believed that nearly all workers may be repeat-edly exposed da y after day w ithout ad verse ef-fect.” ACGIH cautions, how ever, that because of variation in individual susceptibility, some work-ers may still develop an occupational illness fromexposu res at a TLV. The TLVs “should be u sedas guides in the control of health hazards andshould not be u sed as fine lines between safe and

of the 123. In 4 instances, as mentioned above, dangerous concentrations” (8).



This comparison shows, in a limited way, thatOSHA has tended to lag behind NIOSH’s andACGIH’s Protective Levels. There are several in-terrelated reasons for this lag. The first, and mostimportant, is that OSHA is a governm ental reg-ulatory agency. Employers can, if they wish, ig-

nore NIOSH recommendations and ACGIH TLVs.But even though OSHA’s inspection activity islimited (see ch. 12), OSHA standards can poten-tially be u sed a s the basis for civil penalties andrequired abatement. Thus they receive more at-tention.

Opp osition has often accomp anied that atten-tion. Most of OSHA’s health standards have beenchallenged in the courts. Resolution of these caseshas taken time–in most cases, several years. Thecourts now requ ire that OSHA stand ards be basedon adequ ate evidence that the hazard add ressed

by the stand ard poses a “significant risk” and thatcompliance is “feasible” for the affected industry.Moreover, Executive Orders since 1974 have re-quired that OSHA examine the economic impactof its standards prior to issuing them. (For a dis-cussion of this aspect of OSHA decisionmaking,see ch. 14. )

In add ition, althoug h OSHA is to use NIOSH’srecomm endations as one element for its standar d-setting, it is not required to respon d to th ose rec-ommendations within any specified deadline. Be-yond this, OSHA has often concluded that the

NIOSH Criteria Documents d id not prov ide anadequate basis for developing standards. ThusOSHA has u sually developed its own scientificand technical information concerning hazards andcontrols. These factual and legal requirements, aswell as the requirements of the Executive Orders,have consumed time, stressed OSHA’s limited re-sources for standard-setting, and slowed theagency.

NIOSH and ACGIH have their own resou rceconstraints, too. But th ey do n ot have the samepotential for public opposition and legal chal-

lenge. They can issue recommendations based ontheir judgments about employee protection fromadverse health effects, without formal analysis of the feasibility or costs of these recommendations.

Ch. 13—Assessment of OSHA and NIOSH Activities q 261

In 1983, it was reported that a mem orand umhad been prepared by OSHA staff recommend-ing that the agency stop work ing on the devel-opm ent of revised exposure stand ards for 116 sub-stances that are regulated u nder OSHA’s startupstandards. OSHA’s activities concerning these 116

chemicals includ e requests for informat ion on 61of the chemicals, preparation of advance noticesof proposed rulemaking on 55 of them, issuanceof proposed r ules for 23, and hearings on ru lesto regu late 9 of the chemicals. According to thememoran du m, a decision to stop w orking on rulesfor these chemicals would be practical, as theagency no longer has the staff or resources to pur-sue this activity, Althou gh OSHA has stated thata d ecision not to pu rsue regulation of these chem-icals has not been made, there has been little re-cent activity regarding these 116 substances. Thelast hearing to be held on an y of them concernedberyllium, in 1977, and there has been no publicactivity on an y of the others since 1975 (110,366,

517a).

As d iscussed earlier, from 1971 to 1984, OSHAissued 18 separate health standards. But only 12of these established Perm issible Exposu re Limitsor other requirements for 25 specific exposures.Requirements for 3 of these have been overturnedby the courts. Thus, of the approximately 410OSHA-regulated substances, nearly all are still thesame as th ose OSHA initially adop ted in 1971.

In d irect contrast to this is the experience of some European nations. For example, in July1984, Swed en issued a revised list of health stand-ards that included 18 revisions of existing exposurelimits and the addition of limits for 22 new sub-stances previously not regu lated. This is the re-su lt of only 3 years of effort, as the last revisionof the Swedish health standards was published inJun e 1981. Althoug h it is gen erally believed thatthe Swedes are leaders in occupational health andsafety, it is difficult to gather quantitative infor-mation on actual exposure conditions in Swedenand the United States. Thus, it is not clear to what

extent the Swedish limits are translated into ac-tual protection. It is clear, however, that the proc-ess of revising the exposure limits in the UnitedStates is d ramatically slow er.




IMPACTS OF OSHA

Cost of OSHA Compliance

There are a number of difficulties and problemsin securing accurate and m eaningful information

on the costs of health and safety regulation. Theseproblems generally plague both estimates of thecosts of any particular regulation or proposed reg-ulatory chan ge and estimates of the total costs of all OSHA regulations.

First, the basic source of data on the costs of compliance with regu lations is emp loyers, eitherbecause they are th e most kn owledgeable aboutday-to-day conditions and equipment in theirplants or because they have given p ermission tooutsiders to visit their facilities. But businessesgenerally d o not arrange their accounting systems

to keep track of all health and safety expenditures.Although information is sometimes available forcertain health and safety expenses (e.g., the sal-ary of a comp any p hysician), there is generallyno accoun t entry for the total expenditures forhealth and safety. Thus, estimates of current costsand predictions of future costs are generally basedon inexact information and guesses rather thanon d ata that can be verified and aud ited.

Furthermore, when asked to provide these esti-mates, there is a tendency for emp loyers to over-estimate regulatory costs. Employers have a

strategic interest, if they op pose a p articular reg-ulation or Governmen t intervention in general,in overestimating the costs. In ad dition, lower-and middle-level managers, when asked howmuch a regulation will cost in their areas of respon sibility, will tend to overestimate th e costsbecause, in the words of a senior official atALCOA, “it is better to be un der bu dget than overbudget” (140). Facing the possibility that they willhave to budget expenditures within the estimatesthey make, managers may overestimate costs inorder to have a su fficient bud get.

Second, comp liance cost estimates h ave gener -ally not been offset by the ben efits of health an dsafety compliance. In fact, in many cases whatappear as new costs to the business firm aremerely costs that previously had been borne byworkers and society. For example, the costs to abusiness of preventing occupationa l injuries may

merely represent costs previously borne by injuredworkers in terms of lost wages, pain, and suffer-ing. In ad dition, the increased costs to employersoften represent increased revenues for suppliers

of control technologies and an increased numberof jobs for health and safety professionals. More-over, when comp lying w ith regulations, employ-ers often are able to offset, at least partially, thecosts of comp liance with imp rovements in p ro-ductivity and reductions in the costs of lost wages,med ical care, dow n tim e, etc. that are associatedwith workplace injuries and illnesses.

Third, th ere are several d ifficulties in correctlyseparating and attributing health and safety ex-pen ditu res. The first of these concerns h ow to a l-locate the costs of equipment and personnel thatperform multiple functions, including normalbusiness activity, or that enable comp liance withseveral regulations. For example, an employer in-stalls a ventilation system that both reduces thelevel of a toxic air contaminant and provides heat-ing and air conditioning. What percentage of thecost of the du ct work, fans, sw itches, installationcosts, etc. should be attributed to the industrialhygiene function and w hat percentage is a nor-mal business expense for heating and air condi-tioning?

A second, and related, difficulty ar ises mostparticularly in attempts to estimate the costs re-lated to existing OSHA regulations or proposalsfor new standards. This concerns how to sepa-rate incrementa l costs (those due solely to the pres-ence of regulation) from total costs, which includespending that would have taken place even in theabsence of regulation. These could includ e thecosts incurr ed because of corpora te good citizen-ship, collective bargaining agreements, and fearof legal liability. For n ew, m ore stringen t regu la-tions, the distinction is often made between thetotal costs of compliance and the incremental

costs for reducing hazards beyond the existing re-quirements.

Finally, cost estimates generally assume the useof currently available technologies, neglecting thepotential for cost savings with improvements incontrol technology. Over time, industry may



—


learn how to control more cheaply and controltechnologies themselves may improve. Thus con-trol m ay become less costly. Basing th e costs oncurrent technology will thus tend to overestimatethe costs of comp liance (33).

Estimates of Total OSHA Compliance Costs

Robert Smith (446) has reported a NationalAssociation of Manufacturers estimate that itsmem bers needed to spend between $35,000 and$350,000 each to comply with OSHA startupstandards. No other details of the methodologybehind th is estimate were given.

The Econom ics Departm ent of the McGraw-Hill Publications Co. annually surveys a gr oupof large companies about actual and planned cap-ital expenditures an d about th e percentage of theircapital spending that is for employee health andsafety and for air, water, and solid waste pollu-tion control, McGraw-Hill then develops nationalestimates based on these survey responses (298).

There is no independent verification of the surveyrespon ses, althoug h a limited check is condu ctedto ensure internal validity of survey question-naires. Information is not collected on annualoperating expenses, but on ly on capital spending.Nor is information collected on what companieswou ld be spend ing on health and safety even inthe absence of OSHA activity.

The total capital spending for occupational

health an d safety w as estimated to be $4.5 bil-lion in 1982 and $4.9 billion in 1983, repr esent-ing 1.4 percent and 1.6 percent of total capitalspend ing, respectively (table 13-2). When meas-ured in current dollars, capital spending for healthand safety has ranged from $3.3 billion to $6.6

billion (from $2.4 billion to $4.4 billion in 1972dollars). The latest estimate of investmen t, about$5 billion, is only abou t one-sixth as large as th eNational Safety Council estimate regard ing thecosts of work injuries alone—over $30 billion eachyear (324, 530).

In both current and real dollars the peak forreported capital spending appeared in 1978. From1979 to 1983, the expend iture r anged between $2.4and $2.9 billion (in 1972 dollars). In ad d ition, theshare of total capital spending that has been de-voted to em ployee health an d safety, which n ever

Table 13-2.—McGraw Hill Survey of Capital Spendingfor Worker Health and Safety

Health and safety investment

Current 1972 Percent ofdollars dollars

a capitalYear (millions) (millions) spending

1972 . . . . . . 3,279 3,279 2.71973 . . . . . . 3,616 3,552 2.61974 ... , . . 4,403 4,028 2.81975 . . . . . . 3,842 3,044 2.41976 . . . . . . 3,415 2,550 2.01977 . . . . . . 4,291 3,043 2.21978 . . . . . . 6,645 4,439 2.91979 . . . . . . 4,317 2,719 1.61980 . . . . . . 4,128 2,441 1.41981 . . . . . . 5,112 2,848 1.61982 . . . . . . 4,503 2,459 1.41983 . . . . . . 4,945 2,704 1.6aAdjuSted to Ig7z dollars using the implicit price deflator for nonresidential wO-ducers’ durable equipmentEconomic Reporf of the Preslderrt (1984), table B-3

SOURCE (298)

fell below an average for all ind ustr ies of 2.0 per-cent from 1972 to 1978, has been in the r ange o f 1.4 to 1.6 percent for the last 5 years for whichdata are available (298). This decline in recentyears in the percentage shar e of capital spend ingdevoted to health and safety is similar to the d e-cline in the share of capital spend ing for pollu-tion control (410).

Anoth er source of information on OSHA com-pliance costs is a study p repar ed for the BusinessRoundtable by the accounting firm of ArthurAndersen & Co. They surveyed 48 very large cor-

porations to estimate the incremental costs of Government regulations of six Federal agenciesin 1 year-1977. The 48 comp anies w ere estimatedto incur about $2.6 billion in compliance costs.Of this, only $184 million or abou t 7 percent w asattributed to OSHA. About 37 percent of t heOSHA compliance costs were capital costs, 56 percent operating and administrative expenses,and 6 percent research and development costs(26).

Wiedenbaum and DeFina have developed whatis probably the most w idely quoted estimates of

the costs of Federal regulation. Their estimate forthe total costs of all Federal regulations in 1976

amounted to about $65 billion (669), while for1979 their estimate was over $100 billion (670).

(See 195,428,470 for criticism of th ese es timates.)They did not, however, develop any n ew or origi-




nal cost estimates for OSHA comp liance. Rather,their estimate for OSHA was based on the McGraw-Hill survey p lus an estimate of the costs incurr edby universities for OSHA compliance.

OSHA and a nu mber of participants in its reg-ulatory hearings have p rovided estimates of thecosts of comp lying with m any of the prop osalsoffered by the agency. The qu ality of these esti-mates has been qu ite variable and h as usually beencolored by the controversies surrounding the par-ticular regu latory prop osal. Because th ey havebeen especially su bject to th e d ifficulties d iscussedabove, OTA has not attempted to summarizethese estimates.

Impacts on Productivity and Paperwork Burdens

OSHA may also have an impact on economicprod uctivity by diverting resources from “prod uc-

tive” uses to compliance with health and safetyregulations. Unfortunately, available informationon economic productivity generally does not in-clude the benefits of improved worker health andsafety. But even w ithout considering those off-setting factors, the negative effects of OSHA reg-ulation on trad itional measures of productivityapp ear to be small.

Denisen (137) has studied the determinants of U.S. economic growth and has attempted to ex-plain the sources of declines during the 1970s inthe economic growth rate. He estimated the incre-

mental costs of occupational safety and health reg-ulation in three areas: costs of safety equipmenton m otor vehicles used by businesses, costs of mine safety regulation, and the costs of OSHAregulation. He then estimated th e percent of eco-nom ic inpu ts (land , labor, and capital) that hadbeen “diverted” to p rovide for health and safetyprotection. In 1975, the latest year of his esti-mates, business vehicle safety equipment haddiverted 0.09 percent of inputs, mine safety reg-ulation had diverted 0.24 percent, and OSHA reg-ulation had diverted 0.09 percent, compared witha 1967 baseline. All three together, th en, d iverted

0.42 percent of inputs. Thus, if occupational safe-ty and health regulation and other economic in-pu ts had been the same in 1975 as they were in1967, net output would have been 0.42 percentlarger than what w as actually produced.

Thus, the estimated adverse impact of OSHAon productivity is quite small. Moreover, in somecases OSHA compliance has been accompaniedby improvements in productivity. As discussedin box N (in ch. 12) and chapter 16, these casesinclude th e OSHA stand ards regu lating exposures

to vinyl chloride and cotton dust.One other area in which Government regula-

tion may have h ad an adverse impact is in increas-ing the burden of paperwork on businesses. Con-cern about the burden of Federal forms and otherrecord keeping was import ant in congressionalconsideration and enactment of the Paperwork Redu ction Act of 1980 (Public Law 96-511). ButOSHA r ecord keeping is only a very small partof the total record-keeping “burden. ” For the yearending in September 1983, the time spent in keep-ing OSHA-required records is estimated to be 36.9

million hours. This amounts to slightly less than2 percent of the total for all Federal informationcollection activit ies (171,358).

OSHA'S Impact on Injury Rates

During congressional debates concerning theOSH Act, one spon sor of the act expressed thehope that the creation of a Federal regulatoryagency would lead to a 50 percent decline in in-

jury rates (459). Have OSHA standard s and in-spections reduced occupational injury rates? Asdiscussed in chapter 3, analysis of injury ratetrends since the creation of OSHA is difficult, butit is hard to find any large changes in national,aggregated injury rates that d o not app ear to beassociated with the effects of the business cycle.

A nu mber of researchers have condu cted sta-tistical analyses of the possible effectiveness of OSHA in r edu cing occup ational injur y rates. Be-cause of their greater detail, these studies can pro-vide m ore information than a simple analysis of trends. Two basic approaches have been used.The first is to develop a statistical mod el to “ex-plain” injury rates and changes in those rates.

Such an explanatory model can include a variablethat measures the activity of OSHA (usually thenumber of inspections per year). The analysis canexamine whether changes in injury rates correlatewith OSHA activity. Another use of this approach






however, for California or th e Nation u sing datathat aggregated all types of injuries.

Two studies have used variables concerning thelevel of OSHA inspection activity. Viscusi (658),using data that d id not d istinguish between Fed-eral and State OSHA programs, found no signif-icant effect related to the level of Federal activ-ity. His results did reveal, however, a significantdecline in injury rates over time, which may havebeen a statistical artifact or the result of afavorable OSHA effect. Bartel and Thomas (45)limited their stud y to States covered by FederalOSHA, and found that OSHA activity had a sig-nificant effect on employer compliance withOSHA standard s, but that this compliance led toonly a modest reduction in injury rates.

Taken together, these results tend to supp ortthe conclusion of chap ter 3 that m ost of the in-

jur y rate changes since 1972 have been due to theeffects of the business cycle and are not relatedto OSHA activities. (For a more detailed discus-sion of these stud ies, see Working Paper #l. )

OSHA has an alyzed th e effect of one O SHAstand ard on the reported frequency of injuries.Between 1970 and 1978, about 47 injury-pr odu c-ing accidents occurr ed each year with on e typeof wheel rim used on trucks and buses. In 1980,OSHA issued a new regulation concerning theservicing of these wheels, and since then theagency estimates that the frequency of injuries has

fallen by 76 percent, to abou t 11 per year (631).A workplace standard issued by the State of California concerning another type of wheel hasalso led to an injury red uction of about 80 per-cent (631). Although these declines are encourag-ing, they represent only a very small change inthe total num ber of work-related d eaths from allcauses. Moreover, this appears to be the only casefor which OSHA has reported the actual effectsof any particular safety standard on injury rates.

The Mendeloff (300) and Smith (447) stud ieshave been used to estimate the possible benefits

in the United States of OSHA safety regulation.Green and Waitzman (195) have calculated thatthe 5 percent reduction in fatalities and a 2 to 3percent reduction in lost-workday cases found byMendeloff translate into a nationwide reductionof 350 deaths and prevention of 40,000 to 60,000

injuries per year. They also estimated that theSmith find ings of 5 to 16 percent redu ctions ininjury rates in inspected workplaces imply a re-duction of 144,000 to 450,000 injuries in a yearwith 180,000 inspections,

Assigning a dollar value to these reductions isvery difficult (see ch. 14). Using one estimate of the minim um social losses due to d isabling in-

juries, Green and Waitzman (195) estimate thatthe ben efits of OSHA safety regulation ar e, usingMendeloff’s results, at least $408 million to $610million annually. Smith’s results for lost-workdaycases, they argu e, imp ly mon etary benefits of upto $4.59 billion. The red uction of 350 death s p eryear might be valued at over $5 billion if one“willingness to p ay” estimate of the va lue of lifeis used.

The research concerning OSHA can be com-

pared with research about Federal regulation of mine safety. The nu mber of fatalities in mininghas fallen du ring th e last half-centu ry. In 1926-

30, a total of 11,175 miners were killed on the job,while during 1971-75, the figu re w as 715 (536).Congressional activity concerning coal mining hasincluded legislation in 1941, 1952, 1969, and 1977.

Two studies have evaluated this legislationusing aggregated data over time. Lewis-Beck andAlford (270) examined fatality rates from 1932 to1976 and conclud ed th at Federal legislation passedin 1941 and in 1969 significantly d iminished the

risk of fatal injuries in mining, but that the 1952legislation h ad no significant impact on fatalityrates. Weeks and Fox (665) concluded that therehad been no change in underground fatality ratesfrom 1950 to 1969, but a significant decline from1970 to 1980. This d ecline in min ing fata lity ratesmay have recently reversed. Weeks and Fox foundthat in 1981 the fatality rate was significantlyhigher than w ould be expected from the rates from1970 to 1980.

Three other stud ies have used m ore detailed in-formation to control for nongovernmental factors

that influence injury rates in m ining. Boden (63)found that Government inspections reduced injuries and fatalities for the period 1973-75. Con-nerton (114), using data from 1965 to 1975, foundthat th e 1969 Coal Act had r edu ced fatality rates,but that nonfatal injury rates had stayed the same




or increased slightly. Neum ann and Nelson (327)

conclud ed that th e 1969 act had significantly re-duced fatality rates (they estimated that in 1976it had been lowered by 9 percent), but that non-fatal acciden t rates h ad risen. It is not completelyclear why fatality rates have fallen while nonfatal

injury rates have increased since the 1969 act. Partof the reason may be improved r eporting of non-fatal injuries (536).

Several reasons have been suggested to explainwhy mine safety regulation appears to have beenmor e effective th an OSHA’s safety regu lation innonm ining indu stries. First, the fund ing of theGovernment agencies has been greater for minesafety, abou t $150 per w orker, as opposed to $3per worker in general industry. Second, inspec-tion coverage is much greater. Every coal mineis insp ected ever y year —at least twice a year for

surface operations and at least four times a yearfor underground operations. Third, the hazardsof mining are more similar from establishment toestablishment than for the w ide variety of ind us-tries covered by OSHA. Thus, standard s and in-spections can be m ore narr owly focused. Finally,mine safety regulations require mandatory safetytraining of all min ers, which includ es both train-ing for new employees and refresher training forcurrent employees (530).

Some critics believe that safety regulation itself represents the wrong approach to the problem of

workplace injuries; they suggest injury taxes,workers’ compensation, and tort liability as pre-ferred altern atives (see d iscussion in ch. 15 and16). Moreover, some have criticized OSHA’s safe-t y standards because they mostly concern equip-ment and not w orker activities. OSHA’s safetyinspections can only detect relatively permanentfeatur es of the wor kplace and not the transienthazards that lead to many injuries. Thus, thesecritics claim, it is not surp rising that the stu dieson OSHA’s effectiveness have found only limitedimpact or no significant im pact at all.

For examp le, Mendeloff (302) foun d that only13 to 19 percent of the 645 deaths r eported in 1976in California were related to violations of safetystandard s. He then asked a panel of safety engi-neers to review the w ritten reports of these casesto determ ine if the violations w ould have been

detected by an OSHA inspection on the day be-fore the accident. Based on the panel’s evaluation,Mendeloff concluded that only 55 percent of theserious violations wou ld have been detected.

The California Department of Industrial Rela-

tions has analyzed occupational injuries andreports that between 30 and 50 percent of the injuries examined in several different industriescould have been prevented by compliance withstand ards. N early all of the remaining injuries,they concluded, could be prevented by improvedtraining and education (84, 85, 86, 87, 88, 89).

Bacow (37) concludes that most injuries cannotbe prevented by OSHA activity. To reach this herelies on studies of “unsafe acts” and “unsafe con-ditions” (summ arized in ch. 4) and two stu diesin Wisconsin and New York that found violationsof standards to be related to, at most, 30 percentof nonserious accidents and 57 percent of fatali-ties. A Federa l Interagency Task Force on OSHAconcluded that only about 25 percent of work-place fatalities could be prevented by currentOSHA standards (228).

However, the information contained in inspec-tion reports can be limited, especially for deter-mining injury causes and in designing preventivemeasures. Moreover, often these studies do notconsider how changed standards could preventinjuries. Many of these studies either explicitly or

implicitly rely on the belief that most accidentsare due to “unsafe acts” by workers. But, aspointed out in chap ter 4, oftentimes changes inequipment and workplace design can p reventthese “unsafe acts” from occurring or reduce thepotential for injury from “human errors.” Simi-larly, new stand ards concerning d esign an d instal-lation of equipment m ight increase the propor-tion of injuries that are deemed “preventable. ”

In fact, several of these studies automaticallyexclude motor vehicle fatalities as “not prevent-able.” Current OSHA stand ards d o not generally

address motor vehicle safety, but there are tech-nologies available to reduce the incidence of deaths in vehicle crashes (664). These could beman dated by the Federal Government, probablythrough regulations issued by the NationalHighw ay Traffic Safety Adm inistration.




Critics of safety standards frequently point tothe importance of worker training for preventinginjuries. Indu strial lead ers in occupation al safetyalso emphasize worker training programs. Al-though perhap s more difficult than regulating ma-chinery design, OSHA could encourage or even

require safety training programs. Thus, newstandard s that imp rove the design of equipm ent,address hazards not currently regulated, or thatimprove training programs may have a beneficialeffect on injuries.

Trends in Exposure Levels

It is often asserted that exposu res to toxic sub-stances have been going down over time. How-ever, data that would permit evaluation of thisclaim are scarce. Some individual firms have con-du cted ind ustrial hygiene measurements for some

time (see 215 for several examples). But it is notclear, even when records from these firms havebeen maintained an d are available, that it wouldbe appropriate to generalize from their experience.Moreover, while some exposures hav e d eclined,others have risen.

The analysis of exposure levels over time couldbe used to measure the impact of OSHA. Of course, this evaluation encounters similar, but notidentical, problems to those found wh en evaluat-ing OSHA’s impact on injury rates. For hazard-ous exposures, however, comparatively little re-

search has been condu cted to identify the factorsthat influence exposure levels.

Mendeloff (301) analyzed information con-tained in the OSHA Management InformationSystem about OSHA health inspections for asbes-tos, trichloroethylene, silica, and lead from 1973to 1979. Although there are a num ber of limita-tions to those data, the data show substantial de-clines in asbestos exposur es over this p eriod. Fortrichloroethylene, silica, and lead, Mendeloff’sanalysis reveals no major changes over time.

Using OSHA insp ection d ata, Carol Jones (237)

has also found declines in asbestos exposures. Sheestimates that the d ecline in average exposu resfrom t he p eriod 1972-76 to 1977-79 amou nted toabout three fibers per cubic centimeter. This ex-posu re d ecline is equal to t he d ecline in 1976 of the permissible exposure limit from five fibers per

cubic centimeter to two fibers per cubic centimeterand thus m ay be linked to the OSHA standard.However, other factors, particularly the increasein the nu mber of lawsuits concerning asbestos-related d isease, may also have contributed (seech. 15).

It has been estimated that the OSHA asbestosstandard issued in 1972 wou ld result in a reduc-tion of between 630 and 2,563 death s per year,resu lting in social cost savings, in 1970 dollars,of between $110 million and $652 million per year(432). These totals may underestimate the benefitsof the asbestos standard (433). In the case of vi-nyl chloride, exposures d eclined su bstantially afterthe issuance of a new, more stringent OSHAstandard (see box N). It has been estimated thatthis standard wou ld pr event about 2,000 deathsover the years 1976-2000 (32).

Two case stud ies comm issioned by OTA forthis assessmen t also sh ow favorable effects afterthe issuance of new, more stringent OSHA healthstand ard s (see ch. 5 for a fuller d iscussion). Rut-tenberg (413) reports that cotton dust exposureshave declined substantially in the past few years,halving the num ber of workers who w ere exposedabove the new permissible limit. Several textilemills appear to be completely in compliance, wh ileothers fully expect to be in the near futu re. In ad -dition, these changes appear to have been accom-pan ied by or created by the installation of newtechnologies that both decrease employee expo-

sures and increase productivity.

Goble, Hattis, et al. (184) report that in the lasttwo years there have been large declines in bothemployee exposures to lead in the air as well asin measured employee blood lead levels. For ex-amp le, the percentage of workers exposed above200 micrograms/ ma in primary sm elting has de-clined b y near ly 20 percentage p oints. Blood leadlevels have declined even more dramatically. NewOSHA standard s for vinyl chloride, cotton d ust,and lead have clearly r-educed workplace exposures.

Conclusions About OSHA'S Impacts

OSHA’s activities can be group ed as stand ard -setting, enforcement, and pu blic edu cation andservice (see ch. 12). OSHA h as had the resou rcesto develop only a few n ew stand ards each year.



Ch. 13—Assessment of OSHA and NIOSH Activities . 269

But many of its revised safety standards (see table12-4 in ch. 12) have been limited in th eir scopeand h ave not addressed major workplace hazards.There are many areas for which standard s couldbe issued, to improve equipm ent design, add resshazards not currently covered, and establish

workplace training programs. Moreover, manyof the current safety stand ards most frequentlycited by OSHA inspectors are only rarely in-volved in w orkplace fatalities (302).

Many critics of OSHA’s safety standards, how-ever, believe that there must still be a role forhealth standard s (446, 685)). Indeed, analysis of several of OSHA’s health standards reveals sub-stantial reductions in workplace exposures, reduc-tions that should lead to improved worker health.How ever, analysis of OSHA stand ards and therecomm endations of ACGIH and NIOSH reveals

that OSHA’s adoption of health standards haslagged behind professional recomm endations.

Criticisms about OSHA’s health standards areless likely to be about wh ether they are neededthan about the d esirable level of protection. Inparticular, employers have been concerned thatOSHA has not taken accoun t of the costs of thesestand ard s (see ch. 14), or that OSHA requ ires theuse of engineering controls to reduce or eliminatethese hazard s, instead of allowing the u se of per-sonal p rotective equ ipm ent (see ch. 9). Labor, onthe other hand, has criticized the slow pace of

standard-setting, as well as the increasing atten-tion to the pred icted costs of stand ards.

Finally, OSHA and the State programs havebeen able to inspect (combining health and safetyinspections), at most, 4 percent of all establish-ments and less than 20 percent of manufacturingestablishments each year. In addition, the penal-ties for violations are, on averag e, very low, andin most cases, much smaller than the potentialcosts of controls. Because of the low frequencyof inspection and the low penalties, it is particu-

IMPACTS OF NIOSH

OTA has d ivided NIOSH research activitiesinto three categories: hazard identification, devel-opment of controls, and dissemination of infor-

larly important that the people who are alwaysin the workplace —workers and managers—befully informed abou t occup ational hazards. In ad -dition, steps can be taken to pr ovide other incen-tives to ensure that appropriate control technol-ogy is installed (see chs. 15 and 16).

Analysts can disagree on the number of casesof occupational d isease and injury that the cur-rent regulatory scheme m ay be able to prevent.But, in p ractice, there have been substantiallimitations on these regulatory activities. Anychanges in this, how ever, would r equire agree-ment by Congress and the executive branch to in-crease OSHA staff and funding, as well as to ex-pand its ability to influence business decisions onworkplace investments and operations.

There is a general belief that th e pr esence of

OSHA has increased manager and worker aware-ness of occupational health and safety. Kochan,et al. (253) report, from interviews w ith comp anyand union officials, that “management has as-signed a higher priority to plant safety, the abilityof the union to influence management decision-making on safety issues has increased, and the roleof the union-management safety committees hasbeen bolstered” since the passage of the OSH Act.This increased attention has also created a needfor health and safety professionals and probablyincreased their role in company decisionmaking.The presence of a Federal regulatory agency may

lead emp loyers to anticipate potential health andsafety problems and solve them before regulatoryaction becomes necessary. The OSH Act also cre-ated new rights for worker information and par-ticipation concerning health and safety. Althoughall these changes may be desirable, it appears thatOSHA activity has, thu s far, not had a very largeeffect on injury rates. It has had some effect onseveral clearly defined h ealth hazar ds, bu t its ef-fects on the man y hazard s it has not ad dr essedare still in dou bt.

mation (see ch. 12). Assessing the impact of NIOSH in these areas is even m ore difficult thanassessing that of OSHA. In theory, quantitative




measures of inspection activity and injury ratescan be analyzed although, of course, there aregreat difficulties in doing so. But the impact of an agency that conducts research is not subjectto even these limited measures. In fact, quan-titative measures can be especially misleading”

when assessing research. It is not the number of studies completed or papers published that is im-portant, but the quality of the research.

Does this research and dissemination contrib-ute to the ad vance of know ledge in the field of occupational health and safety? Are the epidemio-logic and toxicologic studies based on well-designed protocols followed by comprehensiveand accurate data collection? Can the studies bereprod uced? Do the NIOSH-developed samp lingand analytical methods provide accurate and validresults? Do the control technologies developed or

described actually work as ind icated? Is the in-formation p rovided by N IOSH accurate and u se-ful? Are the edu cational programs sponsored byNIOSH worthwhile? Finally, do all these activi-ties lead to imp rovements in w orking conditionsand in the health and safety of the work force?

In the late 1970s, some concern wa s expressedthat th e quality of NIOSH research w as suffer-

ing (pr imarily following criticism by affected com-panies and industrial consultants of a NIOSHstud y of workers exposed to beryllium ). WhenDonald Millar became Director, he took several

steps to imp rove N IOSH research. One of thesewas the establishment of a Board of ScientificCounselors to advise the Director on all aspectsof research conducted by NIOSH. The Board con-sists of 10 scientists who are knowledgeable aboutoccupational safety and health research. Theboard h as only recently been ap pointed and heldits first m eeting in early 1984. Althou gh the ap -pointm ent of a board is a concrete step, it is not

SUMMARY

An OTA comparison of the standard s and rec-ommendations from OSHA, NIOSH, and ACGIHreveals that OSHA has tended to lag behind th erecomm endations of both NIOSH and ACGIH.OSHA’s startup standards included nearly 400

clear w hat effects this w ill have on the qu ality of NIOSH research.

As in the case of OSHA, the ideal would be toknow w hat the situation would h ave been in theabsence of NIOSH activities. Certainly some re-

search and information dissemination wou ld havetaken p lace at un iversities and in th e private sec-tor, even without Government activity. Althoughit is difficult to quantify this, it is unlikely thatprivate sector parties by them selves wou ld h avedevoted the same level of resources to health andsafety research as the Federal Government hasthrou gh N IOSH. Because information is, to someextent, a “public good, ” private parties have onlya limited incentive to develop it on their own.Once published , many can benefit, but becausethe information is already public, the originalresearcher would encounter great difficulty in

charging each ben eficiary for that information.Thus, it can be argu ed, the Government n eeds tobe involved in order to provide this “public good.”

NIOSH is the only Federal agency dedicated tooccupational health and safety research anddissemination. Although NIOSH is not the onlyorganization that conducts or sponsors epidemio-logic and toxicologic stud ies of workp lace haz-ards, its studies have advanced knowledge in thisfield. Controls are developed in the private sec-tor, but NIOSH h as provided many of the detailedsampling and analytical methods used by private

sector industrial hygienists. NIOSH publicationsare widely distributed and serve as an importan tsource of reference on occupational hazards andcontrols. Today, m ost newly grad uated occupa-tional health and safety professionals in the UnitedStates are educated in p rograms that receive fund -ing from N IOSH, and many come from the pr o-grams at the institutions that hav e been d esignatedas Educational Resource Centers.

Threshold Limit Values published by ACGIH in1968. ACGIH has increased the nu mber of sub-stances on its list to over 600 and h as revised th eTLVs for many substances from the 1968 list.Since 1971, NIOSH h as form ally transm itted r ec-



Ch. 13—Assessment of OSHA and NIOSH Activities . 271

ommendations concerning over 160 different sub-stances, classes of substances, or hazardous work-ing conditions to OSHA, After adopting the initialgroup of startup stand ards, OSHA has issued newor revised Permissible Exposure Limits and otherrequirements for 10 substances, and work prac-

tice, monitoring, and personal protection require-ments for 14 other substances and on e physicalagent. A detailed numerical comparison for agroup of 123 substances shows that, overall,OSHA standard s are less stringent than N IOSHand ACGIH recommendations.

The imp acts of OSHA an d N IOSH are hard toevaluate. Accurate estimation of the costs of OSHA regu lation is difficult for a nu mber of rea-sons. The most compr ehensive cost estimates de-rive from a su rvey condu cted by McGraw-Hill.According to this survey, the share of capital

spend ing devoted to emp loyee health and safetyhas changed little in the last 5 years, remainingat a percentage substantially below the levels of the 1970s.

Assessing OSHA’s imp acts on injury rates andexposur e levels is also difficult. The research o nOSHA effects on injury rates divides into twogrou ps—stud ies that find a statistically significant,but sm all effect, and th ose that do n ot find any

significant effects. The limited research on ex-posu re levels app ears to show positive effects forhazards that were the subjects of new or revisedOSHA regu lations du ring th e 1970s—vinyl chlo-ride, asbestos, cotton dust, and lead.

Because N IOSH’s major activity is research, itsimpacts are even more difficult to quantify. Thequ ality of NIOSH research has been criticized al-thou gh N IOSH h as recently taken steps for im-provem ent. A num ber of other aspects of its oper-ations have been criticized as well. However,many occup ational health and safety professionalshave gradu ated from NIOSH-sponsored trainingprograms. NIOSH has also been an importantsource for the dissemination of information in thisfield.

One final imp act of both OSHA and NIOSHis that their p resence has served to increase the

attention given to occupational health and safety*by workers, employers, and health and safety pro-fessionals. This increased attention facilitates theidentification of hazard s and the d evelopm ent of controls. Thus, indirectly, OSHA and NIOSHactivities have spu rred imp rovements in w orkerhealth and safety, although these effects probablycannot be quan tified.



14.

Decisionmaking for Occupational Safety

and Health: The Uses and

Limits of Analysis



Contents

General Issues in Decisionmaking . . . . . . . .Private Decisionmaking . . . . . . . . . . . . . . .Public Decisionm aking. . . . . . . . . . . . . . . .Decision Tools and Rules . . . . . . . . . . . . .

OSHA Decisionmaking on Standards . . . . .Principles Embodied in the OSH Act . . .

Regu lato ry Relief. . . . . . . . . . . . . . . . . . . . .OSHA Stand ard -Setting. . . . . . . . . . . . . . .Cur rent OSHA Cr iteria . . . . . . . . . . . . . . .Effects of Decision Ru les . . . . . . . . . . . . . .

The Uses and Limits of Economic AnalysisValue of Econom ic Analysis . . . . . . . . . . .Difficulties in Implementation . . . . . . . . .Ethical Con siderat ions . . . . . . . . . . . . . . . .

summ ary . . . . . . . . . . . . . . . . . . . . . . . .q. . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Table No.

14-1. Willingness-to-Pay Estimates

TABLE

of the Valu e of Life . . . . . . . . . . . . . . . . . . . . ,

Page

275

276 276

277 278278

2792$1

289

2$9

2$9292293

Page

291



14 s

Decisionmaking for OccupationalSafety and Health: The Uses and

Limits of AnalysisA number of different criteria are used for judg- This chapter discusses some general issues con-

ing the desirability of changes that might improve cerning decisionmaking for occupational safetyworkers’ health and safety. Some have proposed and health, the history of the use of economicthat gr eater reliance be placed on the u se of cost- analysis by the Occupational Safety and Healthbenefit analysis, cost-effectiveness analysis, and Administration (OSHA), and the merits andother techniques of economic analysis for deci- limitations of the techniques of formal analysis.sions concerning w orkplace health and safety.

GENERAL ISSUES IN DECISIONMAKING

The process of improving occupational safetyand health involves the identification of hazar ds,the developm ent of control techniques, and thedecision to control. Choices need to be made con-cerning prod ucts and w orkplace design by manyactors—the engineers in charge of design, themanagers w ho m ake decisions concerning p rodu c-tion, and pu blic officials w ith r espon sibilities forprotecting the health and safety of workers andthe public.

The decisions we need to make. . . turn on thequestion: Which hazards are acceptable, whichnot, in what amounts, and why?, . . And whoshould be empow ered to make this d ecision? (281)

In many cases, the answers to these questionsare not simple. Oftentimes facts are uncertain andin disp ute. Sometimes, values and ideals conflictwith each oth er. To resolve such d isputes, soci-eties rely on various institutional arrangements.In the field of occupational health and safety inthe Un ited States, the principal institutions areCongress, the courts, the Occupational Safety and

Health Review Comm ission, and OSHA itself.

This issue of decisionmaking—the question of who is authorized to make decisions and on whatbasis—is important because the participants candiffer greatly on the nature of occupational

hazards and the best means to reduce or elimi-nate them. Labor, on the one hand, believes thatemployers have often not done enou gh to redu ceor eliminate workplace hazards and desires astrong governmental pr esence in setting and en-forcing stand ards. Employers, on the other hand ,are often concerned about investing m oney in u n-necessary controls, believing either that theirworkplaces are not haz ardous or that effective,but less costly control methods are ava ilable. They

also often contend that they, as employers, shouldbe permitted to d ecide on ap propriate controlmethod s, without the involvement of Governmentagencies or labor unions.

Some disputes about the Government’s role inoccupational health and safety concern very tech-nical questions about the application of the prin-ciples of industrial hygiene and safety engineer-ing; some are debates at the very frontiers of scientific knowledge on the mechanisms of tox-icity. But beyond these disputes are more generaldebates concerning the criteria on which decisions

will be made and wh o shall be empowered tomake them. The proposed resolutions of theseissues are based on interpretations of technical in-formation abou t risk as well as the m oral and ethi-cal values, the political beliefs, and the immedi-ate economic interests of the various parties

275




involved. In fact, one prominant feature of disputes on occupational health and safety is thatdebates over technical questions are often com-bined with discussions of more general issues of policy, ethics, and social values.

To develop an d present the information need ed

for a fully informed decision on workplace haz-ards, various observers h ave su ggested differentkinds of formal analysis. The techniques are, inmany cases, connected with proposals to specifythe criteria on which decisions must be based.These criteria range from a vague injunction toconsider “all relevant effects” to requirements thatcontrols can be required only when “the benefitsexceed the costs. ”

Private Decisionmaking

On what basis do employers make decisions

concerning w orker health and safety? What d eci-sion rules will they follow? Some employers, of course, take actions to protect the health andsafety of their em ployees either ou t of altruismor enlightened self-interest. But in general deci-sions mad e by employers follow the d ictates of the competitive market system in which theyoperate.

Economists have developed mod els to explainthis market-oriented behavior. The simplest andmost common ly used m odel seeks to explain theactions of firms in terms of profit-maximization

and cost-minim ization. If this is a comp any’s goal,it will take an action only if the expected reve-nu e is at least equal to th e costs of that action.Using the technical language of economics, thismeans that the firm will produce only up to thepoint at w hich the m arginal revenu e from the lastadditional product unit is equal to the marginalcosts of that unit.

App lied to investments and expenditures for oc-cupational safety and health, this m odel p redictsthat to prevent an occupational injury or illness,emp loyers will spend on ly as much as they can

expect to gain in term s of reduced w orkers’ com-pensation costs, improved employee prod uctivity,redu ced “dow n time, ” etc. Thu s, any investmentfor health and safety mu st be justified in termsof the short-term and long-term financial bene-fits to the firm. If the company is attem pting to

be as profitable as possible, it will not take ac-tions to protect employee health and safety solelybecause health an d safety are importan t goals, butonly when there are financial benefits to the firm.If the firm d oes not follow this ru le, it may finditself spending money to improve h ealth an d safe-

ty withou t receiving any correspond ing finan cialbenefit. Competitors that do not also make suchimprovements will be able to produce the sameproducts at lower cost and then increase salesand/ or profits at the expense of the firm that in-vested in health and safety.

Health and safety professionals have often citedthe slogan “Safety Pays” as a justification for im-proving occup ational health an d safety. Althoughin m any cases this is true, in other cases it is not.Moreover, even when it does pay, it generallypays only up to a point.

Therefore some businesses will not always takevoluntary actions because they will not reap anyadvantage over their competitors. One benefit of Governm ent regulation is that it puts all firms onan equal footing. A comp any can undertake in-vestments in employee health and safety withoutfear that it w ill lose money to comp eting firmsthat d o not do so. Expr essed d ifferently, Govern-ment regulations may require certain measuresbeyond those that “p ay” from the p oint of viewof the individu al firm (245).

This is not to say that all employers will ignore

occupational safety and health. Indeed, there arenum erous examp les of emp loyers and their pro-fessional staffs wh o hav e taken extensive actionsto improve w orker health and safety, even with-out pressure from a Government agency. Thiscould be because of the commitm ent of profes-sionals and companies to goals of ethical behavioror corporate altru ism; a decision by the firm topu rsue goals other than maximizing profits; or thebelief by company officials that such investments,although not profitable in the short term, willultimately be to the long-term benefit of the firm.

(See add itional discussion on volu ntary activities

in ch . 15. )

Public Decisionmaking

During the congressional debates concerningthe Occupational Safety and Health (OSH) Act,



Ch. 14—Decisionmaking for Occupation/ Safety and Health: The Uses and Limits of Analysis 277

.


Rescue workers attempt to extricate a trapped worker

man y references were mad e both to the rights of

American workers to safe and healthful workingconditions and to the h igh cost of work-relatedillnesses and injuries. Congress concluded that toomany illnesses and injuries w ere occurring andthat the efforts being made and the institutionsof that day were not sufficient to achieve the goalof preventing disease and injury in the w orkplace.

Broadly speaking, two different typ es of rea-soning have been suggested to justify Governmentintervention. The first is based on ethical argu-ments, MacCarthy (277) describes four differentethical justifications for Government action that

are based on u tilitarianism, workers’ rights, dis-tributive justice, and pu blic values. Others argu e

that Government intervention must be justifiedby economic criteria. In par ticular, the Govern-ment should intervene only in cases of “marketfailure” and only after balancing costs and bene-

fits of its decisions (425,446,463,685). Threesources of “market failure” are particularly im-portant for worker health and safety: inadequateinformation, lack of labor m obility and unequ albargaining power, and the presence of exter-nalized costs.

Decision Tools and Rules

The techniques of cost-benefit and cost-effectiveness analysis have been developed toassist p rivate and pu blic decisionmakers. In pre-

vious assessments concerning medical technology,

OTA has considered cost-effectiveness analysisand cost-benefit analysis as p arts of a family of related techniques (539). Both are designed tocompare the costs and effects of projects or alter-

native projects. The principal difference between

them is that in a cost-benefit analysis, both costsand benefits are expressed by the same m easure,which is nearly always monetary. In cost-effec-tiveness analysis, on the other h and , costs andbenefits are expressed by different measures. Costsare u sually expressed in d ollars, but benefits oreffectiveness are ordinarily expressed in termssuch as “year s of life saved , ” “days of morbid ityor disability avoided , ” or other relevant measu res q

(539).

Cost-benefit techniques became widely used inthe Un ited States in the 1930s and 1940s for the

evaluation of pu blic works projects (in p articu-lar, for analyz ing investm ents of pub lic capital inprojects for irrigation, hydroelectric power, and

flood control). The Flood Contro l Act of 1936 ex-

plicitly called for a cost-benefit decision rule by

permitting the Government to finance a waterproject only when “the benefits to whomsoever

they m ay accrue are in excess of the estimatedcosts” (280). In the 1960s and 1970s, the tech-niques of cost-benefit and cost-efectiveness an al-ysis were ap plied in formal budget plann ing sys-tems in the Federal Government. To some extent,these techniques have also been applied to ques-

tions of health policy (539).

Analysis can be a tool to assist in the decision-making process or it can be used as a formal deci-sion rule. As a tool, the collection of informationand its analysis can assist policymakers to reachsound , well-informed , reasoned decisions aboutthe m anagement of workplace hazards. There iswidesp read agreem ent, at least in principle, thatdecisionmakers need to have some minimal under-

stand ing of the importan t features of the prob-lem to be add ressed, the factors involved in th edecision, and the imp lications of various courses

of action. There are, of course, disagreements con-cerning the application of this principle. In par-

ticular, there are often dispu tes about how m uchinformation needs to be collected and to what ex-tent policymakers should be allowed to act on thebasis of uncertain and incomplete information.




As a d ecision r ule, how ever, formal an alysisis considerably more controversial. A decisionrule specifies the criteria on which decisions mustbe based and usu ally requires that certain find-ings be made before action is permitted. For in-stance, a cost-benefit d ecision ru le wou ld be to

“select the alternative that produces the greatestnet benefit” (463).

As a too l, a cost-benefit analysis of a proposedaction can be p rovided to a d ecisionmaker, w hocan still decide to undertake the proposed actioneven if the analysis shows that the quantified costsexceed the quantified benefits. The decision couldreflect a concern for the distributional conse-quences of a failure to act or consideration of some important benefits of the action that couldnot be qu antified. Thus a cost-benefit analysisprovides information, but the decisionmaker stillhas the flexibility to act even when the “bottom

line” of the analysis says, “Don’t act.” If a for-mal cost-benefit decision ru le were in effect, thedecisionmaker w ould not be able to includ e thoseother considerations in the final decision, but

could only act on the basis of the quantified com-parison of costs and benefits.

As a decision-assisting tool, cost-effectiveness

analysis can be used to d escribe man y of the con-sequences of an action. But because the costs (indollars) and the ben efits (e.g., in lives saved ) areleft in incomparable units, cost-effectiveness anal-

ysis will provid e a clear d ecision ru le only in tw ocircum stances. If a h ealth goal is sp ecified, th ena d ecision ru le based on cost-effectiveness an aly-sis will mandate the selection of the least costlyalternative that achieves that g oal. Alternatively,if a budget or expenditu re is fixed, then a cost-effectiveness r ule w ill require selecting th e alter-native w ith the greatest health benefit.

In occupational health and safety, two othertypes of analysis have become importan t—risk assessment an d feasibility ana lysis. What these im-

ply for OSHA, however, has been the subject of considerable dispute. The meaning of these termsand requirements concerning their use by OSHAhave evolved over the last 14 years.

OSHA DECISIONMAKING ON STANDARDS

Principles Embodied in the OSH Act

When th e OSH Act was p assed in 1970, Con-gress clearly decided to involve the Federal Gov-ernmen t in research and r egulatory activity. Inparticular, Congress mand ated the adoption of health and safety standards and set forth a mech-anism for writing new standard s. To some extent,the law removed decisions concerning health andsafety from the competitive marketplace by limit-ing employer discretion. Congress, however, wasless clear about the precise decision rules thatOSHA wou ld have to follow wh en setting thesestandards.

At the beginning of the OSH Act, Congressdeclared a pu rpose for Government activity in the

occup ational health and safety field: “to assureso far as possible every working man and womanin the N ation safe and healthful w orking cond i-tions.” The act empowered the newly created

agency to set and enforce man datory occupationalhealth and safety standards. Section 6 laid forththe procedures for adopting these stand ards: pub-

lic notice of pr oposed actions, an op por tun ity forpublic comment, the conduct of a public hearingif requested, and a final decision based on the evi-dence presented to the agency. (Further d etailsabout these procedu res are given in ch. 12. )

Two subsections of the Act define health andsafety standards and specify the criteria on whichstand ard s are to be based . Section 3(8) of the Actprovides:

The term “occupational safety and healthstandard” m eans a standard which requires con-

ditions, or the ad option or use of one or morepractices, means, methods, operations, or proc-esses, reasonably necessary or appropriate to pro-vide safe or healthful employment and places of employment.



.

Ch. 14–Decisionmaking for Occupational Safety and Health: The Uses and Limits of Analysis .279

Section 6(b)(5) specifies the criteria for standardsconcerning toxic materials or harm ful ph ysicalagents:

The Secretary . . . shall set the standard whichmost adequately assures, to the extent feasible,on th e basis of the best available evidence, that

no employee will suffer material impairment of health or functional capacity even if such emp loy-ee has regular exposure to the hazard . . . for theperiod of his working life. . . . In addition to thehighest degree of health and safety protection forthe employee, other considerations shall be thelatest available scientific data in the field, the fea-sibility of the standards, and experience gainedunder this and other health and safety laws (em-phasis added).

The extent to which the goals of environmental,consumer, and wor ker protection are to be bal-anced against the costs of protection has defined

mu ch of the debate on regulatory policy d uringthe last decade. Discussions of the stand ard -settingauth ority of OSHA an d th e prop er role for costconsiderations have focused on these two sub-sections.

The legislative history of the OSH Act that isrelevant to this question is, in the word s of theSupreme Court, “concealedly not crystal clear. ”In particular, it does not explain w hat the Con-gress meant by “feasibility” or how O SHA wasto balance economic and technological considera-tions in setting stand ard s. Neither the original Sen-

ate bill nor the H ouse version included sp ecificprovisions about regulating toxic substances; inboth, the section was added in committee.

The criterion of “feasibility” was first proposedby Senator Jacob Javits (R-NY), who was con-cerned that the other bills then u nd er considera-tion “might be interpreted to require absolutehealth and safety in all cases.” The final amend-men ts that resu lted in section 6(b)(5) were ad dedon the Senate floor. They reflect the objectionsto that section from several Senators. SenatorPeter Dominick (R-CO) argued, in particular, that

“[i]t is unrealistic to attempt. . . to establish autopia free from any h azards. ” After some dis-cussion, a compromise was reached (280). Thelanguage ad opted by the Senate was later acceptedby the House-Senate Conference Committee andincorporated in the final bill signed by PresidentNixon.

There is no evid ence that cost-benefit analysiswas ever explicitly p roposed d uring those d ebatesas a decision ru le for the n ew agency. Congresshad previously issued laws that d id contain cost-benefit decision rules, starting with the flood con-trol legislation of the 1930s. The nonu se of such

a ru le in the OSH Act, if not its explicit consider-ation and rejection, was important in the Suprem eCour t’s decisions concerning the d ecisionmak ingauth ority of OSHA (discussed below).

MacLean (280) suggests that one possible rea-son that cost-benefit analysis did not enter thedebates is that it simply did not occur to Congressthat such an analysis could be applied to balancehealth risks against economic costs. At that time—1970—the theory and techniques of cost-benefitanalysis, which had been used to evaluate publicworks projects, were still being developed for ap-

plication to h ealth and safety issues.Because of concern a bout the costs of the O SH

Act, language was add ed to require that OSHAtake into account the “feasibility” of its standards.But the final bill also included the goal that “noemployee will suffer material impairment. ” In thefloor debate, Senator Ray Yarborough (D-TX) ex-pressed the sentiment behind this language: “Weare talking about people’s lives, not the indif-ference of some cost accountants. ” As commen-tators have noted, since the passage of the OSHAct “the degree to which the complete protectionof safety and health should be comp romised bythe technological difficulty an d economic cost of achieving that protection has been an issue of con-stant controversy” (51).

Regulatory Relief

In the early to mid -1970s, policymakers beganto face the simultaneous problems of price infla-tion and u nemp loyment. Add ed to these was thegrowing perception, which was not always basedon empirical analysis, that the Government’shealth, safety, and environmental regulations

were at least partially to blame for these economicills. (For d iscussions of m ore general issues in Fed-eral regulation an d regulatory r eform, see 3,72,133. )

A series of Executive Orders and other proce-dural requirements reflected this new perception




and placed new requirements on the regulatoryagencies. In 1971, the Office of Management andBud get (OMB) issued a memoran du m to all headsof departments and agencies to improve inter-agency coordination concerning standards andguidelines for environmental quality, consumer

protection, and occupational and public healthand safety. Know n as t he Qu ality of Life ReviewProgram, it covered, in theory, any agency ac-tion that would significantly affect other agencies,impose costs on “non-Federal sectors, ” or increasethe need for Federal funds. Agencies were orderedto submit to OMB schedu les of futu re activitiesand prep ublication copies of proposed and finalactions. In ad dition, proposed and final regula-tions were to be accompanied by a summary thatindicated the principal objectives of the rules,alternatives that had been considered, “a com-parison of the expected benefits or accomp lish-

men ts and the costs . . . associated with the alter-natives considered, ” and the reasons for pickingthe selected alternative (424).

Although this program was theoretically appli-cable to all regulatory agencies, in practice onlyactivities of the Environmental Protection Agencywere examined by OMB (158,401). The memohad little effect on the activities of OSHA (47).

President Ford issued the first formal ExecutiveOrd er (E.O. 11821) on regu latory relief on Nov em-ber 27, 1974, as par t of his “W hip Inflation N ow ”progr am. This order required all major rules or

regulations issued by executive branch agenciesto be accompanied by “a statement which certifiesthat the inflationary impact of the proposals hasbeen eva luated ” (176). These w ere called “Infla-tionary Imp act Statement s, ” probably after the“Environmental Impact Statements, ” required bythe N ational Environmental Policy Act.

A Presidential “oversight process” concerningFederal Governm ent regu latory activity was alsoestablished at th is time (659). A new agency, theCouncil on Wage and Price Stability (CWPS), wasestablished in the Executive Office of the Presi-

den t to mon itor the inflationary imp lications of private sector wages and prices. CWPS was alsoauthorized to monitor the inflationary impact of Federal regulatory activity, to review the Infla-tionary Imp act Statements prepared by the regu-

latory agencies, and to participate in agencyrulemaking p roceedings “in order to present itsviews as to the inflationary imp act that might re-sult” (659).

The text of Executive Ord er 11821 did n ot sp e-cifically refer to cost-benefit analysis. However,

in its review of regulatory activities, CWPSdefined as “inflationary” those regulations forwhich the costs exceeded the benefits (304).

Just before leaving office, President Ford ex-tended his Executive Order, without any signifi-cant change in substance, with E.O. 11949, issuedon December 31, 1976. The nam e of the requ iredstatements, however, was changed to “EconomicImpact Statements” (177).

President Carter issued his own Executive Or-der on the top ic of regulatory procedu res (E.O.12044, March 23, 1978; renewed by E.O. 12221,

June 27, 1980), which bore the title “ImprovingGovernment Regulations. ” The name of the re-quired statements was changed to “RegulatoryAnalyses” and in them th e agencies were to pre-sent:

. . . a succinct statement of the problem; a de-scription of the major alternative ways of deal-ing with the problem that were considered by theagency; an analysis of the economic consequencesof each of these alternatives and a detailed ex-planation of the reasons for choosing one alter-native over the others.

Regulatory Analyses were required for any reg-ulation that w ould h ave an “annu al effect on theeconomy of $100 million or more” or a “majorincrease in costs or prices for ind ividual ind us-tries, levels of government or geographic regions”(98,99).

The primary thrust of E.O. 12044 was to im -prove the content of Government regulations andto encourage agencies to comp are alternative ap-proaches. Cost-benefit analysis was viewed as atool “to comp are alternative ap proaches to a givengoal; . . . not to evaluate th e goal, itself” (157,

170). The CWPS continued to prepare analysesof agency regulations. The Carter ad ministrationalso created two other organizations: the Regu-latory Council to compile calendars of future reg-ulatory actions and to encourage innovative reg-



Ch. 14—Decisionmaking for Occupational Safety and Health: The Uses and Limits of Analysis q 281

ulatory techniques, and the Regulatory AnalysisReview Group to review particularly importantregulations (157).

President Reagan issued E.O. 12291 on Febru -ary 19, 1981, as a central comp onent of his cam-paign for “regulatory relief.” Once again, the anal-ysis requirement was renamed, this time to“Regulatory Impact Analysis” (382). Unlike theprevious orders, however, which had only re-qu ired the agen cies to evaluate the econom ic im-pacts of their d ecisions, E.O. 12291 set an explicitcost-benefit decision ru le: “Regulatory action shallnot be taken unless the po tential benefits to societyfor the regulation outweigh the potential costs. ”This Executive Order further specifies that “reg-ulatory objectives shall be chosen to maximize thenet benefits to society” and requires, to the ex-tent possible, that all benefits and costs be quan-

tified in monetary terms, Thus, E.O. 12291 wasthe first to requ ire explicitly that r egulatory d eci-sions be based on a comparison of quantified costsand benefits.

In addition, the Reagan administration cen-tralized regulatory review in one agency -OMB—and required agencies to submit to OMB copiesof proposed and final regulations and the accom-panying Regulatory Impact Analysis in advan ceof publication. Although the legal authorit y forprop osing and issuing regulations still remainswith the heads of the regulatory agencies, in prac-tice the requirement for submission to OMB hasmeant th at the agency mu st receive approval fromOMB prior to pu blication. A Presidential Task Force on Regulator y Relief, chaired by th e VicePresident, was also established to resolve disputesbetween OMB and r egulatory agencies.

Congress has also ad ded procedu ral require-ments for Federal regulatory agencies. In Septem-ber 1980, the Regulatory Flexibility Act (PublicLaw 96-354) was enacted. It requires agencies toprepare “regulatory flexibility analyses” for reg-ulations that w ould h ave a “significant economicimp act on a substantial num ber of small entities”

(defined as small businesses, small nonprofit orga-nizations, and sm all govern men tal jur isdictions).In December 1980, Congress enacted the Paper-work Reduction Act (Public Law 96-511). In gen-eral, the purpose of this act was to reduce the

“burd en” of federally required pap erwork. OSHAand other Federal agencies are required to obtainthe ap pr oval of OMB before cond ucting researchor issuing r egulations th at requ ire the “collectionof information .“ This includes surv ey question-naires and w ritten rep ort forms as well as require-

ments for record keeping. In addition, Congresshas considered, but has not enacted, a numberof bills that would require Federal agencies to con-du ct risk assessments and cost-benefit analysesand that would change other regulatory pro-cedures.

OSHA Standard-Setting

OSHA standard-setting activity has been asource of dispu tes between m anagement and la-bor, between ad vocates of stringent regu lation

and those desiring regulatory relief, and betweenthose p roposing the u se of cost-benefit analysisand those w ho reject any consideration of eco-nomic effects. Important to understanding thosedisp utes is the legislative history of the OSH A ct,the attitudes of business and labor, and the at-titudes of the health an d safety professionals whostaff OSHA and the National Institute for Occu-pational Safety and Health. The disputes concern-ning OSHA stand ards have often been settled inthe courts.

During its first decade, OSHA was criticizedby bu siness representatives for failing to take ac-count of the costs of complying w ith its stand -ards and for not ensuring that those costs borea “reasonable relationship” to the benefits of thestandards. Labor representatives, on the otherhand, criticized OSHA for including compliancecosts as a factor in its decisions.

The values of OSHA personnel have been d e-scribed as “pro-protection” and, it has beenargued, derive from the professional training andbackground of the health and safety professionsand from their view of the agency’s mission. MostOSHA staff have worked or been edu cated in the

occupational health and safety professions. As oneobserver noted, “they believe strongly that work-ers ought to be protected from hazards and thatlarger red uctions of risk are preferable to smallerones (without much thought of cost). ” These val-




ues led the agency to tend to adop t “the more pro-tective of alternatives presented to them by theparties (from outside the agency] or by crediblescientific research” (245).

The agency did, however, recognize the need

to collect information concerning the technicalfeasibility and estimated costs of its regulatoryproposals. From as early as OSHA’s first year(1971), the agency has endeavored to develop thisinformation using a combination of in-house staff and outside consultants. The goal of this earlyactivity w as not to p erform cost-benefit analyses,but to p rovid e feasibility an d cost-of-comp lianceestimates to counter the cost estimates and claimsof infeasibility made by the opponents of particu-lar regu lations (47).

The first major dispu te concerning th e use of

economic criteria involved a more stringent stand-ard for asbestos exposu re, which was issued in1972. At that t ime OSHA lowered the p ermissi-ble exposure limit for asbestos from 12 fibers percubic centimeter to 5, with a further lowering to2 fibers per cubic centimeter by 1976. The delayedeffective date for the 2-fiber limit was designed“to allow em ployers to make the needed changesfor comin g into comp liance.” OSHA w as sued bythe Indu strial Union Departm ent of the AFL-CIOfor, among other issues, having considered eco-nom ic factors in setting this limit. The Ind ustr ialUnion Department argued that the phrase “to the

extent feasible” in section 6(b)(5) should be inter-preted to m ean on ly technological feasibility—i.e. whether or not the technology to control ex-posures was available.

The D.C. Court of Appeals ru led in th is casethat OSHA could take account of the costs of complying with a new standard. Thus, in thisdecision, “feasibility” under the OSH Act wasdefined to include both technology and econom-ics. According to the court, a standard wou ld beconsidered economically feasible if compliancewith it w ould n ot threaten the viability of an in-

du stry as a wh ole, even if ind ividu al firms m ightclose because they could n ot meet the stand ard(223).

Two subsequent decisions refined this two-pronged definition of feasibility. The AFL-CIOchallenged OSHA’s decision to r elax a regulation

concerning the guarding of mechanical powerpresses (“no h and s in dies”). In th is case, the ThirdCircuit Court of Appeals ruled that while the OSHAct was a “technology forcing piece of legisla-tion,” OSHA’s determination that th e standar dwas technologically infeasible was adequately sup-

ported. In addition, this court, following the rea-soning of the earlier asbestos decision, ru led thatOSHA could consider “economic consequences”when setting standards. In particular, OSHAcould not “disregard the possibility of massiveeconomic dislocation caused by an unreasonablestandard” (1).

Secondly, in an industry challenge to OSHA’sregulation of vinyl chloride, the Second CircuitCourt of Appeals upheld a “technology-forcing”standard. By this decision, a standard could beconsidered feasible even if the technology neces-

sary for comp liance was not already w idespreadin the regulated industry. All that was necessarywas that the technology was “looming on today’shorizon” and could be brought into widespreaduse. A standard wou ld be considered technologi-cally infeasible only if meeting the standard wasshown to be “clearly impossible” (454a).

. . . the Secretary is not restricted by the statusquo. He m ay raise stand ards w hich requ ire. . .improvements in existing technologies or whichrequire the development of new technology.

At about the same time as these judicial deci-

sions, Presiden t Ford issued th e first Executive Or -der requiring inflationary impact statements. Infollowing years, OSHA came under pressure fromthe Council on Wage and Price Stability to baseits decisions on the results of cost-benefit analy-sis. A prop osed stand ard concerning coke ovenemissions was the basis for the first clash betweenOSHA and CWPS. CWPS participated in therulemaking p roceeding and argued th at OSHAhad overstated the expected benefits of the pro-posed standard . Using its own estimates of the ex-pected nu mber of lives saved and two estimatesof the “valu e of life” from the econom ics literature,

the Council suggested that the proposed stand-ard was not w orthw hile. Finally, CWPS recom-mend ed that OSHA consider allowing the use of respirators to comply w ith the stand ard (290).

Between the time of proposal and of final pro-mulgation, a new Assistant Secretary for OSHA,




Morton Corn, was appointed. About the use of cost-benefit analysis he has written (122):

After arriving at OSHA, I engaged in an in-dep th consideration of cost-benefit analysis, ap-plying the methodology to the coke-oven stand-ard . . . .With the dose-response data at our dis-

posal, various assumptions were used to ring inchanges on d ifferent method ologies for estimat-ing benefits. The range in values arrived at, basedon the different assumptions, was so wide as tobe virtually useless. The conclusion I reached afterthis exercise was that the method ology of cost-benefit analysis for d isease and dea th effects isvery preliminary, and on e can almost derive anydesired answer.

In October 1976, when OSHA actually issuedits regulation concerning coke oven emissions, itsstatement of reasons clearly rejected the u se of cost-benefit analysis. In part, this position was a

reaction to the argu men ts of CWPS, whose inter-vention was perceived as an attemp t to reduce thelevel of worker protection. In the preamble to thefinal regulation, OSHA based its rejection of cost-benefit analysis on the d ifficulties of accuratelyestimating th e expected benefits of the new stand -ard an d the lack of “an adequate methodologyto quantify the value of a life” (620).

This attitude toward cost-benefit analysis con-tinued du ring the Carter adm inistration. In 1977,Eula Bingham , as Assistant Secretary for O SHA ,expressed concern about p roposed p rocedures

concerning economic imp act analysis (56):While one can argu e over the sp ecific role of

economics in establishing regu lations, it is clearto me that economics should not be a paramountconsideration in setting safety and health stand-ards. The overriding purpose of the OSH Act isto protect workers, tempered by considerationsof feasibility, Accordingly, I would agree thatsome economic imp act analysis should be per-formed to provide a basis for evaluating indus-try representations as to economic impacts andpossibly to influence the length of the complianceperiod allowed for a given standard. I do notbelieve that policy decisions impacting w orkersafety and health can or shou ld be su bject to aformalized benefit-cost test.

CWPS continued to participate in OSHA’sstandard -setting p roceedings and generally wasvery critical of OSHA’s proposals. In a widely

pu blicized case, Charles Schultze (then chairm anof the Cou ncil of Economic Advisers), his staff,and CWPS became involved in the cotton dustrulemaking process in 1978. They suggestedchanges in OSHA’s draft standard. After an ap-peal to President Carter, the major requirements

for engineering controls in the stand ard were notchanged, although some features of the standardwer e mod ified. The intervention by Schultze andCWPS, however, was viewed by m any as an at-temp t to reduce the cost and the protectivenessof that regulation (135,290,479).

In 1978, OSHA issued final standards for ben-zene, DBCP, arsenic, cotton dust, acrylonitrile,and lead. Four of these six final stand ards werechallenged in the courts. The cases concerning thebenzene and cotton d ust standard s are particu-larly relevant to the evolution of the u se of eco-

nom ic analysis at OSHA.

OSHA’s more stringent stan dard for occupa-tional exposure to benzene w as challenged by th epetroleum industry. The Court of Appeals for theFifth Circuit ru led in this case that the ph rase “rea-sonably necessary or appropriate” contained inthe definitional section of the act (section 3(8))meant that OSHA could issue a more stringentregulation only if it estimated the risks addressedby the standard and determined that the benefitsof the standard bore a “reasonable relationship”to the costs. This ruling, in effect, erected a cost-

benefit decision rule for the agency to follow. Thecourt invalidated the standard because it con-cluded that there was insufficient evidence thatthis more stringent standard wou ld have any “dis-cernible benefits” (13).

This decision was appealed to the SupremeCourt, wh ich in the sum mer of 1980 upheld thelower court’s decision to vacate the standard, al-thou gh it did not follow th e same reasoning. Infact, while the Court voted 5 to 4 to strike downthe stand ard , the majority could n ot agree on acommon set of reasons. Five separate opin ions

were issued by the Court, but n o single opinionhad the sup port of more than four justices. Jus-tice Stevens p resented the views of four of the

justices who had voted to strike down the stand-ard. In that op inion, the issue of whether the OSHAct required the agency to follow a cost-benefit



z&f . Preventing Illness and Injury in the Workplace

rule was not addressed. Instead, this pluralitydeclared that the agency had not made a “thresh-old find ing” that risk presented by benzene ex-posure was “significant” (224):

By empowering the Secretary [of Labor] to pro-mulgate standards that are “reasonably necessary

or appropriate to provide safe or healthful em-ployment an d places of employment,” the Act im-plies that, before promulgating any standards, theSecretary mu st make a finding that the w ork-places in question are not safe. But “safe” is notthe equivalent of “risk-free.”. . . a workplace canhardly be considered “unsafe” unless it threatensthe wor kers with a significant risk of harm .

Therefore, before he can promulgate any per-manent health or safety standard, the Secretaryis required to make a th reshold find ing that aplace of employment is unsafe-in the sense thatsignificant risks are present and can be eliminatedor lessened by a chan ge in practices.

After an extensive review of the record in thiscase, the plurality ruled that because OSHA hadnot mad e this threshold finding and because therecord before the agency did not contain “sub-stantial evidence” to support such a finding,OSHA had exceeded its auth ority in issuing themore stringent standard for benzene exposure.The Court did not rule on the issue of whetherthe OSH Act required a cost-benefit test in addi-tion to this requirement to demonstrate “signifi-cant risk.”

The Court provided only limited guidance asto what was meant by “significant risk, ” wordsthat do not actually appear in the language of theact. To quote the plurality opinion (224):

First, the requ irement that a “ significant” risk be identified is not a mathem atical straitjacket.It is the agency’s respon sibility to determ ine. . .what it considers to be a “significant” risk. Somerisks are plainly acceptable and others are plainlyun acceptable. If, for examp le, the od ds ar e onein a billion that a person will die from cancer bytaking a drink of chlorinated water, the risk clearly could not be considered significant. On the

other hand, if the odds are one in a thousand thatregular inhalation of gasoline vapors that are twopercent benzene will be fatal, a reasonable per-son might well consider the risk significant andtake appropriate steps to decrease or eliminate it.Although th e agency has no du ty to calculate theexact probability of harm , it does have an obli-

gation to find that a significant risk is presentbefore it can characterize a place of employmentas “unsafe. ”

In a footnote, the Court noted that the u ltimatedecisions of the Agency concerning the acceptablelevel of risk “mu st necessarily be based on con-

siderations of policy as well as empirically veri-fiable facts” (224).

Justice Marshall filed a dissenting opinion forthe four Justices wh o voted to up hold O SHA’sbenzene standard . In that op inion, Marshall ar-gued that the p lurality’s review of the record w as“extraordinarily arrogant and extraordinarily un-fair” because the p lurality had improp erly madeits own findings concerning factual issues and hadunfairly described OSHA’s analysis of theseissues. Moreover, this dissent argued that the re-quirement to dem onstrate a “significant risk” w as

“a fabrication bearing no connection with the actsor intentions of Congress and is based only onthe p lurality’s solicitud e for the w elfare of regu-lated industries” (224).

The issue of whether the OSH Act required acost-benefit test in ad dition to a finding of signif-icant risk was taken up in a case concerning amore stringent stand ard for exposure to cottondust. Textile industry representatives argued thatOSHA h ad exceeded its statutory auth ority be-cause it had neither conducted a cost-benefit anal-ysis nor explictly determined that the benefits of

the standard justified the costs of compliance. La-bor representatives and OSHA argu ed that theOSH Act did not requ ire such a cost-benefit deci-sion rule. Instead, after determining that exposureto cotton du st presented a “significant risk” (asrequ ired by th e decision in the ben zene case), theagency w as required to issue th e most protectivestandard subject only to the constraint that com-pliance with the standard be technologically andeconomically feasible.

The Sup reme Cour t affirmed the OSHA cot-ton dust standard by a vote of 5 to 3. The major-

ity opinion held that cost-benefit analysis was notrequired by the OSH Act. Instead, Congress haderected a requirement for “feasibility analysis. ”Citing dictionary definitions that “feasible” means“capable of being done, ” the Court ruled (17) thatsection 6(b)(5) of the OSH Act




. . . directs the Secretary to issue the standardthat “most adequately assures. . . that no employ-ee will suffer material impairment of health, ” lim-ited only by the extent to which this is “capableof being d one. ” In effect. . . Congress itself defined the basic relationship between costs andbenefits, by placing the “benefit” of worker healthabove all other considerations save those makingattainment of the “benefit” unachievable. Anystandard based on a balancing of costs and bene-fits by the Secretary th at strikes a d ifferent bal-ance than that struck by Congress would be in-consistent with the command set forth in sec.6(b)(5).

In a footnote, the Supreme Court also endorsedthe d efinition of economic feasibility that h ad beensuggested by OSHA. According to this, to provea standard economically feasible, OSHA mustshow “that the ind ustry w ill maintain long-term

pr ofitability an d comp etitiveness” (17). This def-inition is consistent w ith the earlier courts of ap -peal rulings on the stand ards for asbestos, cokeoven emissions, and lead (10,223,654).

The legal battles concerning OSHA standardswere not just about the details of economic anal-ysis and r isk assessment. In part, these battles took on sym bolic meanings. That is, people on bothsides of these issues took positions based on w hatthey believed these cases symbolized for Govern-ment regulatory activity. Some supported thestandard s issued by OSHA because these stand-ards were believed to represent strong efforts tocontrol occupational health and safety problemsafter decades of neglect. They viewed cost-benefitanalysis as a technique that was being introducedto w eaken governmental protections. Others op-posed these standard s and su pp orted legal restric-tions on OSHA, including requirements for cost-benefit analysis, because th ey believed that t heagency had gon e too far in imposing regulatorycosts on businesses.

1

‘Table A-3 in appendix A presents a list of the legal cases con-cerning OSHA standards. For further discussion of OSH A’s legalobligations concerning the development of standards, see (333,408).Mintz (307) provides excerpts from primary source documents re-lated to this history of standard-setting, including legal briefs andcourt opinions.

Current OSHA Criteria

OSHA now uses a four-step process for mak-ing d ecisions abou t health stand ards, as expressedby former A ssistant Secretary Thorne Auchter.First, the agency determines that the hazard in

question poses a “significant risk.” Second , OSHAdeterm ines that regulatory action can red uce thisrisk. Third , it sets the regu latory goal (for healthstandards, this is the permissible exposure limit)based on redu cing th is risk “to the extent feasi-ble.” Finally, OSHA conducts a cost-effectivenessanalysis of various op tions to determine w hichwill achieve this chosen goal in the least costlymanner (434,638).

However, it is not clear what criteria apply tosafety standards and other regulations issued byOSHA. In the cotton dust decision, the Supreme

Court left this issue unr esolved, but did state thatit is possible that Congress could have set differentcriteria for health stand ards than for safety stand-ard s. It also noted that the “reason ably necessaryor approp riate” language of section 3(8) wou ldapp ly to safety stand ards (224).

“Significant risk”

To determine whether a h azard p oses a “sig-nificant risk of material health impairment, ”OSHA now generally u ses the techniques of quan -titative risk assessment. In several p ublicationssince the Sup reme Court d ecisions concerning

benzene and cotton dust, OSHA has presentedquantitative risk assessments, These risk assess-ments h ave calculated the estimated r isk at thecurrently permitted exposure levels and the an-ticipated risk at the new, lowered exposure levels,in order to show that its proposed stand ards areaddressing “significant risks” and that they willserve to reduce the risk of occupational disease.

As discussed above, the Sup reme Court p ro-vided only limited gu idance on wh at occup ationalrisks should be considered significant. The plural-ity opinion app ears to have ind icated th at a l-in-

1,000 risk of death is “significant” while a one-in-one-billion risk is not. However, the examplein th is opinion refers to a on e-in-one-billion risk from a single drink of water a nd a l-in-1,000 risk from regular inhalation of gasoline vapor s. If this




is adjusted for the total amount of water the aver-age person consu mes, the resulting risk estimatesfor these hypothetical examples concerning inhala-tion of gasoline and consumption of chlorinatedwa ter are about the sam e. (McGarity has reacheda similar conclusion by calculating the total num-

ber of cases expected in the exposed populationsfor these two examples (297a).)

OSHA’s “significant risk” determinations haveprincipally relied on comparing the estimated risksfor a par ticular hazard to the I-in-l, (X)() guide-line. For additional sup port, OSHA has also in-cluded comparisons with the risks of fatal occupa-tional injury (derived from the d ata of the BLSAnnu al Survey) and with the qu antified risks of several occupational health hazard s. For exam-ple, OSHA h as argued that a p articular level of arsenic exposu re p resents a “significant r isk” be-cause the estimated death rate at that level (8death s per 1,000 workers) is

. . . 1/ 4 to 1/ 2 the death rate [from injuries] inthe riskiest occup ations, 2 to 5 times higher thanthe risks in occup ations of average risk, and 10to 100 times the risk of the low risk occupations.It is also 1/ 3 of the maximum permitted rad ia-tion cancer risk but about 3 times higher than thecancer risk which 95 percent of radiation work-ers are u nd er (638).

Finally, OSHA has compared the estimated risksof exposu re at curren tly perm issible levels to theestimated risks for exposure that were regulated

in pr evious years. For instance, in pr oposals con-cerning new standard s for ethylene dibromide andasbestos, OSHA compared the estimated risks forthose substan ces to the risks of exposures to cot-ton dust and coke oven emissions (642,647).

In one case, OSHA h as exemp ted one groupof employers from the OSHA commercial divingstandard because the agency determined th at theestimated risks of injuries for this group werebelow those for industries with low injury rates.In explaining its d ecision, OSHA relied on a cal-culation showing that the injur y rate for scien-

tific and edu cational divers was lower than theinjur y rates for a num ber of ind ustries, includingbanking (634).

2

‘This calculated injury rate was based on the number of reported

deaths and injuries divided by 2,OOO hours p er year, the equivalentof full-time employment, 40 hours per w eek for so weeks per year.

Feasibility

As indicated earlier, for both technological andeconom ic feasibility the general requ irement isthat OSHA mu st show that comp liance with thenew standard is possible, that it is “capable of be-ing don e.” Technological feasibility refers to theavailability of technologies and methods to com-ply w ith the new stand ard. To prove this, OSHAcan, of course, refer to p lants and technologiesthat already meet the new standard. But OSHAis not bound just to the status quo. The courtshave ruled th at the agency has the au thority torequire technological improvements. The agencymust present substantial evidence to prove thatit is reasonable to expect that efforts by industrywill lead to compliance, even if the exposure re-du ctions are greater than those that have p revi-ously been achieved. In the word s of one court(654),

OSHA’s duty is to show that modern technol-ogy has at least conceived som e indu strial strate-gies which are likely to be capable of meeting thePEL [permissible exposure limit] and which theindustries are generally capable of adopting.

To meet this duty, OSHA uses the informationprovided in pu blic comments and the pu blic hear-ings. A feasibility d etermination usu ally relies onthe reports and opinions of expert consultants, theavailability of control technologies, descriptionsof plants and companies already achieving thenew standard, and general comments submittedto OSHA.

Economic feasibilit y refers to the economic ca-pability of the regulated industries to afford thetechnologies needed for control. The SupremeCour t has ru led that an an alysis of econom ic fea-sibility does not mean cost-benefit analysis.Rather, OSHA is required to show that compli-ance with a standard is affordable by the regu-lated industry us a whole. A standard can be con-sidered feasible even if it ad versely affects p rofitsand causes some employers to go out of business

This calculation,howwer, substantially understates the risk dur-ing diving operations because none of these employees is actuallyunderwater for 2,000 hours per year. In fact, the actual underwaterexposure time for these divers is u sually less than one-tenth of thetime assumed by OSHA (249a). The actual risk estimates for thisgroup of emp loyees while engaged in diving would, therefore, beover 10 times greater than the risk shown by the OSHA calculation.



Ch, 14—Decisionmaking for Occupational Safety and Health: The Uses and Limits of Analysis . 287

rather than comp ly with the standard . How ever,OSHA must show that the long-term profitabil-ity and competitiveness of an industry will bemaintained.

To analyze economic feasibility, OSHA gen-

erally estimates the costs of compliance for astandard. These compliance costs are usually pre-sented in several wa ys: for examp le, average costper affected firm, average cost per exposedworker, comp liance costs as a p ercentage of in-dustry sales, and compliance costs as a percent-age of total payroll costs. OSHA h as not set forthany m athematical formu la for d etermining w henthese costs would be considered econom ically in-feasible. Rather, it presents the costs, and ex-presses a jud gment about w hether or not theywould impose a substantial burden or have a sig-nificant impact on the market structure of the af-

fected industries.

Cost-Effectiveness Analysis

Finally, OSHA uses the techniques of cost-effectiveness analysis to evaluate alternative meth-ods of achieving the health protection goal thathas been selected on th e basis of the risk and fea-sibility an alyses. Cost-effectiveness analysis a t th ispoint is applied in a relatively narrow way. It isnot u sed to jud ge the “worth” or desirability of the standard, but only to select among alterna-tive approaches for m eeting that stand ard.

Regulatory Impact Analyses

Executive Order 12291, issued in early 1981, re-quires that OSHA prepare Regulatory ImpactAnalyses. These consist of detailed d iscussions of the quantified benefits, compliance costs, and eco-nomic impacts for alternative standards consid-ered by OSHA.

The order also requires that all OSHA regula-tory actions be reviewed by OMB, which, to theextent p ermitted by law, requ ires regulatory agen-cies to demonstrate that their regulations are cost-

beneficial. Generally, the results of the OMB re-view and agency responses need n ot be made pu b-lic. Thus, it is difficult to determine if OSHA deci-sions have been altered by OMB’s cost-benefitreview (510). It has been argued that OMB andthe Pr esidential Task Force on Regulatory Relief

have imp roperly influenced at least two OSHAregulatory proceedings, concerning hazardouscommunication and commercial diving, after pri-vate meetings with representatives of the indus-tries affected by the regu lations (519,520).

In several cases concerning proposed standards,OSHA has published alternatives suggested byOMB. These includ e, for examp le, the 1981 pr o-posal for hearing conservation (637) and the 1984proposal on grain elevators, which includedOMB-sugg ested altern atives (348). Two disp utesbetween OMB and OSHA concerning proposedstandard s have been appealed to the PresidentialTask Force on Regulatory Relief. In both cases

(the cotton du st and hazard commun ication stand -ards), OSHA was allowed to pu blish its prop osals(637).

OMB sugg estions have been incorpor ated in atleast two final stand ard s. For the hearing conser-vation amendment, several technical requirementswere altered (637). In another case concerning afinal stand ard for ethylene oxide exposu re, OMBexpressed “reservations” about part of the OSHA-drafted stand ard (in p articular, the provision es-tablishing a short-term exposure limit). In re-sponse, OSHA r emoved th at provision from th efinal, published standard, and requested addi-tional public comment (649). OSHA considersOMB review to be “akin to internal review,” afterw hich all final decisions are ma de by O SHA and

the Department of Labor (637).The General Accounting Office has studied

agency comp liance with Executive O rd ers 12044and 12291 and has collected information on thecosts of preparing economic analyses. For ON-IA,these analyses cost an average of $338,000 (510).Although it is difficult to determine the value andeffects of these an alyses, the am oun t of resour cesused by OSHA to develop th em has been sub-stantial.

Effects of Decision Rules

Qu estions remain, however, concerning the ac-

tual application of the current OSHA criteria.How large does a risk need to be in order to beconsidered significant? How is risk to be meas-ured? How is technological feasibility determined?




How costly can a standard be before it threatensthe viability of an indu stry and thus is consideredeconomically infeasible (277)? Indeed, there havebeen and continue to be disputes about the ap-plication of any set of decision criteria by a regu -latory agency. In p ractice, decision criteria may

only define a range of allowable decisions and willoften not mandate a particular result.

The positions adopted by the participants inOSHA’s regulatory proceedings, general politicalconsiderations, and the personal judgments of OSHA’s Assistant Secretaries and its staff havebeen and continue to be important to OSHA’sdecisionmaking. Moreover, OSHA has alwaysbalanced various factors before issuing standards.For instance, OSHA stated in its preamble to thevinyl chloride regulation that its “judgments haverequired a balancing process, in which the over-

riding consideration has been the protection of employees.” These more informal judgm ents maybe even more imp ortant than the formal decisionrules used by an agency.

In addition, the court battles about OSHA deci-sions an d more general discussions of “regulatoryreform” were not only about w hat the decisionrules should be, but also about w ho should be em-powered to interpret and apply those rules.Shou ld th e Assistant Secretary for OSHA hav ethe authority to make these decisions with onlylimited review by the courts? Or should review-

ing judges become extensively involved in analyz-ing the factual record and OSHA’s jud gments?And to what extent should outside agencies, suchas CWPS and OMB, be involved in examiningand approving OSHA’s decisions?

Because jud gmen t and the iden tity of the d eci-sionmaker are important, and because there areman y uncertainties in estimating effects (discussedbelow), the adop tion of a cost-benefit ru le maynot lead to d ecisions that are d ifferent from thoseadopted under a feasibility test. DeMuth (136) hassuggested that “just as the Corps of Engineers be-

came adept at demonstrating that every dam thatcould be built wou ld pa y for itself, so the regu la-tory agencies will learn to demonstrate, with in-creasing analytical verve, that every new regula-tion is cost-beneficial. ”

Would OSHA’s decisions have been differentunder a cost-benefit decision rule? One contractreport (262) prepared for this assessment suggeststhat for at least some of the major OSHA healthstandards, the use of a cost-benefit decision rulewou ld have led to less stringent standard s.

Jud ith and Lester Lave (262) applied several dif-ferent decision frameworks to four health stand-ards issued by OSHA--those for coke oven emis-sions, benzene, vinyl chloride, and cotton du st.They comp ared the regulations actually issued byOSHA u sing its criteria of technological and eco-nom ic feasibility and those tha t the Laves believewou ld hav e been issued und er a cost-benefit deci-sion rule. In three of these cases-for coke ovenemissions, benzene, and vinyl chloride-a cost-benefit analysis would have led to a less stringentregulation. For cotton dust, the conclusion of an

analysis is very dep endent on the discount ratechosen and the value placed on p reventing addi-tional cases of byssinosis (see below for a discus-sion of these issues). This case, they conclud ed,is one in which “reasonable analysts can choosevalues within the ran ge accepted by the econom-ics profession and wind up with op posite conclu-sions about the desirability of a stringent standard.”

The conclusions about the fates of the vinylchloride and cotton dust standards are note-worth y because in both cases imp rovemen ts inproductivity accompanied compliance with a

stringent OSHA standard. In part, those improve-ments m ay have been spu rred by the necessity tocomply w ith OSHA’s stringent requ irements. If a cost-benefit d ecision ru le had been in effect forOSHA, these gains in employee health and in eco-nomic productivity might not have occurred.

It cannot be conclusively shown that the ap-plication of a cost-benefit decision rule wouldhave changed OSHA’s decisions and the natureof technological change in affected industries.Lave and Lave had to rely on currently availableinformation. Had a cost-benefit ru le been in ef-fect, OSHA m ight have prep ared ad ditional quan-titative information, especially on the ben efits of its standards.

However, their conclusion does support theconcern of many participants and observers that




cost-benefit analysis in practice w ould not be aneutral decision rule, but one that is biasedagainst imp rovements in worker h ealth and safety(43,65,115,194,411). For example, Baram (43) hasconcluded that in many cases “[c]ost-benefit anal-ysis is a ‘nu mbers gam e’ that is u sed to op pose

regulatory actions that have been proposed toprotect public health and the environment .“ Con-nerton and MacCarthy (115) believe that the use

THE

Value

of cost-benefit analysis w ill prevent regulatoryagencies from carrying out their responsibilitiesto protect health and safety and will lead to ex-tensive d elays in an already slow regulatory proc-ess— in other words, to a “paralysis by analysis. ”Boden (65) has expressed concern that under cur-

rent circum stances, the use of cost-benefit an aly-sis “may bias political decisions against even th oseregulatory decisions that are cost-effective. ”

USES AND LIMITS OF ECONOMIC ANALYSIS

of Economic Analysis

Econom ic analysis—including cost-benefit ana l-ysis, cost-effectiveness analysis, and the feasibil-ity analysis performed by OSHA—can provide

decisionmakers with important information onthe problems and alternatives they face and theconsequences of various courses of action. In “TheImplications of Cost-Effectiveness Analysis of Medical Technology” (539), OTA described 10general principles of analysis that are applicableto the conduct of both cost-effectiveness and cost-benefit analyses. These principles are:

q

q

q

q

q

q

q

q

q

q

Define problem.State objectives.Identify alternatives.Analyze benefits and effects.Analyze costs.Differentiate perspective of analysis.Perform discounting.Analyze uncertainties.Address ethical issues.Interpret results.

Following these principles can lead to the d evel-opment of clear and useful analyses. But the proc-ess of collecting information, ordering it, andanalyzing it can be just as important as the finalresults of an analysis.

Performing an analysis of costs and benefits canbe very helpful to decisionmakers because theprocess of analysis gives structure to the p roblem,allows an op en consideration o f all relevan t ef-fects of a decision, and forces the explicit treat-ment of key assump tions (539).

Lave and Lave (262) have suggested that the useof economic analysis “sharpens the questions,clarifies the imp lications of po licies, and gener-ally manages to attain solutions at lower cost. ”

In add ition, wh en the necessary data are avail-able and w hen th e quan tification of intan gible ef-fects is not a problem, cost-benefit analysis canshed light on the implications for economic effi-ciency of alternative projects.

As one element of the decisionmaking process,as a decision-assisting tool, economic analysis canprovide guidance and information. In addition,economic analysis can provide support for deci-sions or actions that may be taken on othergrounds. For example, in some cases, decisionsbased on n oneconomic ground s will also be sup-ported by the results of economic analysis. In

those cases, most people would support the useof economic analysis. Arguments arise when theanalysis supports less stringent standards thanthose chosen for other reasons.

Difficulties in Implementation

The limitations of these techniques are particu-larly evident w hen they are considered as d eci-sion rules. In 1980, OTA conclud ed tha t cost-ef-fectiveness and cost-benefit analyses exhibited toomany methodological and other limitations to justify sole or even p rimary r eliance on th em inmaking decisions (539). That conclusion is stillapplicable for the analysis of measures to improveoccup ational safety and health.

A nu mber of the analytical pr inciples-definingthe p roblem, stating objectives, identifying alter-




natives, differentiating the perspective of the anal-ysis, analyzing uncertainties, and interpretingresults—are relatively u ncontroversial, in largepar t because they are compon ents of any proc-ess of rational decisionmaking. However, thequantification of benefits and costs and applica-

tion of a discount rate to them are distinctivefeatures of these typ es of analyses. They ar e alsothe features that present the most difficult meth-odological issues and arouse the most contro-versy, especially w hen ap plied to governmentalregulation of worker health and safety.

Benefits Analysis

The benefits of various alternatives must beidentified, and if possible, quan tified. Qu antifica-tion bears the danger that the effects that can bemeasured will receive m ore attention than those

that are not quantified, even if the unquantifiedare believed to be more important. Lave (263) hascalled this a “Gresham’s law of decisionmaking. ”On this dan ger, Mishan has written (308):

. . . the ou tcome of all too man y cost-benefitstud ies follows that of the classic recipe for m ak-ing horse and rabbit stew on a strictly 50-50 basis,one horse to one rabbit. No matter how carefullythe scientific rabbit is chosen, the flavor of theresulting stew is sure to be swamped by the horse-flesh. The horse, needless to say, represents thoseother [un quantified] considerations . . . .

The uncertainties of any quantification of bene-fits begins with uncertainties concerning the rela-tionship between exposures and health hazard s.Epidemiologic studies are often limited by smallsamp le sizes, a lack of information on past ex-posu res, and the presence of confoun ding vari-ables. The results of animal testing present prob -lems in d etermining the app licability to hum anpop ulations and in extrapolating from the highdoses often u sed in such stu dies to the lower dosesfound in the w orkplace (see ch. 3 and 542).

Even after id entifying th e risks involved, an

analysis of the benefits of controlling them mustdiscuss the effectiveness of the various technol-ogies that could be ap plied. Often, informationcrucial to that analysis is lacking. For example,personal protective equipment is often suggestedas a cost-effective alternative to eng ineering con-

trols, but there is only limited information avail-able on the actual workplace effectiveness of suchdevices (ch. 8).

After identifying and quantifying the benefitsto be expected from a given a ction, a cost-benefit

analysis (but not a cost-effectiveness analysis) re-quires that these be converted to units that canbe directly comp ared w ith the costs of the action.Analysts almost invariably choose m onetary u nitsfor this.

There are two major app roaches to placing avalue or a p rice on h um an lives or lifesaving pro-gram s. The first is to consid er the va lue of a lifeto be the p resent discounted value of the person’sfuture income. Because this method, known as th ehum an capital app roach, assumes that the valueof a person ’s life is equal to their expected income,it imp lies that “wom en are valued less than m en,blacks less than w hites, retired peop le less thanworkers, and low-paid textile workers less thanhigher-paid steel workers” (115). In addition, itcannot include the value that other people attachto saving a p articular person’s life.

The other major approach has been to evaluatelifesaving program s on w hat p eople are “willingto pay” for them. This approach, too, run s intoproblems. It is difficult to find out exactly w hatpeop le are “willing to pay.” A survey could beused , but the interp retation of the results is dif-ficult.

Another m easure can be obtained from analy-sis of the ad ditional pay that w orkers may receivefor taking unsafe jobs. (These have been termedhazard premiums or compensating wage differen-tials. See ch. 15 for a d iscussion . ) It is also poss i-ble that consumers are willing to pay “extra” forless hazard ous consum er prod ucts. Some econ-omists, using the techniques of statistical analy-sis, have attemp ted to m easure the extent of these“revealed preferences. ” These stud ies are sub jectto a nu mber of techn ical problems in the m eas-urement of risk levels and in adjusting for other

factors tha t influence wages and prices. The resultsof these stud ies have been used to calculate the“value of a life. ”

Table 14-1 show s the w ide ran ge of impliedvalues for hum an lifesaving derived from su ch



. ——


Table 14-1 .—Willingness-to-Pay Estimates of theValue of Lifea

Value perstatistical life(thousands of

Method 1977 dollars)b

Survey approach:Acton (1973) . . . . . . . . . . . . . . . . . . . . 38Jones-Lee (1976) . . . . . . . . . . . . . . . . 8,440Landefeld (1979) . . . . . . . . . . . . . . . . 1,200

Revealed preference:Labor market:

Dillingham (1979) . . . . . . . . . . . . . . . 277Thaler and Rosen (1975) . . . . . . . . . 364Viscusi (1978) . . . . . . . . . . . . . . . . . . 1,650Smith (1976) . . . . . . . . . . . . . . . . . . . . 2,045Olson (1981) . . . . . . . . . . . . . . . . . . . . 5,935

Consumption activity:Dardis (1980) . . . . . . . . . . . . . . . . . . . 101

c

Ghosh, Lees, and Seal (1975) . . . . . 260Blomqist (1979) . . . . . . . . . . . . . . . . . 342Portney (1981) . . . . . . . . . . . . . . . . . . 355

%/here a study included a “central” or “most reasonable” estimate, that is shown,

where only a range was ~iven, the lowest value is presentedbvalue~ were convefled t. 1977 dollars using the U S Bureau of Labor Statis t ics

Consumer Price Indexcit IS un c l e a r from the Dardis study what year’s dollars apply, although the

estimate presented here appears to be based on an average value for the period1974-79

SOURCE. (262)

studies. Two different types of studies are cited.The first, labeled the survey approach, involvessurveying groups of people and asking them whatthey think should be spent on lifesaving p rograms.The second type, revealed preference, uses dataconcerning either work and employment (labormarket) or consumer p urchasing (consum ption ac-tivity) to calculate either w orkers’ or consum ers’“willingness to pay” for risk reduction.

The wide range in these values creates difficul-ties for analysts attempting to use the “willingnessto pay” ap pr oach to place a value on the benefitsof programs. Besides this practical problem of choosing a figure for valuing benefits, there arealso several conceptual problems with using the“willingness to pay” approach to assess lifesav-ing programs. (See 277 and 297 for a discussion. )

Recently a third approach has been suggested

(259). Called “ad justed w illingness t o p ay,” it at-tempts to combine the two traditional approachesby estimating w hat an individual should be will-ing to p ay to avoid the financial losses associatedwith p remature d eath. However, it still is not ableto include the willingness of family, friends, co-workers, and strangers to contribute to lifesav-

ing programs. Moreover, the value of life derivedfrom this approach remains a function of incomeand wealth.

Cost Analysis

The estimation of costs is often thou ght to p re-sent fewer difficulties than the analysis of bene-fits. Nevertheless, the costs of controls are oftenhard to estimate accurately. In part this is becausemany control technologies involve changes in theactual p rodu ctive process or h ave mu ltiple uses.For examp le, w hat p ortion of the costs of install-ing duct work in a new plant should be attributedto the need to dilute an air contaminant? Andwhat percentage should be listed as the cost of providing heating and air conditioning to aplant—an ord inary cost of doing bu siness?

In addition, company officials are usually in thebest position to know wh at needs to be changedin their plants to comp ly with a proposed stand -ard. But these people also have a vested interestin the regulatory proceeding. Moreover, line man-agers and plant engineers would rather overstatethan understate expected costs in order to ensurethat they w ill be given a sufficient bu dg et withinthe company to pay for the controls (140). Finally,when OSHA “forces” the diffusion of technology,there is little or no experience on w hich to esti-mate the costs of widespread use of a particularnew technology. Consequently, the costs of pro-

posed regulations are often overestimated. (Forexamples of this, see 195. )

Uncertainties

Estimates of both costs and benefits are usu -ally surrounded by uncertainty. The combined ef-fect of these uncertainties and of assumptionsmade by the cost-benefit analyst, both of whichare found at every stage of the estimation of costsand benefits, can prod uce large differences in th eanalyses conducted by different people. Thus itis possible for one an alyst to take a high estimate

of costs and a low estimate of benefits and con-clude that the program should not be undertaken,while another analyst can take a lower cost esti-mate and higher estimate of the benefits and con-clud e that the p rogram is worthw hile. Often thesedisputes cannot be resolved. (For a discussion of several kind s of uncertain ty, see 175. )




Discounting

Finally, these analyses require that costs andbenefits be made commensurate over time. Thisusu ally involves adjusting future costs and bene-fits at a specified d iscoun t rate to calculate the pre-sent value of the costs and benefits. The general

justification for d iscoun ting d erives from th e factthat resources can be invested to earn interest overtime. Thus, in order to compare costs and bene-fits that occur in different years, all future effectsare discounted and expressed in terms of “presentvalues. ”

In pr actice, there is considerable disagreem entover what discount rate should be used (539).Moreover, although the logic of discounting is

derived from several basic propositions of eco-nom ic theory, the discounting of futu re costs andbenefits has two effects that create somecontroversy.

First, the effects (both costs and benefits) onfuture generations are almost completely ignoredwith most discount rates. Second, the process of discoun ting implies that risks that man ifest them-

selves in the very near futu re are to be p reventedbefore risks 10, 15, or 20 years in the future. Thismean s that, all other th ings being equal, the risksof occupational injury should be reduced beforeredu cing th e risks of occup ational cancer. Or, forexample, that OSHA should act to reduce the risksof exposure to beta-naphthylamine (which has

caused cancer in some workers after a latentperiod of less than 5 years) before it acts to re-duce the risks of exposure to asbestos (whichcauses various typ es of cancer with latent peri-ods ranging from 15 to 30 years).

Distributional Effects

Although cost-benefit and cost-effectivenessanalyses were designed to evaluate economic effi-ciency, they are not very well developed for theevaluation of distributional implications. This isan important problem for the application of these

techniques to p rograms d esigned to improve oc-cupational health and safety. Usually these pro-grams are aimed at benefiting a group of work-ers, while the costs of the p rogram s fall largelyon employers. In addition, the benefit to theworkers often involves the prevention of irrevers-

ible da mage to their health or well-being w hilethe costs to employers involve increased expensesand, possibly, reduced profits. This further com-plicates the comp arison of costs and benefits.

Alternatives to Aggregated Analysis

Some analysts believe that ultimately solutionsto these problems can be found . OTA (539) hassuggested th at the alternative of “arraying” thevarious effects of a program or proposal shouldbe investigated, rather than trying to redu ce alleffects to a single “bottom line. ” Ashford, et al.(33), for example, have suggested “trade-off anal-ysis.” This approach would involve a comprehen-sive description of the expected effects of anagency’s actions on three “flows”: economic, en-vironment/ health, and legal. To avoid the prob-lems of monetization and valuation, all effects are

left in their natural units. To reduce discountingprob lems, the time pattern of the effects is pre-sented. Finally, the analysis provides a matrix of effects and actors, to presen t a clear p icture of whogains or loses what from th e regulatory action.

Ethical Considerations

The use of cost-benefit and cost-effectivenessanalyses also raises ethical considerations. Sup-porters of the greater use of these techniques pointto the limited resources available for improvinghealth an d safety. This, they believe, imp lies that

the only m oral course of action is to use those re-sources in a way that maximizes net social bene-fit. As a moral doctrine, this belief derives fromthe traditions of utilitarianism (246). The ad -vocates of cost-benefit analysis believe that theuse of formal analysis will help achieve the great-est possible level of hu man welfare (304,446).

. . . estimating benefits and costs is often diffi-cult, esp ecially . . . where the benefits may bein terms of lives saved or p ain and sufferingavoided . Some say this means pu tting a value onhum an p ain, suffering, and death, which is notonly ludicrous, but downright immoral. If any-thing, we w ould argue, the reverse is true. Sinceresources are limited, we cannot avoid the needto identify—and, in some way, to estimate-ben-efits and costs. The more compassion we have forour fellow human beings, the more important thisbecomes (304).



.

Ch. 14—Decisionmaking for Occupational Safety and Health: The Uses and Limits of Analysis 293

In d isagreement, MacLean an d Sagoff (281) dis-cuss the philosophical justifications used to supportcost-benefit decisionmak ing and conclude thatthese just ifications fail. Cost-benefit an alysis isnot, in their view, a neutral decisionmaking rulebecause it is unable to take account of many com-

monly held ethical principles and values. In or-der to include concerns for equity and justice, aformal cost-benefit analysis wou ld either ha ve tofind some way to assign a p rice to these concernsor ignore them. But justice and equity are notmerely matters of consumer preference; they de-pend on p olitical and moral argum ents: “Equityis a matter of right or wron g; it is to be though tover and argued about. It is not a consumer serv-ice or a fungible good” (281).

On examining the cost-benefit decision rule pre-sented in President Reagan’s Executive Order

12291, MacLean and Sagoff conclude that itsunitary yardstick of positive net benefits is

SUMMARY

Improving occupational safety and health in-volves the identification of hazard s, the develop-ment of control techniques, and the d ecision tocontrol. The issue of decisionmaking—the ques-tion of who is to make decisions and on whatbasis—is important because interested parties can

differ greatly about th e natu re of occupationalhazards and the best means to redu ce or elimi-nate th em. Employers’ decisions tend to followthe d ictates of the competitive market system;public decisions can consider a number of otherfactors.

Various techniques of economic analysis includ -ing cost-benefit and cost-effectiveness analyseshave been developed to assist private and p ublicdecisionm akers. As decision-assisting tools, thesetechniques can h elp policymakers to reach sound ,well-informed, reasoned decisions about themanagem ent of workplace hazards. There is wide-spr ead agr eement, at least in p rinciple, that d eci-sionmakers need to have some m inimal under-standing of the imp ortant features of the p roblemto be addressed, the factors involved in the deci-sion, and the imp lications of various courses of

severely limited: How can cost-benefit analysisclaim to be either neutral or comprehensive if itcannot deal with a w ide range or m oral, cultural,aesthetic, and political concerns? There may besome issues that raise few important cultural or

mor al issues; for examp le, the comm odities mar-

kets may be left to d etermine the p rices of hogbellies or potash. This does not show, however,that markets or market analysis can give us anadequate policy for public safety and health. Onthe contrary, wh ere mora l, political, and culturalvalues—not simp ly econom ic ones—are at stake,we need to m ake moral, political, and aesthetic

judgments. Cost-benefit analysis does not replacethese “su bjective” judg men ts w ith “objective” or“neutral” ones. Rather, it distorts or ignores thenon economic values it cannot han dle (281). (See205,246,277, and 297 for additional discussion of

the ethical implications of cost-benefit analysis. )

action. As decision roles, however, formal anal-ysis is considerably more controversial and sig-nificantly more limited in its u ses.

In 1980, OTA concluded that cost-effectivenessand cost-benefit analyses exhibited too manymethodological and oth er limitations to justifysole or even p rimary reliance on them in makingdecisions. That conclusion is still app licable forthe analysis of measures to imp rove occup ationalsafety and health.

These limitations include difficulties in quan-tifying th e magn itud e of the expected ben efits, invaluing these benefits, in calculating the expectedcosts of improved health and safety, in perform-ing discounting, and in analyzing the distribu-tional implications of alternative policies. The useof cost-benefit an d cost-effectiveness analyses alsoinvolves ethical consider ations. The adv ocates of cost-benefit analysis believe that the use of for-ma l analysis will help a chieve the greatest possi-ble level of human welfare. Critics of formal anal-ysis, however, argu e that cost-benefit analysis islimited because it is unable to take account of




many commonly held ethical principles andvalues.

The history of decisionmaking at OSHA is in-tertwined w ith debates over the allowable use of cost considerations. Some of that debate has been

over the specific requirements of the OSH Act andwh ether OSHA m ust base its decisions on a cost-benefit analysis. When it passed the OSH Act,Congress brought the Federal Government intothe field of occupational health and safety. Con-gress, however, was less clear about the precisedecision rules for OSHA to follow when settinghealth and safety standards. Because of the con-cern of a n um ber of Congressmen abou t costs andeconomic effects, OSHA was required to considerthe “feasibility” of its stand ard s. But the final billalso includ ed th e goal that “no employee will suf-fer material impairm ent . . . “ In add ition, du r-

ing the 1970s, a series of Executive Orders andother procedural requirements have affectedOSHA’s standard-setting activities.

A number of legal challenges to OSHA stand-ards have brought the courts into this arena. Twoof these challenges were decided by the SupremeCourt. The Supreme Court has ruled that the

OSH Act does not require that OSHA base itsdecisions on the results of cost-benefit analyses;instead the agency must base its decisions on deter-minations of “significant risk” and “feasibility. ”

OSHA now uses a four-step process for mak-

ing decisions abou t health stand ards. First, theagency determines that the hazard in questionposes a “significant risk.” Second, OSHA deter-mines tha t regulatory action can redu ce this risk.Third, it sets the regulatory goal based on reduc-ing this risk “to the extent feasible. ” Finally,OSHA cond ucts a cost-effectiveness an alysis of various options to determine w hich w ill achievethis chosen goal in the least costly m anner.

OSHA also prepares Regulatory Impact Anal-yses to comply with the requirements of ExecutiveOrder 12291. Because the results of the OMB re-

view of these analyses are not made public, it isdifficult to determine if OSHA decisions havebeen altered by OMB’s cost-benefit review. In ad-dition, one contract report prepared for thisassessment suggests that for at least some of themajor OSHA health standards issued in the 1970s,the use of a cost-benefit decision rule would haveled to less stringent standard s.



15.

Incentives, Imperatives, and the

Decision to Control



Page

297 ‘

301302

313320322

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. . . . . . . . . . . . . . . . * * * . . * . * . . . * . .

TABLE

Page

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Safety Clauses,... .., ... ,,, ,O . . . . . . . . .

FIGURE

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q q . q q q q q q q q q 310& Lawsuits 1970-82

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15Incentives, Imperatives, and the

Decision to Control

OTA has identified a num ber of incentives and

one major imperative for the implementation of

control technologies. As used here, an “incentive”is something that encourages an employer to im-plement a control. Because of the special valueplaced on health and safety, many people believe

that society should, by law and regulation, requireemployers to take the steps necessary to preventwork-related illnesses and injuries. This belief und erlies the basic approach of the Occupational

Safety and Health (OSH) Act of 1970, which is

an “imperative” for implementing controls.A great deal that is know n abou t controlling

the causes of occupational illness and injury has

not been ap plied in m any of the N ation’s 4.5 mil-lion workp laces. Examining incentives and im-

peratives can assist in und erstanding the decisionsto implement controls and can outline areas forimprovement. Most incentives and imperativescan be used together and , in some cases, they in-teract and build on each other. In some othercases, however, various historical circumstanceshave led to compromises that bar the use of someincentives (e.g., workers’ compensation laws gen-

erally proh ibit emp loyees from suing their em-

ployers), This chapter presents a description an dassessment of these incentives and imperatives.

ASSESSMENT OF EXISTING INCENTIVES

Voluntary Efforts

After being informed of or discovering the ex-istence of job hazards, some employers will takeaction to reduce, minimize, or eliminate those

hazard s. They d o so either because of altruismtoward their workers or out of enlightened self-interest. Strictly speaking, pure altruism impliesthat th e employers take these actions only because

of concern for their workers without thought of the u ltimate im plications for the firm in term s of worker good will, productivity, profits, or futu resales. Although this will often be true for the per-sonal motivations of health and safety profes-sionals, most decisions concerning company pol-icy will consider carefully the potential effects onprofits.

Probably more common than pure altruism arevoluntary actions out of enlightened self-interest.

These actions are taken because a firm perceives

that voluntary efforts, although not n ecessarilyprofitable in the short term, will benefit the firmin the long run. This long-term benefit could be

Photo credit OffIce of Technology Assessment

Signs are often used to provide information to workers.This one is a gentle reminder about the

use of safety shoes

an enhan ced corporat e image or the perceptionthat a given firm is a “good place to work. ” Inadd ition, voluntary efforts may be un dertaken tosolve a particular p roblem before the Government

or other groups become involved. (Of course,there may be other benefits to the firm in term s

297




of reduced workers’ compensation costs, reducedcapital costs if accidents damage plant and equip-ment, or a reduced threat of potential liability oran Occup ational Safety and Health Ad ministra-tion (OSHA) fine. )

The pressures of the competitive marketplacewill, however, substantially limit the ability of in-dividu al comp anies to imp rove employee healthand safety. As described in chap ter 14, if a com-pany spends resources on improving workplaceconditions and its competitors do not, this com-pan y can easily find itself at a disadvantage be-cause its competitors can use the resources thussaved to expand or improve production. Unlessthe company can save money in some other way,it will have lost money by attemp ting to do the“right” thing.

There are several ways in w hich the comp any

may receive a financial return on its health a ndsafety investment—through reduced workers’comp ensation p remium s, for example, or an im-proved labor relations atmosphere, or reducedvu lnerability to fines for violating Governm entregu lations. In th is case, the action is not exactly“voluntary, ” but results from some other in-centive.

Voluntary actions may result in a firm savingon both the d irect and indirect costs of occupa-tional accidents. The d irect costs includ e w ork-ers’ compensation payments for lost wages and

med ical care, while the ind irect costs includ e lossof produ ctivity, disrup ted schedu les, equipmentand property damage, administrative time for ac-cident investigations, and training of replace-ments. Estimates of the size of indirect costs rangefrom 4 times to 20 times the direct costs of ac-cidents (82,380). The National Safety Council hasestimated that the average total cost (both directand indirect) to an emp loyer of a lost-workdayaccident is about $9,400 (324). Sheridan (436)reports that on e large firm has estimated th e totaldirect and indirect cost to be $14,000 for a lost-work-time injury, $100,000 for a fatality, and

$200,000 for injuries involving permanent dis-ability.

As noted in chapter 10, it has frequently beensaid that the most imp ortant variable in d etermin-ing w hether a firm w ill be generally protective of

employee health and safety is the commitment of top management. Two studies (441,443) havefound that low-accident-rate plants tended to have“greater man agement commitment and involve-ment in plant safety matters” (443), although bothof these studies involved relatively small numbers

of comp anies. In addition, a number of com-panies, particularly large ones, have created de-partm ents to hand le issues of occup ational andenvironmental health and safety, have hired pro-fessional staffs with technical expertise concern-ing health and safety, and h ave established inter-nal review mechanisms to ensu re compliance withhealth an d safety stand ards. (See 179 for a dis-cussion of some of these arrangements, and boxP.)

The important role played by managementcommitment to the goals of occupational safety

and health mu st be stressed. In the United States,employers are responsible for the organization,design, and man agement of workp laces. If im-provem ents in emp loyee health and safety are tooccur, they will have to involve decisions by man-agement. It is therefore not surprising that man-agement commitment h as been called the singlemost important ingredient in effective health andsafety programs.

The other incentives and imperatives describedin this chapter can be thought of as ways of ob-taining the comm itment of employers when vol-

untary efforts are insufficient to correct occupa-tional health and safety hazards. These incentivesand imperatives generally reward or penalize com-panies. It has also been suggested that the com-pensation of ind ividu al line managers should belinked to improvem ents in prod uct safety, pollu-tion control, and occupational health and safety(139).

In addition, there are a number of voluntaryorganizations and associations that have been ac-tive in the occup ational safety and health field.These include professional societies, voluntary

standards organizations, trade un ions, and em-ployer associations. Companies and their employ-ees may participate in these voluntary organiza-tions and these voluntary organizations aresometimes involved in the d evelopm ent of someof the other incentives and imperatives. This is



Ch. 15—incentives, imperatives, and the Decision to Control q 299

Box P.—Example of Voluntary Control Efforts: Du Pont

Effective company-run safety and health organizations require strong imp etus and initiative on thepart of management. At E. I. du Pont de Nemours and Co., this is reflected in the company’s “ninesafety principles” (described inch. 6). The commitment of Du Pont to worker safety dates to the 19th

century, when it produced gunpowder.In the early days the company’s mills blew up so regularly that they were built with three sturdy stone

walls and one flimsy wooden wall, facing Brandywine Creek. When the inevitable explosion came, the woodenwall would blow out. The rest of the mill would remain stand ing and could be economically restored to serv-ice. “Going across the creek” became a company euphemism for being blown to bits (284).

In fact, two du Pont family mem bers were killed in these explosions.

Du Pont req uires all levels of management and all employees to be responsible for health and safetyon the job. Not only does this attention imp rove employees’ working conditions, but w hether dealingwith 19th century gunpowder or 20th century petrochemicals, this attention reduces the chances of de-stroying valuable plant and equipment and incurring expensive downtime. In add ition, Du Pont integratessafety with the management of the firm and uses the safety records of managers in making decisionsabout promotions.

Du Pon t established th e Corpora te Environ men tal Quality Committee in 1966 to carry out “topmanagem ent’s commitment to environm ental quality, including safety and health.” It meets weekly andis the overseer of four supporting committees, including an “Occupational Safety and Health Committee.”

At the plant level, Du Pont has Central Safety Committees consisting of plant staff managers andassistant managers, the superintendent of safety and health, the environmental control manager, andthe plant p hysician or medical supervisor. This committee directs the plant safety and health program,and meets at least once a month. Plant subcommittees, headed by first-line supervisors, vary in numberand function, depending on plant size and needs. Anywhere from 6 to 10 workers serve on subcommit-tees; there are no requirements, however, for minimum employee representation on the subcommittees.Individual employees are selected by the plant manager to serve on subcommittees, which are consid-ered the focal point for plant involvement in safety policy. Their findings are reported to the CentralSafety Committee.

About 95 percent of all safety hazards are corrected b y line organization, and the resolution of indi-

vidual safety hazards rarely requires involvement of a subcommittee. The minority of complaints thatare referred to the committee concern issues that potentially involve plant-wide policy changes.

It has been noted that because of its low injury rate, Du Pont annually saves millions of dollarsfor workers’ compensation compared with what its costs would be if its injury rate equaled the nationalaverage for all manufacturers (284). But the chemical industry as a whole, of which Du Pont is a part,generally has had a lower injury rate than that for all manufacturers, although Du Pont’s injury ratesare better than even the chemical industry average. Little information is available on what it costs DuPont to achieve this savings in workers’ compensation costs.

Finally, while Du Pont is also a widely recognized leader in providing a comprehensive occupa-tional health program for its employees, data on the incidence of occupational illnesses are limited (seech. 2). Thus it is impossible to quantify Du Pont’s occupational illness rates and compare them withaverages for the chemical industry or for all manufacturers.




especially true for OSHA regulatory proceedings,in which both trade u nions and emp loyer asso-ciations are often extensively involved.

Voluntary Standards

These voluntary activities may includ e coop-erative efforts to develop voluntary standards, in-dustry standards, or consensus standards. How-ever, comp aratively few of these standar ds areconcerned with occupational health and safety.

Some voluntary standards are purely advisory;others, because th ey specify certain prod uct at-tributes or dim ensions, are ignored by firms onlyat their peril. For example, some voluntary stand-ards specify the d esign an d d imensions of nuts andbolts. If a firm wishes to manufacture nuts to fitthe bolts of other man ufacturers, the firm mu stfollow the “voluntary” stand ard. Another exam-ple would be the various standards concerning theelectronic components, such as stereo componentsand computers. The use of voluntary standardsin these areas enables consum ers to pu rchase sev-eral pieces of equip men t from d ifferent manu fac-turers and th en hook them together into a smooth-ly functioning system.

Still other “voluntary” standards have beenadopted by Government agencies and now havethe force of law. For examp le, the Na tional Elec-trical Code, developed u nd er the ausp ices of avoluntary organization, the National Fire Protec-

tion Association, is widely u sed as the basis forthe mandatory building codes of many localities(203). Similarly, most of th e existing OSHA safetystand ards, which now h ave the force of law be-hind th em, began as “voluntary” standard s de-veloped und er the ausp ices of the Am erican N a-tional Standards Institute (ANSI). (See discussionin ch . 12. )

The standard-writing work of technical orga-nizations, professional organizations, and tradeassociations is often d elegated to su bgroup s orcommittees. OTA has n ot pr ecisely d etermined

what fractions of the participants in these volun-tary standard -setting grou ps represent emp loyers,manufacturers, labor unions, public interestgroups, government, and others. It is clear, how-ever, that labor and pu blic interest groups havebeen and continue to be und errepresented in the

deliberations of these committees. Small busi-nesses may also be underrepresented.

There are several reasons for this. First, par-ticipation involves the commitment, at the veryleast, of staff resou rces. Oftentim es, unions and

public interest groups lack sufficient staff re-sources to participate. Second, standard-settinggroups have generally been created and staffedby manufacturers and employers, in part becausethese groups began the process in ord er to stand-ardize equipment and designs (the “nuts and bolts”standard s). Labor and pu blic interest group s aregenerally not interested in those issues and do n otparticipate. This historical nonparticipation mayhave carried over into the safety and health stand-ards activities. Third, the membership of the com-mittees is often unbalanced. For example, thecommittee that drafted the ANSI standard for

abrasive blasting operations consisted of 14 man-ufacturer and trade association representatives,6 people from professional organizations, 5 rep-resentatives of government agencies, 3 ind ivid-ual m embers, and 1 person r epresenting a labororganization. Such unbalanced representation notonly provokes questions about the degree of pro-tection afforded by volun tary stand ards, it alsomakes labor and pu blic interest group s hesitateto par ticipate for fear that th eir involvement w illimply app roval of a voluntary standard that theyhad only minimal influence on.

In add ition, voluntary standard s are just that,“voluntary, “ and probably cannot be enforced.Enforcement by a trade association or other orga-nization may violate the antitrust laws. The Su-preme Court has ruled th at companies can ex-change safety-related data an d set standards toprotect the public’s health and safety or to p ro-tect themselves from product liability actions. TheCourt has also cautioned, however, that thestandards must not be used as a guise for ex-cluding comp etitors or for facilitating price fix-ing. The Federa l Trade Comm ission, wh ich sharesauthority for the enforcement of antitrust laws

with the Justice Department, has advised thatcompliance with su ch a standard mu st remainvoluntary. There app ears to be a limited excep-tion to this general ru le-trade associations canrequire members to abide by a standard that isestablished to provide the legitimacy of something



Ch. 15—Incentives, Imperatives, and the Decision to Corftrol . 301

(e.g., a breed of cattle) or to establish a network in which the rules or stand ards are fundam entalto its functioning (e.g., the arrangements sur-round ing the pu rchase of flowers by telephone)(203).

It is not likely, therefore, that a tr ade associa-tion wou ld try to enforce a health or safety stand-ard by excluding an offending company frommembership, organizing a boycott, or taking someother punitive action. It may make efforts to en-courage compan ies to comp ly, but the p ossibil-ity of running afoul of the antitrust laws will makeit stop short of requiring companies to comply(203). Thus even if a comp any follows a recom-mend ation concerning w orker health and safetymad e by a trade association or standards orga-nization, the emp loyer has no assuran ce that com-petitors will follow suit. (Voluntary standards also

play some role in liability actions and the enforce-ment of the “general d uty” clause of the OSH Act(203).)

Moreover, there is concern about the adequacyof voluntary standards, even if they are fullyadhered to by employers. Beyond the commonlack of labor and pu blic interest representationon the committees that write these consensusstandards, some people object to the standardsbecause they often involve a comprom ise amongthe various interests, which may red uce the levelof protection afforded by these standards. In ad -

dition, the employer and manufacturer represent-atives on these committees are likely to agree toa standard that each of them can already ad hereto. They are un likely to ad opt a standard thatwould require large changes in their currentoperations, even if some industry leaders haveachieved higher levels of protection. Thus thesestandard s are likely to rep resent the “lowest com-mon denom inator” of performance within an in-dustry.

Voluntary standards are an important sourceof information for employers, workers, govern-

ment agencies, and others involved in the healthand safety field. They rep resent hou rs of effortby man y pr actitioners and professionals in thisfield and can often be useful sou rces of technicalinformation, especially for defining term s andstandardizing certain technical aspects of meas-urement and control.

Although they can be upd ated more quicklythan OSHA h as tended to rewrite its regulations(see ch. 12), unions and public interest groupsquestion whether voluntary standards are suffi-ciently p rotective. The existence of these stan d-ards m ight bring th e practice of comp anies to a

common level, but, in general, voluntary stand-ards an d th e voluntary app roach will often leadto only limited changes in the health and safetyconditions of the wor kplace.

Provision of Information

The availability of information about occupa-tional hazards and their control is a necessary firststep for many improvements in workplace healthand safety. It may be provided by pr ivate sectororganizations, including professional societies,

voluntary standards organizations, insurancecompanies, employers’ associations, trade unions,universities, and ind ividu al experts. Or it m ay beprovided through the research and disseminationefforts of Federal and State Governm ents. Theavailability of information can combine with theother incentives to prompt employer action. Forexample, a company management committed toimproving job safety and health wou ld u se avail-able information to analyze job cond itions andto make imp rovements. But without both com-mitment and information, no actions will beundertaken.

The provision of information through researchand dissemination is an important activity u nlike-ly to be met by private parties because informa-tion, once disclosed, becomes a “public good. ”This means that the d eveloper of the informationcannot capture its full economic benefit becausethat p erson cannot always charge for the infor-mation. Furthermore, as illustrated by the descrip-tion of a company’s use of computer conferenc-ing (ch. 10), a compan y m ay elect to h old p rivateits safety and health information or to release itonly und er its own terms.

State and local “right to know ” laws, and thedevelopment of an OSHA regulation concerning“hazard commu nication” (labeling) promise toprovide more information to w orkers and em-ployers. The impetus for three laws has been pro-vided by coalitions of un ions, health an d safety




professionals, and public interest groups whobelieve that w orkers and their doctors have a rightto be informed of the identity of substances theywork with and the potential hazards of those sub-stances. Econom ists have also sugg ested that on eway in which the existing market system mayhave failed is by not p roviding workers w ith suf-ficient inform ation abou t hazar ds. In either case,one p ossibility is to requ ire that information beprov ided to w orkers (628).

The new OSHA “hazard comm un ication” reg-ulation requires, among other things, that con-tainers of “hazardous” chemical substances beara label with information on the nam e of the sub-stance and the precautions to be taken. Both thelaws and the OSHA regulation enhance the dis-semination of information to ind ividu al workersin expectation that this will lead to improvem ents

in on-the-job health an d safety conditions. In ad-dition, labels provide imp ortant information to“down-stream” employers who previously hadbeen ignorant about hazards in the materials theypurchase.

One important issue in this area concerns man-ufacturers’ desire to limit the information p ro-vided in order to p reserve trade secrets, such asthe chemical comp osition of a prod uct. A secondissue concerns which substances are deemed “haz-ardous” and who determines this. A third con-cerns the coverage of the laws and regulations.

Do citizens and commun ities, in ad dition to work-ers, have access to this information? And wh atindustries are covered? Fourth, there are questionsabout the relationship between th e new OSHAregulation an d the State and local “right to know”laws. In particular, Federal OSHA is arguing that,in general, its “hazard communication” regulationpr eempts State and local “right to know” laws.All of these issues are being considered in the re-cent legal challenge to th e OSHA regu lation. (Fora general d iscussion of these issues, see 44. )

The increased availability of information on

workplace hazards may serve as an incentive forcompanies to introduce controls. However, whilethe provision of information through both re-search and dissemination is an important firststep, it is not su fficient by itself to guara ntee im-provements in h ealth and safety. It may n ot coun-

terbalance other factors th at affect em ployers’decisions about w hether or n ot to implement con-trols (box Q), which may be more important thana lack of information in explaining why manyemployers have not invested in health and safetyimprovements. (In add ition, as described in ch.12, the OSHA consultation program also providesinformation on hazards and controls to employers. )

Workers’ Compensation and Insurance

Employers may take actions to improve jobsafety in order to reduce the costs of workers’comp ensation and prop erty insurance. The m ostimportant purpose of the workers’ compensationsystem is to p rovide workers suffering from w ork-place injuries and illnesses with medical treatment



Ch. 15—Incentives, Imperatives, and the Decision to Control q 303

and to compensate them for the income lost be-cause of those injuries and illnesses. But the im-provement of occupational safety and health isalso a goal of wor kers’ comp ensation. To the ex-tent that employers, through this system, pay forthe costs of med ical treatment and lost w ages,there is a monetary incentive to redu ce those costs.Thus, emp loyers may install control techn ologiesin order to save on their workers’ compensationpremium s. In ad dition, the insurance comp aniesand the state agencies that p rovide w orkers’ com-pensation insurance often provide services to im-prove health and safety conditions in their clientcompanies.

Similarly, actions to reduce the costs of prop-erty insur ance may coinciden tally benefit workerhealth and safety. For example, preventing firesand explosions in a factory may r esult in lower

property insurance costs, as well as reducing thenumber of workers injured.

The history of workers’ compensation revealsdifferent motives and goals for the various inter-ested grou ps (described furth er in ch. 11). Pro-gressive reformers sought to alleviate the loss of income suffered by acciden t victims and th eir fam-ilies and to encourage prevention. Businesseswanted to stabilize the uncertainties inherent inthe liability system, to limit the growth in the sizeof awards, and to restrict more sweeping socialchanges. They were also interested in prevention,

in part as an ad ditional means to control or re-du ce costs. The N ational Association of Manu-facturers, for example, was very impressed withthe preventive effects of the German compensa-tion system . In their view, the causes of acciden tsneeded to be given equal consideration w ith theconsequences (274). Nearly every contemporaryobserver includes prevention as one of the goalsfor workers’ compensation (30,46,106,131,317,656,657),

Workers’ Compensation and

Occupational InjuriesAlthough many employers and insurance com-

panies believe that workers’ compensation is anincentive for preven tion of occup ational injur ies,the precise circumstances under which this is trueare fairly complex (see, e.g., 656,657). Moreover,

emp irical evidence concerning th e effect of thisincentive is thin.

There are, of cour se, difficulties in estimatingwhat injury rates would have been in the absenceof workers’ comp ensation. In theor y, various sta-

tistical techniques can be used to analyze the ef-fects of particular p rogram s, after ad justing forother factors that influence injury rates. One study(105) found a decrease occurred in the nu mber of certain occupational fatalities at th e same tim ethat wor kers’ compen sation wa s created. Severaloth er stu d ies (53,104,106,107), how ever, ha ve no tfound a favorable effect on injury rates fromworkers’ compensation.

The economic incentive regarding occupationalinjuries is diluted to some extent because manyemployers pay premiums that are based on th e

average experience for their ind ustry or line of business (so-called manual rates). These ratesapp ly, it w as estimated in 1972, to the 85 percentof comp anies that emp loy about 15 percent of thework force (317). These firms are so small thatyear-to-year injury rates vary wid ely purely bychance. Thus, in ord er to ensu re year-to-year cer-tainty of payout by the insurance carriers, as wellas to min imize adm inistrative costs, these com-panies are group ed and pay rates determined fromthe manual.

At the other extreme are firms large enough topr edict with a h igh d egree of confidence their ac-ciden t rates from year to year. Except in Statesthat prohibit it, these firms generally insure them-selves. It has been estimated that less than 1 per-cent of firms self-insure, but that those firmsemploy 10 to 15 percent of the workers includedunder the compensation system (317).

Finally, firms in the middle are “merit-rated,”generally using either “experience-rating” or“retrosp ective-rating,” w hich are method s for ty-ing a firm’s premiu ms to its actual loss experience.Under experience-rating, insurers modify the man-ual or class rate for a firm by its actual accident

experience for th e most r ecent th ree years. Thus,successful efforts to prevent injuries in the cur-rent year w ill lead to prem ium savings in the fol-lowing three years. As the firm’s size increases,mor e weight is given to the compan y’s actual ex-perience and less to the employer’s class or indus-



304 Preventing Mess and Injury in the Workplace

try average (409,656). Under retrospective-rating,the emp loyer pays for losses up to sp ecified ceil-ing limits and the insurer pays for losses abovethe ceiling. Thus this plan “provides the firm witha combination of insu rance and self-insu rance”(656,657).

In addition, premium discounts are given tolarge policyholders an d some insurance compan iesp ay dividend s to their policyholders (682). Thesedividends can be either “flat rate” (the same toall policyhold ers) or “sliding scale” (higher ratespaid to employers with better loss records an d tolarger p olicyhold ers). The sliding scale plan s, be-cause they tie dividen ds to th e loss experience of firms, m ay p rovide safety incentives (657).

Although the rates for small companies are gen-erally not d irectly based on th eir experience, if such a firm has a p articularly bad r ecord it mightbe placed in an “assigned risk pool,” with a cor-respondingly higher p remium . Small firms withvery good records, how ever, generally d o not re-ceive a reduction in th eir prem iums (317).

A primary goal of insurance is to spread risksamong employers, thu s preventing, for a givenemp loyer, a very large or catastrop hic loss in anyone year. The losses to be paid out are made,through insurance arrangements, into predicta-ble and regular annual payments. Moreover,when the pooling of risks places safe employersin the same group with less safe employers and

both ha ve the same prem ium ra te, the less safewill not have any incentive to imp rove perform-ance. Thus, the goal of insurance or loss spreadingacts to d ilute the incentive provided by w orkers’compensation.

Although this effect has been often noted, thedegree of dilution is unclear because, althou ghmost emp loyers d o not ap pear to be experience-rated, most emp loyees work for emp loyers wh oare. Moreover, as Victor (656) has shown, the sizeat which a firm becomes eligible for experiencerating varies dramatically among industries,

largely because of the differences in injury ratesamong indu stries. Finally, although most em ploy-ees work in firms that have some form of experience-rating, it is difficult to determine whatportion of all occupational injuries and illnessesoccur in these firms.

There have been only a few empirical studiesof the effects of experience-rating on injury rates.Russell (409) found that large firms, which aregenerally experience-rated, had lower injury ratesthan medium-sized firms. But she also found thatsmall firms had low injury rates as well, even

though they, as a group , are not experience-rated.Two other pu blished stu dies have not been ableto isolate any measu rable effects for the experi-ence-rating system used in workers’ compensation(109,464).

A second limitation on the safety incentive pro-vided by workers’ comp ensation is found in thebenefit levels. Emp loyers’ incentives ar e d irectlyrelated to the degree that the workers’ compen-sation system prov ides for the full social costs of injuries. Generally speaking, w orkers’ comp en-sation pays th e med ical expen ses associated w ith

the injury bu t only a p ortion of the employee’slost wages.

The States generally replace two-thirds of lostwages u p to a maximum amoun t or ceiling. Thisreplacement, however, is usually based on the em-ployee’s wages just before the injury and are oftennot adjusted for potential increases in the em-ployee’s earnings over his or her career. In addi-tion, many States have m andatory waiting peri-ods or m inimum lengths of time that a d isabilitymu st last before any p ayment w ill be made. Al-though workers’ compensation benefits are not

taxable, the system d oes not rep lace lost fringebenefits, which have become an increasinglylarger portion of employee wage packages in thelast decade. Moreover, the ceiling on paym entsis frequen tly so low th at many wor kers receivemuch less than the theoretical two-thirds replace-ment. It was estimated that during the late 1960s,workers’ compensation had a median wage-replace-ment rate of only 50 percent (52). More recently,a grou p of researchers found earnings-replacementrates of 46 percent, 59 percent, and 75 percent inCalifornia, Florida, an d Wisconsin (81). But it isnot clear to what extent this applies to other

States.

Furthermore, as a general rule, workers’ com-pen sation replaces only lost earnings. It does n otusu ally compensate for “pain and suffering” oreven the loss of physical capabilities that do not



Ch. 15—Incentives, Imperatives, and the Decision to Control 305

directly result in loss of earning s (260). “In [work-ers’] compensation . . . the only injuries com-pensated for are those w hich p rodu ce disabilityand th ereby presum ably affect earning pow er”(144). One example of this are injuries that arelimited to damage to the workers’ reproductive

system. The States generally do n ot allow com-pensation for this because such dam age does notredu ce the w orkers’ earning pow er (144,260). Inthese cases, injured and ill workers are not fullycompensated.

How ever, in nearly all of the States, workerswith certain kinds of perm anent p artial injuries(e.g., loss of a h and or leg) receive comp ensationpayments based on schedules of fixed dollaramou nts for the p art of the body affected. (Fora list of these, see 484. ) For th e sam e injury, allworkers receive that same payment, even if their

wage levels d iffer. Thus, compensation for per-man ent p artial injuries is often not d irectly tiedto an ind ividu al’s lost wages, although the pay-ments m ay ultimately be based on the averagewa ges of all workers.

A third limitation is that som e occupa tional injuries (and most occupational illnesses) are notcompensated at all because the worker fails to filea claim, Some of these w orkers become depen-dent on other social insurance programs (e.g.,Social Security) or pension programs that providedisability benefits. Although this is mainly a prob-

lem for occupational diseases (see discussion inth e next section) it may also be a factor for oc-cupational injuries.

Based on d ata from the 1972 Survey of Disabledand Non-Disabled Adu lts, a Departmen t of La-bor rep ort (596) conclud ed that only 43 percentof people severely d isabled by work -related in-

juries received workers’ compensation payments.Severe d isability was d efined as complete inabilityto work. The work-related disabilities were deter-mined by analysis of survey responses and thu sthe results of these surveys need to be interpretedcautiously.

An analysis of a similar survey cond ucted in1978 found that on ly 33.1 percent of those w hosemain d isability was d ue to an on-the-job injurywere currently receiving workers’ compensationbenefits (437). This analysis also found that work-

ers’ compensation appeared to provide only 22.5percent of the income maintenance for thosetotally disabled b y occupationa l injur ies. The re-maining three-quarters of their su pp ort came fromSocial Security, employer/ union retirement anddisability fun d s, veterans’ benefits, private insu r-

ance, welfare, and other sources. Workers’ com-pensation should not necessarily be “charged”with replacing all the lost income of injured work-ers if other factors contributed to the totaldisability. It is, however, surprising that most of the income support for this group comes fromother sources, Employees and other public wel-fare programs thus may be bearing much of thecost of occupa tional injuries (437).

These results may occur because the disabledworkers did not apply for workers’ compensationbenefits, because no benefits were ever awarded

or because the workers’ compensation benefits ranout while the disability remained. Further researchis needed to d etermine the factors that contrib-ute to this app arently inadequ ate comp ensation.But from the standpoint of evaluating the incen-tives of workers’ compensation for prevention,the conclusion is the same. To the extent th at thesecosts do not enter th e workers’ comp ensation sys-tem, employer prem iums w ill not rise, and em-ployers d o not face the full financial incentive toreduce the incidence of injuries and illnesses.

Finally, one other factor may influence the

safety incentives provided by the workers’ com-pensation system. As is discussed later in thischapter, under certain assumptions it is possiblethat employers may pay w orkers additional wagesin order to attract them to hazard ous jobs. If theseadditional wages or hazard premiums do exist,the creation of a workers’ compensation systemmay lead only to reductions in the hazard prem i-um s. In effect, compensation wou ld sh ift frombefore the accident to after the accident, and fromall exposed workers to those who incur injuries.

However, this shift may not result in any

change in injury rates (131,151,300). Three recen tstudies (83,150,151) have found, in fact, that in -creases in workers’ compensation costs and bene-fits are associated with decreases in employeewa ges. Tw o of these stu dies (150,151) foun d thatincreases in workers’ compensation costs were,




at least for nonunion workers, completely offsetby decreases in employee wages. This result im-plies that for these employees, workers’ compen-sation has no net effect on employer safety in-centives.

Workers’ Compen sation andOccupational Disease

As opposed to th e situation regarding work-place injuries, most observers agree that man ycases of work-related disease fail to enter theworkers’ compensation system. It is clear that anyeconomic incentive provided by workers’ compen-sation w ill be red uced su bstantially if only a fewoccupational illnesses are compensated. However,representatives of the insurance industry claimthat on ly a few occup ationally related d iseases gouncompensated (285,286).

There have been several estimates of the num-ber of cases of occupation al disease that are com -pensated. Data collected by the Bureau of LaborStatistics in the Supp lementary Da ta System su g-gest that only 3 to 3.7 percent of all first reportsof workers’ compensation concern an occupation-al disease. Barth an d Hu nt (46) report that the p er-centage of all comp ensation cases that concernedoccup ational diseases ranged from 0.1 percent to5.5 percent for the 12 States for w hich d ata w ereavailable in 1975. Half these States fell in th e ran gebetween 1 and 2 percent. They also report the

results of a large survey conducted by Coop er &Co. of 44,066 workers’ compensation cases in thefall of 1975. Abou t 0.8 percent of the cases con-cerned on-the-job heart attacks and about 2.1 per-cent were related to other occupational diseases.

Because there are n o firm estimates of the totalnumber of occupational disease cases, it cannotbe said with certainty that this range of 2 to 4 per-cent means the compensation level for disease istoo low, too high, or just right. However, as men-tioned in chapter 2, the number of all work-relatedcancer cases currently reported to worker’s com-pensation agencies is substantially less than thenumber of cancer cases estimated to be caused byoccupational asbestos exposure. In addition, be-cause of th e d ifficulties faced by an yone filing aclaim for occup ational d isease compensation (dis-cussed in th is section), it is probable that manydisease cases go u ncompensated.

Barth and Hunt (46) describe a number of scien-tific, legal, and regulatory barriers that impair thecertain and timely compensation of occupationalillnesses. They note that the system provides a bi-furcated respon se to d isease claims. Those thatare readily connected to workplace exposure and

that ar e relatively inexpensive (e.g., acute d erm a-toses) are compensated much like accidental in-

juries. Disease claims that involve serious dis-abilities that are less clearly linked to w orkp laceexposures (e.g., chronic respiratory disease) aremarked by extended controversy and long waitingperiods between a claim being filed and first pay-ment. Moreover, these cases create a dispropor-tionate amount of administrative costs for the sys-tem. They note th at “[f]or su ch claims th e systemretains m any of the un desirable features of the tortsystem that workers’ compensation was sup posedto sup plant” (46).

For occupational illnesses that manifest them-selves only after a latent period of years there maynot be a stron g economic incentive for p reven-tion. Firms contemplating an investment that w illreduce their workers’ compensation payments 20to 30 years from n ow (or even paym ents for prod-uct liability, as discussed later) can invest themoney elsewhere for a better return. That alter-native investment m ay be more profitable thanthe possible reduction in future compensationcosts. Moreover, the firm may not even be in ex-istence in 20 or 30 years, and i ts man agers wi llalmost certainly have changed. Thus a firm mayfail to take actions to prevent occupational illness.On the other han d, the threat of having an oc-cupational disease disaster similar to that associ-ated with asbestos may ou tweigh this f inancialcalculation (286).

A number of State statutes and interpretationsof them imped e compensation for occupationaldiseases. For examp le, some States h ave restric-tive definitions that make it difficult for diseasevictims to receive compensation. Most States haveabandoned or gone beyond the “schedules” or listsof occupational diseases, which were often undulyrestrictive (such as textile producing States thatdid not list byssinosis on their schedules, or coalmining States that d id not compensate coal work-ers’ pneumoconiosis). Many States, however,den y comp ensation for “ordina ry d iseases of life”



Ch. 15–incentives, imperatives, and the Decision to Control q 307

and will comp ensate only those that are “pecu-liar or particular” to som e line of work . This ru lehas been ap plied even for occup ations that facean increased risk of contracting an “ord inary d is-ease of life. ” Legal strictures concerning timelimitations and the requirements for proving

causation also create difficulties for compensatingpeople with occupational diseases (46,261).

The Surveys of Disabled and Non-DisabledAdu lts provide some information concerning thesources of income for people disabled by disease,though, as mentioned earlier, the self-identifica-tion of “job-related” diseases mean s care must betaken in analyzing th e results. The 1978 surveyshowed that of those who attributed their disabil-ity to bad working conditions, only 21.8 percenthad ever app lied for workers’ comp ensation, asopposed to 64.4 percent for on-the-job injuries.

This application rate was static between the 1972,1974, and 1978 surveys (437).

Th e 1972 survey found that of those whothought their disabling illness was du e to work-place cond itions, only 3 percent w ere receivingwor kers’ comp ensation. The 1974 figur e is essen-tially the same-5 percent (596). By 1978, of thoseciting “bad working conditions, ” about 13 percentwere receiving workers’ compensation benefits,compared with 33 percent for those with job-related injuries (437). Althoug h ab out 23 percentof total income rep lacement for job-related injuries comes from workers’ compensation, fordisabilities du e to “bad wor king conditions, ” thefigure is about 12 percent. Nearly half the incomemaintenance for this disease-disabled group comesfrom Social Security Disablity Insu rance. Theseestimates have been criticized for various reasonsrelated to the d esign of the survey, the size of thesurvey population, and the use of self-reportingto describe both health conditions an d the work-relatedness of those conditions (214,285,680).

How ever, more d etailed stud ies of two well-know n occup ational hazards, asbestos and cot-ton du st, supp ort the general conclusion that most

of the income su pp ort for workers d isabled by oc-cupational illnesses does n ot come from the w ork-ers’ compensation system (217,431). Because bothasbestos and cotton dust have been clearly linkedto occup ational disease and have received wid e-spread public attention, they represent the “best

cases” for the compensation of disease by theworkers’ compensation system.

A stud y (431) of a grou p of insulation w orkerswh o died from asbestos-related d isease found thatof those wh o stopped wor king because of their

terminal illness, two-thirds never filed fordisability benefits from wor kers’ compensationbefore their death s. Of the claims that w ere filed,nearly half were still pend ing at the time of theworkers’ deaths. When there was a survivingwidow, claims for death benefits were filed infewer than half the cases.

In add ition, workers’ comp ensation w as the soleor primary source of medical benefits for onlyabout 4 percent of these workers. The workersand their families app ear to have relied on unionwelfare funds, Medicare, other private insuranceplans, and their own savings to pay for the med-ical costs of asbestos-related disease. A tort lia-bility su it was filed in fewer than one-fifth of thecases for which data were available. In only 9 per-cent of the cases did the worker or spouse file botha claim for workers’ compensation and a lawsuit.In over half the cases (57 percent), neither a work-ers’ compensation claim nor a liability su it wasfiled. The m ost imp ortant factor in explaining thefailure to file for workers’ comp ensation ap pearsto be “ignorance, either of the source of the dis-ease or of the legal rights of survivors to compen-sation. ”

Johnson and Heler (236) have calculated the ex-pected m onetary losses for the families of theseworkers. They estimated that the gross loss dueto disability and death from asbestos-associateddisease amou nted to over $250,000 per family.Half the widow s they stud ied received no bene-fits at all. The other half received a variety of ben-efits. About 28 percent of these benefits came fromwor kers’ compensation, w hile 16 percent camefrom tort suits and settlements. The remaindercame from Social Security, private p ensions, andveterans’ benefits. John son an d Heler also calcu-

lated th e net finan cial losses for these families. Onaverage, the w idows wh o received benefits hadapproximately one-third of their losses replaced.

In theory, through the workers’ compensationsystem, emp loyers bear the costs of occupationa ldisease. But for this group of workers, about 85




percent of the gross wage loss was borne by thefamilies of the affected workers. Of the small por-tion of lost wages that were rep laced, less thanhalf were paid for by employers through work-ers’ comp ensation and by prod ucers through tortsuits and settlements.

Hughes (217) has similarly studied income re-placement for a group of workers exposed to cot-ton du st who d eveloped byssinosis, He found thatworkers’ compensation replaced only 6.9 percentof the estimated lost income for this group. Fortypercent of lost income was replaced by funds fromSocial Security, 3.5 percent from Veterans Admin-istration benefits, and 2.6 percent from privatepension plans. The total income replacementamou nted to about 53 percent of expected earn-ings. “Even w ith Social Security fun ds in crisis,it is apparent that a massive shift of costs has been

mad e from the emp loyers to the general taxpay-ing public, due to an almost nonexistent work-ers’ compen sation system—a form of pu blic sub-sidy to disease-producing industries . . . “ (217).

Role of Insurers

Beyond the incentives faced by private employ-ers, insurance carriers might h ave an in depen d-ent financial incentive to prevent injuries and ill-nesses. If an insurance company can improve theloss experience of its policyholders, it maybe ableredu ce the amoun t that mu st be paid out in claims.

In practice, however, this incentive is limited,too. Low benefit levels reduce the incentives toinsurers just as they reduce the incentives to em-ployers. In addition, if the merit-rating system isworking properly, insurers will have little incen-tive to improve the loss experience of firms thatare fully merit-rated. For such companies, the ben-efits of reduced claims will be received by the em-ployer.

Insurers will receive an independent benefitonly if they can cut losses in the time period beforethe prem ium s are adjusted by the experience fac-

tors. Insurers will also benefit if they can reducethe losses for firms that ar e not fully merit-rated.However, insurance industry representativesargue that red uced rates are important for attrac-ting and holding customers, and that maintain-ing customers is a powerful incentive for reduc-ing claims and therefore rates (286).

In fact, many insurers provide loss-control serv-ices to their policyholders. The results of onesurvey imply that p rivate insurers and State work-ers’ compensation fun ds provid ed a total of 1.6million such visits to policyhold ers in 1974. Pri-vate insurers provided 1.5 million of these visits

(472,473). More recently it has been estimated thatthe insurers who are members of the two majortrade associations (the Alliance of American In-surers and the American Insurance Association,or AIA) emp loyed about 8,600 loss-control spe-cialists in 1983, while independent firms addedabout another 1,000, for a total of 9,600. The8,600 specialists working for the m embers of thetwo associations conducted about 1.5 millionvisits to policyholders. It is also estimated thatabout 177,000 samples of suspected toxic sub-stances were analyzed in 1983, while approx-imately 40,000 policyholders participated in train-

ing program s provided by the Alliance and AIAmember companies (286).

Some of the expenditures for “loss control” areexpenses for inspecting workplaces in order to de-termine the nature of the op erations and to setpremiums (30,473), rather than to suggest or man-d ate p reventive actions. Little statistical inform a-tion is available to determ ine the percentage of insur er visits that are p rimarily for collecting in-formation for rate-setting and the percentage of visits that provide safety advice (473).

Aside from this rate-setting activity, insurershave offered loss-control services as one way of comp eting in an industry th at until recently wassubject to detailed price and service regulation byState agencies. In general, that regu lation did notallow insurers to compete by charging differentrates. It is not clear wh at effect various efforts to“deregulate” this ind ustry w ill have on the pro-vision of loss-control services (268).

However, although insurers do provide consul-tative services to their p olicyhold ers, they gener-

ally d o not gran t rate decreases to emp loyers whoaccept such services. It is likely that the adviceprovided by insurers has a positive effect onsafety, but this effect may be limited b y fear thatthe emp loyer, a valued client, will simp ly chan geinsurance companies rather than make a large ex-penditu re for health and safety controls.



——

Ch. 15—Incenfives, Imperatives, and the Decision to Control q 309

To the extent that occupational d iseases do n otenter the comp ensation system, there is no finan -cial incentive to prevent them, either on the partof the employer or the insurer. Compensation forillnesses will also be discounted substan tially be-cause of the latent period between exposure and

disease manifestation. The insurance indu stry,how ever, maintains that it is taking steps to avoidfuture occupational disease disasters similar to theasbestos situation (286,675).

Changes in Workers’ Compensation

In pr actice, the w orkers’ comp ensation systemonly p rovides a limited econom ic incentive forpr evention, esp ecially for occup ational illnesses.Changes have been suggested to improve eco-nomic incentives provided by this system. Theseinclude increasing the degree of experience-rating

in the compensation system (317), instituting em-ployer d edu ctibles or copayments for the first $500of compensation expenses (449), and changing theFederal income tax deductions allowed for work-ers’ compensation premiums (228). However, be-cause workers’ compensation is currently admin-istered by the States, the first two suggestionswou ld involve changes in each of the States orcreation of a single Federal system.

Moreover, the effects of the suggested changesare not completely clear. For example, Victor(656) suggests that the creation of employer de-

ductibles might increase the incentives faced bysome employers while decreasing the incentivesfaced by other emp loyers. The net effect on in-

juries is u nclear. In a dd ition, increasing th e eco-nomic incentives of workers’ compensation couldincrease emp loyers’ incentives to contest claims,as well as their incentives to prevent illness andinjur y. Finally, man y of the limitations of injurytaxes (discussed in ch. 16) also apply to these sug-

gested changes in the workers’ compensationsystem.

There has been considerable recent discussionconcerning the possibility of creating a Federal

system to comp ensate for occup ational exposur esto asbestos (517). Prevention sh ould be a consid-eration in any changes in compensation. A com-pensation system shou ld be designed to “inter-nalize” the costs of disease. In other words,

prod ucers and emp loyers shou ld bear the costsof occup ational disease (14). How ever, the u se of Federal funds to supplement an occupational dis-ease fund may dilute this incentive. If Congresstakes action concerning occupational disease com-pensation, this action could include a requirement

that companies take concrete steps to preventfuture cases of disease.

Tort Liability

The effects of court-enforced tort liability onemployer practices concerning health and safetyhas been highlighted by the large number of law-suits concerning worker exposure to asbestos (boxR). In particular, attention has focused on thewell-publicized case of one su pp lier of asbestos,the Manville Corporation (formerly Johns Man-

ville), wh ich h as filed for a corpor ate reorgan iza-tion u nd er the bankrup tcy laws because of theburd en of paying n um erous liability suits. Fac-ing the th reat of potentially costly lawsu its andlarge awards for damages, employers and manu-facturers may take action to improve workplacehealth and safety.

As discussed in chapter 11, before the passageof workers’ compensation laws in the early partof this centu ry, injured w orkers could sue theiremployers for damages. They encountered sub-stantial difficulties in winning these suits, how-ever. Workers’ rights to sue their employers weregreatly restricted with the creation of the work-ers’ compensation system. For most cases of oc-cupational injury or illness, workers are notallowed to sue their emp loyers for such compen-sation. Instead, the workers’ compensation sys-tem, in theory, provides a specified level of ben-efit that is awarded to pay medical costs andcompensate for lost wages.

In general, the law of torts provides the op por-tunity to su e for mon etary compensation wh enprop erty has been dam aged or a person has beeninjured, but precisely defining the field of tort law

is difficult. One noted scholar has w ritten:

A really satisfactory d efinition of a tor t has yetto be found. . . . Included under the head of tortsare a miscellaneous group of civil wrongs, rang-ing from simp le, direct interferences with the per-




I

Asbestos Use

19s0. .-,



textile fibers, and polypropylene fibers.

son . . . or with prop erty . . . up through vari-ous forms of negligence. . . The law of torts . . .is concerned with the allocation of losses arisingout of hu man activities. . . So far as there is [ageneral p rinciple] . . . it would seem that liabil-ity must be based u pon conduct which is sociallyun reasonable . . . or unreasonable interferencewith the interests of others . . . (Presser. Quotedin 379).

Baram (379) notes th at controv ersies involvingrisks to h um an h ealth h ave trad itionally involvedlegal concepts grouped und er tort law. Four areasof tort law have been used to resolve controver-sies that involve such risks: negligence, productliability, nuisance, and strict liability. Of these,negligence, product liability, and strict liabilityare applicable to issues of workplace health and

safety.Negligence has been defined as “conduct which

falls below th e standard established by law forthe protection of others against unreasonable risk of harm. ” To maintain a suit based on negligence,four elements must be shown: the existence of alegal du ty or obligation to protect people fromharm , a failure to conform to that d uty , a prox-imate causal connection betw een that failure an da resulting injury, and an actual injury (379).Under the general doctrine of negligence, a per-son can be held liable for an injury if he or shefailed to act in a “reasonable” way to p revent th einjury.

Product liability developed out of warrantylaw. The courts have ruled that manufacturers

and sellers imp licitly warrant that their pr odu ctsare suitable and safe for all reasonably anticipated

uses. Whether or not th e seller wa s legally negli-gent is irrelevant in this situation because the veryfact of the d efect indicates a breach of the w ar-ranty (203).

Under strict liability , the m anu facturer is lia-ble for injuries resulting from a d efective prod -uct that is unreasonably dangerous, without re-gard to fault or contractual limitations. Here, thed egree of diligence or care in preven ting injuriesis immaterial (203). Strict liability has traditionallybeen used for “ultrahazardous” or “abnormallydangerous” activities (42). In recent years, thecourts have adopted in the field of produ ct lia-bility law some of the concepts of strict liability.In fact, product liability suits can be based onnegligence, warranty, and strict liability. Liabil-

ity is now applied in cases where: 1) a prod uctwas defectively designed, 2) a product was defec-tively manufactured, or 3) a product was soldwithout p roper w arnings concerning its use anddangers.

The “duty to w arn” has been the basis for man yof the successful lawsuits concerning asbestos ex-posures, in which courts have ruled that the man-ufacturer h as an obligation to take reasonable ac-tions to discover the hazards associated with aprod uct and to w arn accordingly. This du ty mayinclud e sp ecialized testing (69):

The manufacturer is held to the knowledge andskill of an expert. . . [This] means at a minimu mhe must keep abreast of scientific knowledge, dis-coveries, and advances and is presumed to knowwhat is imported thereby. But even m ore impor-tantly, a manufacturer has a duty to test and in-




spect his product. The extent of research and ex-periment must be commensurate with the dangersinvolved.

By far the most common use of tort actions inoccup ational safety and health are suits againsta third party—for example, the manu facturer of

products purchased by the employer for use inthe workplace. Thus, employees injured by a mal-functioning pu nch press can sue the m anufacturerof the press, while employees who used asbestosin their work can sue the manufacturer of theasbestos product. Because the ill or injured workeris not directly employed by th is third party, law-suits concerning work-related illness or injury arenot prohibited by workers’ compensation laws.

Although many employers are concerned aboutlegal liability, in most cases it does not directlyaffect them as employers. Rather, it affects the

prod ucts that they sell to consumers or to otheremp loyers. In 1978 it was estimated that w hileonly 11 percent of all prod uct liability award s in-volved work-related injuries and illnesses, thesecases accounted for 44 percent of the total d ollarsawar ded for prod uct liability (228).

This slightly roundabout approach of third-party su its may lead ultimately to impr ovementsin working conditions and in the health and safetyof the work force, but a num ber of factors limitits effectiveness. The first is that it d oes not app lyto employers, even in cases in which the employermay h ave been in the best position to ensure thatthe equipment and products were being used ina safe and healthful fashion. In these cases, themanufacturer is still held responsible.

Other limitations on the usefulness of third-party su its are found in the traditional degree of proof demanded by the courts in liability actions.This burd en of proof is often very d ifficult for theworker, especially in cases of occupational dis-ease. The problems employees can encounterinclude:

It is difficult to prov e (or even recognize) that

harm has occurred when a disease, such ascancer, may be caused by many factors, in-cluding occupational ones.The isolation of the produ ct or prod ucts that“caused” the harm is difficult, especially if there are harmful interactions with other

q

q

q

products, or when the proof for the causalconnection is only through statistical in-ference.The long periods of time that often elapse be-tween exposure and effect make the causalconnection and the identification of products

and manufacturers much more difficult.Even if the manufacturer can be identified,the firm may have gone out of business, becurrently u np rofitable, or otherw ise not ableto pay damages.In some States, statutes of limitations barsuits for d amages beyond a certain length of time (generally 3 to 10 years) after the lastexposure to the ha zard , even if the diseaseonly manifests itself 20 or 30 years later (203).

As noted earlier, State workers’ compensationlaws generally bar suits by employees against their

employers, although there are several exceptionsto this. First, any emp loyer that is not coveredby the State workers’ compensation law may besued. Some employment categories that com-monly fall in this group are agricultural employ-ees, domestic servants, employees of very smallbusinesses, railroad w orkers, and emp loyees of charitable organizations (407).

Second, courts may grant employees “injunc-tive and declaratory relief. ” In one case, Shimpv. New Jersey Bell Telephone Co., an employeeobtained a court injun ction to requ ire the employ-

er to p rohibit smoking in general working areas.The court ru led that such an injunction would notbe barred by th e workers’ compensation law of New Jersey and that the employee, who was al-lergic to cigarette smoke, had a common-law rightto a healthful w ork environm ent. It is not clearwh ether other courts will also adop t this reason-ing (407).

Third, in nearly all States work ers can sue em-ployers for damages in cases of willful or inten-tional acts. This includes situations in which theemployer actually intended that the emp loyee be

injured, as well as cases that involve fraud ordeceit. by th e emp loyer. For examp le, if an em -ployer d eliberately conceals from a w orker infor-mation concerning a work-related illness, employ-ees may be successful in collecting damages fromthe employer. The West Virginia Supreme Court



Ch. 15—Incentives, Imperatives, and the Decision to Control q 313 —

extended this rule to cases of willful, wanton, orreckless employer misconduct (407), although thiswas su bsequently restricted by a new State law(2,342).

Fourth , in some jur isdictions an emp loyer maybe sued by an employee when acting in a “dualcapacity. ” The three m ain typ es of dual capacitycases involving workplace health and safety issuesare based on the obligations of the emp loyer asland owner, medical practitioner, or seller of prod ucts. Thu s an emp loyer, for example, whooffers an on site medical service and wh o negli-gently treats an emp loyee maybe sued for medi-cal malpractice. Similarly, an em ployer m ay alsobe sued by a w orker for injuries or illnesses in-curred due to a product manufactured by the em-ployer. It should be noted that only a minorityof jur isdictions curr ently allow su ch “du al capac-

ity” suits (407).It has been suggested that emp loyees be allowed

to sue th eir employers. For exam ple, Amchan (2)has pr oposed that w orkers and their families beallowed to sue emp loyers if the worker is killedor p ermanently d isabled d ue to the “willful, in-tentional, or grossly negligent conduct” of the em-ployer. Although such change might enhance em-ployer incentives for pr evention, it would alsohave a n um ber of social, legal, and economic im-plications that need to be considered carefully.

The future im por tance of tort liability as an in-

centive to control workplace hazards is unclear.Although mu ch attention has been given to th ecircumstances of asbestos exposure, asbestos maynot be typical. Currently the prohibition of mostemployee suits against employers severely weakensthe incentive. In add ition, the p ractical problem sof proving causation w ill tend to limit to just afew hazards the lawsuits by workers against sup-pliers.

Congress is currently considering legislation tochange certain aspects of product liability law. Assuggested earlier for changes in workers’ compen-

sation it is important that the effect of thesechanges on incentives for prevention be consid-ered carefully,

Labor Market Forces, CollectiveBargaining, and Workers

sRights

To some extent, employers are m otivated to im-prove em ployee health and safety because of pres-sures from the labor market. Economists since

Adam Smith have hypothesized that employerswou ld have to p ay more to attract workers to jobswith u nsafe conditions or other adv erse workingcond itions. In theory, if there is complete infor-mation about w orkplace hazard s and alternative

job opportunities, employers may find that theycannot attract enough workers. There are thentwo ba sic choices—raise the w ages or red uce thehazard s. Thu s, the possibility exists that this la-bor market pressure may induce improvementsin employee health and safety.

The paym ent of add itional wages for occupa-

tional risks can be seen in the existence of “haz-ardou s du ty pay” in certain high-risk occup ations.But th ese add itional wages ma y also be built intothe general pattern of wages for an ind ustry oroccup ation. In this situation, they wou ld not bedirectly observable, but w ould be includ ed as partof the total wage. The add itional wages paid forworkers exposed to occup ational risks have beentermed “hazard premiums” or “compensatingwage d ifferentials. ” In theory, various statisticaltechniques could be used to separate the factorsthat determine w ages, thus testing whether a “h az-ard premium ” existed and determining its size. In

pra ctice, the d ata are d ifficult to an alyze becauseof problems in measu ring job risks and in ad just-ing for other factors tha t influence wages.

To date, the published stud ies on th is questionhave generally found compensating wages for in-creased risks of death, but are inconsistent onwh ether there are also compensating w ages forincreased r isks of nonfatal injur ies. In fact, sev-eral studies have found, contrary to expectations,that some grou ps of w orkers were not receivingcompensating wages. In some cases hazardouswork was associated with lower wages (138,192).

Moreover, even the stud ies that have found in-creased wages for hazardous work have not beenconsistent on the size of these increased wa ges or




the im plied “value of life.” (See ch. 14 for a tablepresen ting this wid e range of values. For reviewsof this literatu re, see 191 and 448. )

In addition, employers may find that theirworkers are quitting soon after starting work be-cause of unsafe or un healthful w orking conditions(658a). Efforts to reduce such turnover and to im-prove emp loyee morale may lead to investmentsin health and safety controls.

Of course, all these labor market pressures arevitally dependent on the existence of alternative

job opportunities. In areas and times of high un-employment, this incentive to control hazards willbe substantially reduced. Moreover, other labormarket imperfections, such as incomplete infor-mation about job hazards, the costs of searchingfor jobs, and unequal bargaining power also limitthis incentive.

Collective Bargaining Agreements

Negot iation and collective barga ining can alsobean incentive. This requires that un ions be com-mitted to the recognition of health and safety con-cerns and assign high p riority to these issues incollective bargaining. Other important union obli-gations for the success of this strategy include be-ing fully informed about OSHA regulations, en-forcement procedures, and employee rights underth e OSH Act. In addition, the union must estab-lish a system to monitor employer actions, usu-

ally through safety stewards or trained local rep-resentatives, as w ell as develop pr ocedu res forhazard identification, managemen t negotiationprocedures, enforcement of committee findings,and rank-and-file feedback about these findings(253).

Labor un ions can exert influence because th eirrepresentatives can be present for all plant oper-ations, every working day. However, because thecollective bargaining process involves a processof negotiation and compromise, unions may m aketradeoffs between economic benefits (including

greater wages, job security, and fringe benefits)and more attention to occup ational hazards.

There are app roximately 150,000 separ ate col-lective bargaining agreem ents in the United States,and 82 percent of these contain som e reference

to health and safety. Apparently, emphasis onthese issues at the plant level has increased dur-ing the last d ecade. This may be because of a belief “that control and prevention of job hazards canbe improved through the combination of more ef-fective OSHA rules, regulations, and enforcement

programs with trade union programs, includingmore effective collective bargaining contracts andtheir administration” (185).

The Bur eau of National Affairs (BNA ) has tab-ulated the m ajor p rovisions in ov er 5,000 collec-tive bargaining agreements and analyzed closelya representative sample of 400 contracts (77).Table 15-1 illustrates th e frequency of h ealth an dsafety provisions in collective bargaining languagefrom 1954 through 1981. Until 1971, accordingto the BNA, there was only a slight increase inthe prevalence of such provisions: for example,

from 38 percent of contracts in 1954 requ iringmanagement to “take measures” to protect thework ers to 42 percent b y 1971. The on ly type of contract provision that showed more than a slightincrease was tha t for safety comm ittees.

Passage of the OSH Act in 1970 coincided withan increase in the number of contracts that in-clud ed h ealth and safety clauses, and the pr ovi-sions became increasingly specific. The overall fre-quency of safety and health clauses between 1954and 1970 had remained between 60 and 65 per-cent, but by 1975, 82 percent contained such

clauses. There w as also an increase of 11 percent-age points in clauses requiring employer com-pliance with laws from 1971 to 1975.

The general statement of responsibility in mostcontracts states that the comp any m ust m ake “rea-sonable prov ision for the health an d safety of theemployees, “ wh ich app ears to be redund ant withthe general d uty clause of the OSH Act (see ch.12). Moreover, 29 percent of the contracts in 1981required the comp any to comply with p resentlegal standards. These provisions enable localunions to use the grievance process (an internal

dispute mechanism negotiated by labor and man-agement for the resolution of employee com-plaints) to change or influence health and safetyconditions, in ad dition to filing an OSHA com-plaint.



Ch. 15—Incentives, /imperatives, and the Decision to Control q 315

Table 15-1.—Percentage of Contracts Containing Health and Safety Clauses, @ 1954-81

Company obligation Employee obligation Other

To meet To provide To provide Must wear provisions

To take legal safety first-aid safety Must obey SafetyYears Clauses measures standards equip ment equipmen t equipment safety rules committees

1954 . . . . . . 600/0 380/ o 13 ”/0 270/o 11 ”/0 7% 17“/0 180/01961 . . . . . . 65 34 11 32 16 7 11 28

1966 . . . . . . 62 35 NA 28 12 6 8 291971 . . . . . . 65 42 15 32 14 7 13 311975 . . . . . . 82 50 26 36 21 NA NA 391981 . . . . . . 82 50 29 42 21 NA NA 43

%cmsiderable overlap was noted in all categoriesNA—Not available

SOURCE (77)

Joint Labor-Management Health andSafety Committees

Joint committees vary in structure, organiza-tion, and capacity for intervention. The role of the committee ranges from a limited monitoring

of workplace routines to a strong source of pres-sure on workers, union, management, and OSHA.The proportion of contracts with a clause con-cerning health and safety committees rose from18 percent in 1954 to 43 percent in 1981, with mostof the increase following p assage of the OSH Act(see table 15-1).

The growth in labor-managem ent safety andhealth committees may represent an attempt onthe part of both labor and management to resolveissues at th e local level. An imp ortant factor ina union’s ability to improve safety and health is

rank-and-file concern about these issues and therelative priorities that u nion m embers and theirleaders place on health and safety in relation toother negotiable prov isions, such as wages, work hou rs, seniority, and gr ievance procedu res. Ac-cording to Kochan and his colleagues, the mostimportant determinant of committee effectivenessfrom the m anagement p erspective is the attitudeand commitment of the top man agement. It is alsoimp ortant tha t there be a balance of strength s be-tween both bargaining groups. Acting as an ex-ternal pressu re, the presence of OSHA may p lacea w eak union in a m ore equal bargaining posi-

tion w ith man agement (253).Collective bargaining is commonly associated

with op position in interests and an atmosph ereof limited tru st, but there may be “integrative”issues over wh ich p arties share comm on goals. It

has been suggested that safety is such an “inte-grative” issue, leading to a cap ability for cooper-ative problem solving on safety issues throu ghhealth and safety comm ittees in th e context of anoverall bargaining relationship (253).

Collective bargaining often serves as a directand immediate stimulus for setting up these com-mittees. How ever, it d oes “not guaran tee that anactive and ongoing committee will develop” (253).Indeed, there are numerous instances where thepresence of a contract clause requiring safety com-mittees has not resulted in regu lar meetings or use-ful recommendations by functioning committees.

There has been only a limited amount of re-search assessing the impact on worker health andsafety of these joint committees. Kochan, Dyer,and Lipsky studied union and management atti-

tud es in 59 plants (253). For several reasons, theywere unable to obtain data on actual injury andillness experience at these p lants. Thu s their resultsare generally based on subjective perceptions of workers and managers from su rveys and interviews.

They attempted to describe the conditionsunder which labor-management committeeswould have a high level of activity and wouldcontinue to function. These conditions occurredwhen OSHA pressure w as perceived to be strong,wh en the local union w as perceived to be strong,when there was substantial rank-and-file involve-ment in health and safety issues, and wh en man-agement approached these issues in a problem-solving manner. The committees that producedthe largest number of recommendations tendedto have a high level of inpu t from the local un ionmem bership, frequen tly reported back to those




members, and w ere in w orkplaces with a h ighprop ortion of youn g w orkers. The d egree of topmanagement commitment was also a very impor-tant var iable for d etermining th e success of thesecommittees. In particular, management tended toadop t a p roblem-solving ap proach to health and

safety issues when they were u nd er pressure fromOSHA to comply with par ticular regu latory re-quirements (253).

Cook and Gautschi (121) used data for 113manufacturing firms in Maine to study the effec-t iveness of OSHA an d labor-management com-mittees. They found a favorable effect on p lantinjury rates from OSHA citations. In ad dition,there was some evidence that union-managementsafety comm ittees were also effective in red ucinginjury rates. For the p lants w ith 300 or more em -ployees, this effect was significant at the 90 per-cent confiden ce level. Howev er, for all the p lantswith 200 or more em ployees, the effect w as notstatistically significant.

California has created a program to encouragethe formation of joint comm ittees on construc-tion sites. Und er th is “Coopera tive Self-InspectionProgram, ” a site will be exempt from routineOSHA insp ections if a joint comm ittee is set upto perform regular inspections of the workplace.This program has been implemented on six pro-

jects. The California Division of OccupationalSafety and Health reports that the injury rates atthese worksites are “substantially lower” than

both the rates for other California constructionprojects and the experience of these same com-panies at other sites not includ ed in th e program(337,347).

In a study of survey responses from 127 firmsin Massachusetts, Boden and colleagues (66)found that th e “mere existence” of a joint com-mittee in a workplace had no effect on either thenu mber of OSHA inspections prom pted by workercomplaints or the relative hazardou sness of thefirm as measu red b y serious OSHA citations. Theresearchers also conducted more detailed inter-

views with union and m anagement representativesat 13 of the firms w ith labor-managem ent com-mittees. The data from these interviews suggestthat th e comm ittees that w ere perceived as “ef-fective” ap paren tly increased perceived safety

(leading to fewer w orker complaints to OSHA)and improved employer comp liance with OSHAstandards (leading to fewer citations) (see also 335and 341 and box S.)

OSHA and Workers’ Rights

The OSH Act itself created a n um ber of oppor-tunities for worker participation concerning oc-cupational safety and h ealth. The act providedthat

q

q

q

q

q

q

workers could:

request OSHA inspections,participate in the condu ct of an OSHA in-spection,participate in any of the stages of a pro-ceedin g before the Occupa tional Safety andHealth Review Commission,contest the “reasonableness” of the abate-ment date set by OSHA,participate in standard s development and theissuance of variances, andrequest a Health Hazard Evaluation from theNational Institute for Occupational Safetyand Health.

The right to p articipate in O ccup ational Safetyand Health Review Commission proceedings andto contest OSHA citations has been the su bjectof several court cases. The resu lt of these cases,interpreting the language of the OSH Act, is thatemployees and their unions can participate inthese pr oceedings if the cited emp loyer is con-

testing a citation. Employees and unions also havean ind epend ent right to contest the reasonablenessof the prescribed abatement date. How ever, em-ployees and unions do not have an independentright to contest an agreem ent between OSHA andthe employer concerning the nature of the re-quired controls, the typ e of citation, or the p en-alty amount. If OSHA and an em ployer agree onthese issues and th e employer withd raws its “con-test” before the Review Commission, the employ-ees can object only to the sp ecific abatemen t dates.(See 307 for excerpts from several of the impor-

tant cases on this issue. )In addition, the act created a mechanism in sec-

tion 11(c) to protect employees from job discrimi-nation for having exercised any of the rights listedabove. However, the resources devoted to OSHA’s



—

Ch. 15—lncentives, imperatives, and the Decision to Control 317

Box S.—Collective Bargaining Results: Worker Training and Health and Safety Committees

Training Concerning Health, and Safety

Approximately 420,000 of the total 800,000 General Motors (GM) employees are members of theUnited Automobile Workers (UAW). The UAW-GM contract provides for training of full-time union

health and safety representatives for each GM plant with more than 600 employees (37). The full-timeunion safety representatives, selected first by the locals and finally by the UAW international headquar-ters, train alongside GM’s own safety representatives for 40 hours at the General Motors Institute. Traininginvolves hazard recognition, OSHA complaint procedures, and OSHA regulations. In accord with theUAW-GM contract, the union representative accompanies his or her management counterpart twicemonthly on inspections, and also walks with OSHA inspectors on their tours. The union member’s rolealso includes reviews of training and education programs and accident reports, and the person is em-powered to shu t down a hazardous operation, but only with joint approval by the p lant safety officer.In add ition, the union safety and health representative is involved in the initial stages of grievance resolu-tion concerning health and safety issues.

Some unions that represent workers who move frequently from worksite to worksite, such as theInternational Brotherhood of Painters and Allied Trades (lBPAT) and the United Association of Plumb ersand Pipefitters, also place high priority on the training and education of their workers and union safetyrepresentatives. Part of this attention is directly related to securing desirable contract language concern-

ing health and safety. IBPAT has concluded, for example, that its training program had a “statisticallysignificant impact on collective bargaining, leading to more and better safety and health bargaining lan-guage in both local and district.”

Labor-Management Committees

One refinery plant of the Shell Oil Company that has 2,000 workers organized by the Oil, Chemi-cal and Atomic Workers (OCAW) also has contractual provisions for union-management committees.The current contract language was drawn up in 1973. Unlike most OCAW contracts, this one providesno trained hygienist to survey worksites regularly. It does, however, provide for a union-managementhealth and safety committee that:

q is to be composed of an equal number of representatives from the hourly and staff [management] groups,., and is to meet periodically to discuss health and safety matters and make recommendations to management.#

Where a recommendation made to the company is not accepted, an explanation w ill be made to the committee.$-

,, Decisions by the company with respect to heaIth and safety recommendations shall not be subject to the griev-* . ance and arbitration p rocedures of th e articles of agreement (emphasis added).u .

~ Company perceptions, however, differ. Shell has described the joint committee policies as having

:.? “dispelled rumors and improved relations” between th e adversarial parties, and having “removed the>.’q , mystery” with regard to company initiative and support of w orkplace health and safety. Management

representatives felt that these issues were best handled in the joint committee setting, and contended~’ that union desires to use the grievance procedure were often motivated by wanting to push other issues

into the grievance setting “under the guise of safety.” -,,,. .-



enforcement of this have been very limited. More-

over, employees do not have a right to pursue acourt-ordered remedy independently, but mustrely on OSHA to negotiate a settlement or file

suit. Thus, one commentator has suggested thatthe imp lementation of this provision “has beenseriously flawed” (406).

This protection from discrimination coversworkers who refuse to engage in imminently haz-ardou s work. An OSHA regulation prevents em-ployers from disciplining employees for such a re-

fusal if there is insufficient time to eliminate thedanger of death or serious injury through any

other means. In Whirlpool Corp. v. Marshall, th e

U.S. Supreme Court unanimously upheld this reg-ulation (307,408). This right is limited to refus-ing imminent injury hazards and does not extend

to most chronic health hazar ds.

Under a provision in the National Labor Rela-tions Act, emp loyees who refuse to perform haz -ardous work may be protected from disciplinary

action if they are acting together and in good faith(408). Recently, how ever, the National Labor Re-

lations Board ru led that this did not app ly to oneworker who refused a hazardous assignment be-cause he was acting only by himself (328).

Of great importance to effective worker par-ticipation in labor-management activities is the

availability of information to w orkers and theirunions about plant-specific hazards. The OSH Acthas several provisions requiring that employees

be fully informed abou t health an d safety issues.The act provides that OSHA issue regu lations re-

quiring that employers inform employees of the

protections and obligations pr ovided by the actand the standards that apply to their workplaces(section 8(c)(l)).

The OSH Act also mandates OSHA to issueregulations requiring employers to m aintain rec-

ords of employee exposures, to provide emp loy-ees and their representatives with the opportunityto observe employer-conducted exposure moni-toring, and to provide access to these records.Employers are also required to n otify emp loyeeswho have been or are being exposed above per-missible limits and inform them of “the correc-tive action being taken” (section 8(c)(3)). Finally,

the Act requires that standards issued by O SHA“shall prescribe the use of labels or other appro-priate forms of warnin g as are necessary to in-

sure that emp loyees are apprised of all hazardsto which they are exposed, relevant symptomsand appropriate emergency treatment, and properconditions and precautions of safe use and ex-posure” (section 6(b)(7)).

Several OSHA regulations give w orkers andtheir un ions the right to obtain information fromemployers. For example, an OSHA regulationissued in 1978 requires that the employer-main-tained Log of Injuries and Illnesses be made avail-able to workers upon request, and em ployers arerequired to post a sum mary of the log each year.

The OSHA Access to Records regulation and re-cent rulings by the National Labor RelationsBoard also assist unions and workers in obtain-ing information concerning exposu res and em -ployer-held medical records. Finally, as discussedearlier in this chapter, various state and local



Ch. 15–incentives, /imperatives, and the Decision to Control 319

right-to-know laws and the recent OSHA regu-lation concerning hazard communication mayalso aid workers and their unions in learningabout hazards. (For further discussion of em ploy-ee rights, see 307, 333, and 408. )

Possible Changes in Workers’ Rights andCollective Bargaining

I t has been proposed that workers’ rights con-cerning w orkplace health and safety be expanded .Several observers have argued, based on the ex-perience of other countries, that health and safetyimprovements could be made by enhancing work-ers’ rights to full information on job hazards, re-

quiring w orker participation in h ealth an d safetydecisions, and perm itting workers to refuse allwork assignments they consider to be hazard ous(64,242,677).

In Sweden, for examp le, since 1974, every es-tablishment w ith five or more employees mu sthave at least one worker-elected health and safetysteward; larger workplaces typically have a stew-ard for each area of the workplace with oneworker designated as the chief health and safetysteward. The health and safety stewards have theauth ority to inspect the workp lace for hazard s,are involved in the design of the w orkplace, andhave the right to examine company records. Theyalso have the auth ority to order, for health andsafety reasons, that a particular plant operation

be shut d own , even over the objections of man-agement. In cases of a labor and managem ent d is-pu te, the operation remains shut dow n u ntil agovernm ent inspector visits the workp lace andresolves the issue.

In addition, all workplaces with 50 or more em-ployees must have a labor-management healthand safety committee. The committee discussesplans to im prove w orking conditions, is involvedwith the design of new facilities and worker train-ing, and sup ervises the comp any health and safetystaff. Although the w orkers have a m ajority on

these committees, most decisions are reached byconsensus of both labor and m anagement repre-sentatives. Finally, a nu mber of different typ es of training courses have been d eveloped for work-ers, supervisors, and the worker h ealth and safetystewards. These courses are commonly adminis-

tered by the Swed ish trade un ions, both at tradeunion schools and in worker-organized “studycircles” (64,242,677).

As described in chapter 10, employers, unions,universities, and other groups in the United States

have developed and administered worker train-ing and education programs. The “right to know”movement in this country (discussed earlier) re-veals the desire of many workers, unions, andcommunities for complete information aboutworkplace hazards and for greater involvementin health and safety issues. In addition to the“right to know, ” Mazzocchi has suggested thatwor kers be afford ed a “righ t to act .“ This wou ldmean that, in each workplace, a worker wouldbe “deputized” to represent fellow workers in seek-ing outside assistance to evaluate information ob-tained u nder the “right to know” laws and the

OSHA “hazard commu nication” standard (345).However, direct application in the United States

of the experience of other countr ies will be im-paired by d iffering legal, cultura l, economic, andpolitical conditions. In addition, greater employeeinvolvement in health and safety would representchanges in the traditional authority of m anage-ment to m ake decisions concerning all workingconditions.

It has also been suggested that greater use of collective bargaining could improve occupationalsafety an d health. Collective bargaining agree-

ments can detail procedures and investments thatare tailored for individu al plants and firms, thusdecentralizing the process of implementing healthand safety controls. The r esult, it is claimed , canbe health and safety improvements that are both“more efficient and more effective” than those pro-du ced by the current system of national regula-tory stand ards (37).

There are three significant factors that limit theeffectiveness of collective barg aining in im pr ov-ing occupational safety and health. First, onlyabout 20 million workers, or about 20 percent of

the U.S. work force of 100 million, b elong to la-bor u nions. Moreover, the percentage of the la-bor force belonging to un ions has been d ecliningsince the 1950s. This may represent the result of social and cultural patterns and the preferencesof U.S. workers and man agers, but it should also




be noted that U.S. law has not always perm ittedcollective bargaining. Because of this, one laborunion rep resentative on th e adv isory p anel for thisassessment suggested that changes in labor rela-tions law have health and safety imp lications.

Second, not all unions h ave the kind s of exper-tise in ind ustrial hygiene, injury p revention, oroccup ational medicine needed to negotiate and en-force agreements on occupational health andsafety. A recent survey of 14 U.S. labor unionsshows that union spending on worker health andsafety ranged from about 20 cents to over $15 permember. These 14 unions employed only two full-time ph ysicians and one part-time one, while themajority of these unions em ploy few full-time in-dustrial hygienists, public health professionals, orother health and safety staff (678).

Third, by definition safety and health p rovi-

sions must comp ete for attention and resourceswith other bargaining issues. In periods of eco-nomic down turn, workers and their unions, con-cerned about m aintaining wage levels and p reserv-ing employm ent security, may pu sh safety andhealth issues down the list of priorities.

Government Regulation

The final factor th at influences emp loyer d eci-sions to control hazards is an imperative: the reg-ulations and standards issued by Governmentagencies, mainly OSHA. As d etailed in chapter12, OSHA h as been emp owered to issue mand a-tory regu lations, to condu ct inspections, and toprop ose penalties and require correction wh en itfinds violations of those regulations. OSHA reg-ulations are often the focus of health and safetydiscussions because they r equire response andcompliance. Nevertheless, they are limited as afactor in health and safety because few regulationshave been prom ulgated and enforcement is spotty.Any changes in this, however, will occur only if Congress and the executive branch act to increaseOSHA resources or change standard-setting and

enforcement procedures.(As part of this assessment, Mendeloff analyzed

some of the factors that affect compliance withseveral OSHA h ealth stand ards. See box T.)

In addition to OSHA, other Federal agenciesmay r equire emp loyer actions that either directly

or coincidentally improve worker health and safe-ty. Using the authority granted by several dif-ferent statu tes, both the Environm ental Protec-tion Agency (EPA) and the Consumer Productand Safety Commission (CPSC) regulate productsthat m ay also be workp lace hazard s. For exam-

ple, EPA regu lates the pr odu ction of pesticidesand requires notification before other chemicalsare man ufactured in order to protect public healthand the environment. EPA’s regulations, in manycases, also redu ce worker exposu res.

For some toxic substances, in fact, workers maybe the only significantly exposed group. In lightof their overlapping authorities, EPA and OSHAhave considered joint regulatory proceedings. Themost recent public announcement of this has in-volved possible regulation of methylenedianiline,although it now app ears that the agencies have

decided th at OSHA, not EPA, will take respon-sibility for regu lating w orkp lace exposu res (346,354).

Regulation of the prod ucts pur chased by busi-nesses may, in some cases, be more cost-effectivethan requiring installation of industrial hygienecontrols. For examp le, a nu mber of w orkers ex-posed to formaldehyd e are employed in establish-ments w here the only source of exposure is theemission of formaldehyde from p rodu cts sup pliedby other ind ustries. These includ e app arel man-ufacturers using cloth treated with formaldehyde-

based resins and office workers w ho are exposedto formaldehyde from p articleboard or plywoodpr odu cts in th eir offices. In these cases, stand ard sconcerning formaldehyde emission rates or prod-uct content might be both less expensive and easierto enforce than efforts to increase general ventila-tion in numerous small establishments in dispersedlocations (206).

One way to issue standards for these hazard-ous pr odu cts used in the w orkplace would be co-ordinated regulatory efforts between OSHA an dthe EPA or the CPSC . This app roach holds som e

prom ise for redu cing the hazard s of prod ucts pur-chased by small businesses. However, this ap-proach will have only a limited imp act on hazardsrelated to the imp roper use of produ cts in theworkplace. In addition, there are difficulties inregulating products already manufactured and inuse.



Ch. 15—Incentives, Imperatives, and the Decision to Control . 321

Box T.—Factors Affecting Worker Exposures

On contract to OTA, Mendeloff analyzed OSHA inspection data from 1973 through 1979 for foursubstances: lead, trichloroethylene, asbestos, and silica. Mend eloff developed several different measuresof employee exposure and attempted to explain observed variations in exposure using other informationincluded in the OSHA data. His analysis was limited because, first, not all inspection results were in -cluded in the OSHA computer system. Second, the results of his analysis explain only between 5 and

25 percent of the variation in the dependent variables. Thus, the variables he was able to test do notcapture all the factors that determine success in controlling hazards (301).

Mendeloff found that complaint and programed inspections were equally effective in discovering em-ployer noncompliance with OSHA standards. Mendelhoff predicted that the presence of a union atan inspected establishment would contribute to lower exposures and fewer citations. However, this wasnot supp orted by the OSHA insp ection data. He did find that, other things b eing equal, exposures tendedto be higher at plants in nonmetropolitan (rural) areas compared with those in metropolitan areas. Itmight be speculated that workers in nonmetropolitan areas have fewer job choices and are thus morewilling to tolerate higher exposure levels. Alternatively, it could be that information about hazards andcontrols reaches rural areas more slowly or is adopted more reluctantly there.

Size of establishment was also examined. The results indicate that both large and small establishmentswere less likely to have overexposures than medium-sized establishments, paralleling the situation withinjuries in which medium-sized establishments appear to have higher rates. However, in many cases thedifferences between the various establishment sizes were not statistically significant. Moreover, inter-pretation of the observed differences was hampered by ambiguities in the definitions of the employeeexposure variables.

Mendeloff also examined the possibility that employer efforts to control hazards depended on thecost of doin g so. Using information from an O SHA report, he calculated the average costs per exposedworker of complying with OSHA’s proposed lead standard. The industries with the higher average com-pliance costs (primary smelting, secondary smelting, battery manufacturing, brass, bronze, and copperfoundries) tended to have higher employee exposures. The industries with lower average compliancecosts (newspapers, com mercial printing, can manufacturing, gray iron foundries), whose costs were one-tenth to one-twentieth those of the higher cost group, had a substantially lower proportion of overex-posures. These results support the claim that employees tend to be protected from exposures when pro-tection is cheap and overexposed when it is expensive.

Mendeloff reviewed the results of a number of recent inspections with OSHA inspectors. For firmsin violation of OSHA standards, the compliance officers estimated the costs of reaching compliance.In som e cases the complian ce costs were mod est, but for others, the costs were qu ite large. This groupof cases may not b e a representative sample, but for most of them, the costs of compliance would b esubstantially larger than b oth the average OSHA fine and th e maximum OSHA penalty for serious viola-tions ($1,000). Profit-maximizing businesses that take actions based on the “bottom line” will in-vest in health and safety only to the extent that such investments minimize their costs of doing business.If compliance costs are substantially higher than expected penalties, the profit-maxim izing firm will notvoluntarily udertake these health and safety investments.

Jones (237) examined OSHA inspection data for asbestos exposures from 1972 to 1979. She foundthat an in crease in engineerin g control costs of $l00 per emp loyee was associated with an increase inth e average asbestos exposure level of 0.7 fibers per cubic centimeter , while an increase in OSHA penaltiesof $350 per citation was associated with a decrease in average exposure level of 1 fiber per cubic centi-meter. Thus employers appear to be sensitive to costs: as the costs of control go up, employers decide

not to implement controls (leading to higher worker exposure levels), while as the expected costs of OSHApenalties go up, compliance improves. However, increased penalties were also associated with employersmore frequently deciding to contest the OSHA citations, again consistent with the theory that employerdecisions are sensitive to costs. Jones foun d that an increase in th e total pen alties of $1,000 was associ-ated with a 27 percent increase in the p robability that the employer would contest the results of theinspection. <




SUMMARY

OTA has id entif ied a n um ber of incentives orimperatives for the implementation of controltechnologies. These include: voluntary efforts byemployers and voluntary associations, the avail-

ability of information, the desire to reduce insur-ance or workers’ compensation losses, fear of tortliability actions, labor market pressures and col-lective bargaining agreements, and governm entregulations. One or all of these may influen ceemployers to instal l and maintain appropriatecontrols. However, all have significant limitations.

Management commitment has been called thesingle most important ingredient in effectivehealth and safety programs. After being inform edof or discovering the existence of job hazards,some employers will take action to reduce those

hazards, although the pressure of competition willsubstantially limit these voluntary employer activ-ities. In addition, employers and their employeesoften participate in the development of voluntarystandard s, which are an important sou rce of in-formation in the health and safety field. But be-cause they are voluntary, these standards willoften hav e only a limited impact on w orker healthand safety.

Making information about occup ational haz-ards and their control available is a necessary firststep for many improvements in workplace health

and safety. Providing information through re-search an d dissemination- is an important govern-mental activity. The increased availability of in-formation on workplace hazards may serve as anincentive for companies to introduce controls, butit is not sufficient by itself to gu arantee im prov e-ments in w orker health and safety.

Employers may take actions to improve jobsafety in order to reduce the costs of workers’comp ensation an d prop erty insurance. The costsof medical treatment an d lost wages paid th roughthe workers’ compensation system p rovide a m on-

etary incentive to redu ce those injuries and ill-nesses. In addition, insurance companies and Stateagencies that sell workers’ compensation insur-ance usua lly offer ‘loss-cont rol services” to im-prove health and safety conditions in their clientcompan ies. It is likely that workers’ compensa-

tion is an incentive for prevention of occupationalinjuries, although data supporting this conclusionare limited. For occup ational illnesses, the eco-nomic incentive provided by workers’ compensa-

tion is reduced substantially because few cases of work-related illnesses enter the workers’ compen-sation system. This appears to be tru e even forwell-studied occup ational diseases, such as thoseassociated with asbestos and cotton dust.

By far the most common use of tort actions inoccup ational safety and health are suits againsta third party—for example, against the manufac-turer of produ cts pu rchased by the employer foruse in the workplace. These suits may lead to im-provements in w orking conditions, but a n um berof factors limit their effectiveness. The first is that

suit cannot usually be brought against employersbecause w orkers’ compensation laws bar employ-ees from su ing their emp loyers in cases involv-ing work-related disease and injury. Other limita-tions involve recognizing and proving causation,and identifying the responsible manufacturers. Itis not now clear how important tort liability willbe as an incentive, although it has pr obably en-couraged the development of substitutes forasbestos.

To some extent, employers maybe motivatedto impr ove employee health and safety because

of pressures from the labor market. However, aslack labor market, with relatively high unem-ployment, and other market imperfections limitthis incentive.

Neg otiation and collective bargaining can alsobean incentive. Passage of the OSH Act in 1970coincided w ith an increase in the n um ber of con-tracts that included safety and health clauses, andthe clauses became increasingly specific. But thisis significantly limited because, first, only a smallpercentage of U.S. workers belong to labor unions.Second , not all unions have the kind s of exper-

tise in ind ustrial hygiene, injury p revention, oroccup ational medicine needed to negotiate and en-force agreements concerning health and safety.Third, by definition safety and health provisionsmust compete for attention and resources withother bargaining issues. Many workplaces have



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Ch. 15–incentives, Imperatives, and the Decision to Contr ol q323

joint labor-management health and safety com-mittees, but the research assessing the effective-ness of committees in improving worker healthand safety is limited.

The OSH Act itself created a nu mb er of oppor -

tunities for worker participation concerning oc-cupational safety and health. For example, Stateand local “right-to-know” laws and the OSHA“hazard communication” standard will provideworkers with m ore information about hazard s.

However, there is still controversy about the re-quirements of these regulations.

The final factor that influen ces employer d eci-sions to control hazards is an imperative: the reg-ulations and standards issued by government

agencies, main ly OSHA . In ad dition, some of theregu latory actions of other Federal agencies mayrequire emp loyer actions that either d irectly orcoincidentally improve worker health and safety.



16.

Economic Incentives,

Reindustrialization, and Federal

Assistance for Occupational Safety andHealth



and. . . . . . . 337

.,



—

16 s

Economic Incentives,Reindustrialization, and Federal

Assistance for OccupationalSafety and Health

Econom ic incentives, tax progr ams, and finan - ble to integrate productivity-improving invest-cial assistance have all been su ggested for stim u- ments in plant and equipm ent with the installationlating improvements in occupational safety and of control technologies that safeguard workerhealth, but have been little used in the United health and well-being. Finally, the Federal Gov-States. In addition, the process of industrial ernm ent could also establish new pr ograms forchange can itself be harnessed as a mechanism for financing research and training activities and forimproving occupational safety and health. Dur- assisting small businesses.ing a time of reind ustr ialization, it may b e possi-

ECONOMIC INCENTIVES AND FINANCIAL ASSISTANCE

The general notion behind economic incentivesis to use the economic self-interests of individualsand firm s to accomplish social goals. For occupa-tional health and safety, the aim is to set incen-tives so that employers, while seeking to earnprofits, will also prevent injuries an d illnesses.

In theory the w orkers’ compensation systemprovides an economic incentive for prevention,but in p ractice it is limited, esp ecially for illnesses(see ch. 15). Another possible type of economicincentive wou ld substitu te an injur y tax or an ex-posure tax for traditional regulatory standards.A third possibility involves the use of various gov-ernmental tax policies and financial assistanceprograms.

Injury/Exposure Taxes

The idea an “injury tax” is generally well-

received among economists as a substitute forhealth and safety regulations (see, for example,330,425,445,446). Although th e idea has been crit-icized a s p olitically in feasible (37,300), it ha s offi-cially surfaced at least twice—in a draft 1976 re-port of the Council of Economic Advisers and in

a 1977 mem o to President Carter from h is chief economic adviser, his budget director, and his do-mestic policy adviser. In both cases, union offi-cials were outraged and the injury tax referencewas either deleted or suggested as a supplement,not an alternative, that shou ld be stud ied by an

interdep artm ental task force (300). The task forcelater rejected the injury tax approach (228).

As opposed to the regulatory system, whichpenalizes firms for violations of regulations, aninjury tax system would levy direct financial pen-alties on firms for each injury. Firms w ould befree to choose the least costly methods of acci-dent prevention. Under certain assu mp tions, thisw ould b e the most “cost effective” way to red ucethe num ber of injuries. Moreover, an injury taxis appealing because it is directly related to safetyoutcomes. (Similarly, it has been suggested that

effluent taxes or emission fees be used in the areaof environm ental p rotection. See, for examp le,251. )

The advocates of injury taxes believe them tobe better than regulatory standard s, which areconsidered inflexible and unnecessarily uniform

327




across firms and industries, not necessarily relatedto workplace or work-force characteristics thatcause in juries, and not necessarily the least costlyway to red uce injur ies (445,446). In add ition, aninjury tax, if set at an app ropr iate level, mightprov ide employers with a stronger incentive to

prevent injuries than the current OccupationalSafety and Health Administration (OSHA) pro-gram s. It could also reward emp loyers for effortsto go beyond current regulatory standards, as wellas for condu cting research on impr oved controls.

Smith (445,446) concluded that firms do re-spond to financial incentives and estimated theeffect that various levels of injury tax would haveon injury rates. To be effective, the taxes wouldhave to be fairly large. Using 1970 data on in-

jur ies, Smith estimated that a tax of $500 per injur y w ould lead to a 2.2 to 3.2 percent red uction

in the disabling injury rate (injuries involving lostwork time as defined by standard Z-16 of theAmerican National Standards Institute). A tax of $1,000 would reduce injuries 4.4 to 6.2 percent,wh ile one of $2,000 wou ld redu ce injuries 8.8 to12.5 percent (446).

Although Smith suggests moderate f ines foreach injury as a replacement for safety regulation,he does not extend that approach to health regu-lation. Because occupational diseases often man-ifest themselves only after a latent period, therewould be considerable difficulty in determining

which of several employers was responsible forthe disease (446). Moreover, as discussed in chap-ters 2, 3, and 15, there are considerable d ifficultiesin distinguishing job-related diseases from non-occupational ones.

Taxing hazard ous exposure levels rather thanillnesses might be one possible way to affect job-related d iseases. This could wor k like an effluentor emission tax, un der w hich firms pay a fixedamou nt for each ad ditional unit of pollution theyadd to the water or air. Nichols and Z eckhauser(330) have suggested such a tax on occupationalnoise exposure. But Smith p oints out th at enforc-ing an exposure tax approach wou ld require a“monumental inspection and monitoring pro-gram” (446). The attending ad ministrative costswou ld p robably offset the advan tages of such asystem. (To a limited extent, provisions of theOSHA lead standard that require paying work-

ers their usual wages if they must be removedfrom lead -contam inated w ork areas have somecharacteristics of an illness/ exposure tax. )

An injury ta x, even if limited to cases of acutetrauma, would encounter serious difficulties. The

first w ould be in setting an ap prop riate level forthe injury tax. Smith (445) estimated in 1970

dollars that a tax of $1,000 per disabling injurywou ld lead to a d ecline in injury rates of about5 percent, wh ile a $2,000 tax per injury w ould beassociated w ith a 10 percent d ecline. Adjustinghis estima tes to account for inflation since 1970yields injury taxes in the range of $2,500 to $5,000(in 1983 dollars) per lost-workday injury toachieve a 5 to 10 percent injury rate decline.

1

Furthermore, if a tax for d eaths or perm anentdisabilities were set equal to the lost earnings of the killed or disabled worker, it would be ex-

tremely high-ranging from tens of thousands tohu nd reds of thousand s of dollars. These values,large as they are, do not include the psychic costs,the pain an d su ffering associated with su ch in-

juries. To maximize the efficiency of the tax sys-tem it would be necessary to prohibit firms frominsuring themselves against these large losses toensure that firms would pay the full tax. But suchlarge penalties wou ld generate considerable po-litical opposition (64).

A second p roblem wou ld be ensuring the ac-curacy of the injury records on which any tax

wou ld be based. With a d irect financial penaltyfor each injury, employers have an incentive notonly to prevent injuries but also to underreportthem. (Ch. 2 and Working Paper #l discuss thecontroversy about the accuracy of current em-ployer-maintained records. ) Independent, firm-by-firm au dits to gua rantee the accuracy of thesedata would be quite expensive. Moreover, assess-men t of the results of an injury tax wou ld be d if-ficult because any declines in injur y rates follow-ing implementation might represent decreasedrepor ting, not increased pr evention (64). In somecases there wou ld also be p roblems in distinguish-

‘This approximate adjustment for the effects of inflation is basedon the two-and-a-half-fold increase in average hourly earnings from1970 to 1983 and is consistent with the increases during that periodin the most commonly used price indexes (the Consumer Price In-dex, Producer Price Index, and Implicit Price Deflator for the GrossNational Prod uct).



Ch. 16–Economic Incentives, Reindustrialization, and Federal Assistance for Occupational Safety and Health q 329

ing occup ational (and taxable) injur ies from non -occupational ones. These would include manysprains and strains, as well as many injuries tothe back.

Third, an injury t ax might in crease the level of

controversy in this field. Boden and Wegman (64)argue that it would be politically feasible only forthe less severe in jur ies. Mendeloff (300) suggeststhat even a ta x of $250 per injury m ight be moreexpensive to firms than current OSHA safetystandard s. In theory, an injury tax should app lyto all injur ies. But in p ractice, there wou ld be con-troversies concerning ap plication of an injury taxin cases of claimed “employee misconduct. ”

Fourth, the operation of such a system wouldbe relatively invisible to workers. Employerswou ld calculate the nu mber of injuries and sendthe Government a check (64). If an injury tax sys-tem replaced existing standard s, and suspend edunan noun ced inspections and workers’ rights torequest “complaint inspections, ” it w ould changedram atically the w orker and governmental rolesin solving health and safety problems.

Fifth, an injury tax might create an incentivefor larger firms to subcontract dangerous jobs tosmaller, less financially solvent firms that lack theresources to prevent injuries as well as to pay theinjury tax. An injury tax might also lead to chan gesin emp loyment p olicies, for example, in h iring andfiring decisions. The effectiveness of these policies

in redu cing injuries has been questioned (64) (seealso ch. 4), and such a response by employers mayhave oth er social and economic imp lications thatwould need to be considered.

Finally, injury taxes have been criticized onethical grounds. It has been asserted that such atax wou ld be a “license to m aim” or a “ license tokill.” By providing a system of “taxes” and “li-censes, ” society w ould seem to be saying that itis all right for a certain number of occupationaldeaths and injuries to occur. But if an injury taxreduced injuries while preserving other social

values, it would p robably be considered an ad-vance because fewer workers were being harm ed,

The operation of an injury tax w ould also leadto variations in the level of protection that de-pend ed on the costs of prevention. Workers in in-du stries facing low p revention costs would have

safer jobs than those in industries with high p re-vention costs. Job risks wou ld thus remain un-equally distributed. This, however, runs counterto a commitment to the goal of equal protectionfor all (277).

Tax Programs and Financial Assistance

When th e topic of econom ic incentives is raised,most employers think of changing the taxes theyare most familiar with—the business income taxsystem. Congress could modify the structure of business taxes to encourag e investm ent in healthand safety control technologies or could assistbusinesses in financing such investments.

A congressional decision to modify the taxstructure or p rovide financial assistance can bethought of as providing some level of “social fund-

ing” for investments in occupational safety andhealth. The general rationale for this is to red ucethe costs of health and safety investments, thu sencouraging firms to und ertake them. Burstein(531) states that tax policy can be u sed to lowerbusiness taxes on certain kind s of investments,thereby increasing the returns to business “to re-flect the external benefits provided by the activ-ity.” These external economic benefits, such asreductions in the cost of medical care due to im-provements in employee health, are ones that in-dividu al firms wou ld not ordinarily receive be-cause companies do not shoulder all the costs of

ill health . Some of those costs are borne by em-ployees, by other insurance policyholders, and bythe Government. Tax policy might be used toreward the individual firm for actions that reducethese “social costs, ”

Many believe that society ought to a ssist busi-nesses in m eeting certain social goals, such as re-ducing pollution or improving worker health andsafety. This is especially tru e w hen, for variousreasons, society changes the goals by, for exam-ple, increasing th e stringency of ap plicable regu -lations. Thus these tax an d financial assistance

program s lead to su bsidies for bu sinesses, but thismay be app ropriate to reach socially valued goalsof environmental and worker p rotection.

Four kinds of programs are of interest: invest-ment tax credits, accelerated depreciation, Gov-ernment loan program s, and d irect subsidies. All




have already been used in the area of environ-mental protection and loan programs h ave beenused , to a limited extent, for occupa tional safetyand health.

An investment tax credit allows a business toapply a certain percentage of the purchase priceof a capital good directly against the taxes owedby the firm, in add ition to the normal d eprecia-tion of the investment over time. When firms havebeen allowed such credits, some of the invest-ments m ay have included controls for w orkplacehazards or p ollution. How ever, Federal tax pol-icies have not created an investment tax creditespecially for employee health an d safety invest-ments, although such credits have been p roposed.

Accelerated depreciation or rapid amortizationof investments is a second tax subsidy m echanism.This permits bu sinesses to w rite off the costs of

an investment more rapidly than the norm al de-preciation rules would allow. Federal tax law hasallowed 5-year amortization of pollution controlequipment (651). This accelerated depreciation forassets that will last longer than 5 years has beenperm itted only for investments that lead to pol-lution control w ithout also creating “sign ificant”changes in other asp ects of the facility. It ha s not,however, been available for investments to pro-tect worker health and safety (31).

A p roposal to allow accelerated depreciationfor OSHA-mandated investments moved through

the legislative p rocess to the conference commit-tee stage in 1978. A compr omise reached in con-ference was to requ est a Treasury Departmen t fea-sibility stud y of such a chan ge in the tax law (228).(The major conclusions of that study are discussedlater in this section.)

A third kind of Government program is to pro-vide financial assistance, either directly or in-directly. Financial assistance is defined here tomean p rograms that provide loans or other typesof financing (such as bonds) to assist businessesin paying for health and safety investments. Busi-

nesses must repay th e loans or bonds, but the costof these obligations is often partially subsidizedand they p rovide a sou rce of capital for invest-ments that m ay not return a profit to the firm.Private lenders are often reluctant to loan mon eyfor such “nonproductive” investments so, it is

argued, the Government h as a role in p rovidingsuch financing.

Financial assistance can take a number of forms,including Government guarantees of privateloans, Government interest subsidies for privateloans, direct Governm ent loans (often at red ucedinterest rates), and the u se of tax-exempt financ-ing by p rivate firms. In loan guarantee p rograms,the Government promises to repay a private loanif the borrower d efaults. This can be combinedwith interest subsidies, und er w hich th e Govern-men t pays a shar e of the interest costs. Und er di-rect loan programs, the Government acts as if itwere a bank and loans the money directly at mar-ket interest rates or at a lower, subsidized rate.Tax-exempt financing allows private business totake advantage of the lower interest rates onbond s issued by States and local governm ents.

When Congress passed the Occupational Safetyand Health (OSH) Act in 1970 it concluded thatthe burd ens of comp liance would often d ispropor-tionately affect small businesses. Rather than ex-empt such firms from th e requirements of the act,Congress chose to amend section 7(b) of the SmallBusiness Act to allow th e Small Business Ad min-istration (SBA) to ma ke or guaran tee loans forOSHA compliance expenditures. The require-ments w ere, first, that the expenditures mu st beto comply w ith OSHA regulations and , second,that the small business was “likely to suffer sub-stantial economic injury” without such assistance(OSH Act).

From Septem ber 1971 to Au gu st 1981, the SBApr ocessed 261 OSHA-related loans for $72.8 m il-lion—about 26 loans per year, each averagingabout $280,000. In fiscal year 1981, 9 loans weremade for a total of $7.1 million.

These loans constituted a very small part of SBA loans. Although exact figures are not readilyavailable, in recent years the agency has beenmaking or guaranteeing between 20,000 and30,000 loans annually for between $2.5 billion to

$4 billion. It is possible that som e firms have u sedregular SBA loans to finance OSHA complianceexpenditures in ad dition to other investments, Thededicated OSHA loans, however, usually carrieda lower interest rate than the regular loan pro-gram (233).



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Ch. 16—Economic Incentives, Reindustrialization, and Federal Assistance for Occupational Safety and Health . 331

The OSHA loans program, as well as the SBAloans for pollution control, were eliminated bythe Omnibus Budget Reconciliation Act of 1981(Public Law 97-35, Section 1905). It is not clearhow effective this loan program was in improvinghealth and safety in the handful of firms that re-ceived loans. In 1979, the General Accounting Of-fice (GAO) criticized the program, in part becausefew loans had been mad e. In add ition, G AO con-clud ed, after an examination of SBA files concern-ing a samp le of loans, that it was not clear thatthe loans had been gran ted only to businesses thatneeded the loans or that the use of the loans ac-tually resulted in the elimination of workplacehazards (509).

Tax-exempt bonds, issued by State or local gov-ernments to provide financing for private firms,are backed by the credit of the borrow ing firm,

the revenue from the project financed, or the valueof the facility. Defaults are borne by those wh ohold th e bond s, not the State or local governmentthat issued them. Because the interest on suchbonds is exempt from Federal income taxes,lenders ar e willing to accept lower interest rates.Thus, private firms that use these bonds are ableto finance investments at interest rates lower thanthey would otherwise pay. In 1968, Congresslimited the use of bonds that exceeded a certainsize to those that finance pollution control andcertain pu blic facilities (such a s airp orts, conven-tion centers, parking garages, sports stadiums,etc. ) (492).

The Internal Revenu e Service (IRS) has had dif-ficulty in administering this provision of the taxcode. More than 6 years passed before it publishedtemporary regulations, and they encountered dif-ficulties in en sur ing th at this financing is limitedto pollution control and is not used by firms for“productive investments” (651). The IRS hastended to limit “pollution control” to certain “end -of-pipe” technologies that have no productivevalue, such as effluent water treatment. More fun-damental process changes that also reduce the

amou nt of pollution have generally not qua lifiedfor tax-exempt financing (538). The IRS has alsodisallowed tax-exempt financing for containmentdevices for nuclear power plants, as well as spend-ing for the disposal of hazardous wastes, becausethese were considered to be normal expenses for

plant operations, not extra costs due to pollutioncontrol requirements.

Despite these restrictions, it has been estimatedthat about 48 percent of all capital spending forpollution control has been financed with tax-

exempt bond s (538). However, the IRS has notallowed tax-free financing for investments thatprotect employees from toxic substance exposurein addition to preventing environmental damage,app arently on the belief that the comp any w ouldhave invested in w orker protection in any caseas part of a prudent personnel policy (651). In thelast few years, Congr ess has also enacted severa lrestrictions on the am oun t of tax-free financingthat can be issued by State and local governmentsto private businesses.

Finally, the Government could assist businesses

by giving them direct subsid ies or grants. Econo-mists generally prefer d irect subsid ies to ind irecttax subsidies or loan programs because they createfewer market distortions, are simpler for the IRSto administer, and can often be more cost effec-tive. Direct grants do, however, enter directly intothe approp riations process and th us m ay be morevisible and hence m ore d ifficult to legislate. More-over, a firm will probably incur a greater paper-work bu rden while applying for a d irect grantthan it w ould w ith an indirect tax subsidy.

As noted earlier, in the Revenu e Act of 1978,

Congress requested the Department of the Treas-ury to study the feasibility of tax incentives foroccupational health and safety spending. The re-port, w ritten by th e Office of Tax Analysis of theTreasury Department and published in January1981, was very critical of tax subsidies for OSHAand Mine Safety and Health Administration(MSHA ) comp liance. It noted th at such a su bsidyprogram wou ld be d ifficult to adm inister, mostlybecause of pr oblems in distinguishing health an dsafety expenditures from normal business costs.Second, the Treasury Department analysis ex-pressed concern th at subsidies for capital costs

only would encourage firms to adopt unneces-sarily capital-intensive compliance methods.Third, they criticized special investment tax cred-its, accelerated depreciation, and tax-exemptfinancing on several more technical grounds, in-cluding the differential treatment of assets with




different lifetimes, the differential advantage in-curred by profitable (as opposed to unprofitable)firms and by capital-intensive (versus labor-inten-sive) companies, and the large benefit that tax-exempt f inancing gives to upper-income bond-holders (651).

The In teragency Task Force had previously ex-amined the issue of direct economic incentives.In contrast to the negative comments by the Treas-ury Dep artment report, they recommen ded , if general economic conditions permitted, both theextension of the investment tax credit to noncap-ital expenditures for health and safety investmentsand the creation of a program of direct financialassistance. This should, they suggested, take theform of a direct subsid y rather than a tax credit.The subsidy would be limited to high-hazard firmswithin h azardous ind ustries, and w ould only ap-

ply to the firm’s health and safety spending thatrepresented an increase over their spending in abaseline year. The program could be administeredeither through the Treasury Department or throughthe regulatory agencies (OSHA and MSHA) (228).To date, these recomm endations concerning fi-nancial assistance have not been acted u pon .

OTA concludes that the use of tax incentivesand financial assistance programs might spur the

implementation of controls, assist businesses incomp liance, and possibly redu ce the controversyof regulatory proceedings because of the availabil-ity of sources of finan ce. How ever, there are sev-eral disadvantages.

First, they would represent either a reductionin Federal tax revenues or an increase in budgetoutlays. Second, a tax incentive program wouldalso tend to increase the complexity of the tax law,wh ile a direct assistance program wou ld requirepersonnel and resources for program administra-tion. Third , these prog ram s will often provid e fi-nancial benefits to firms that would have installedcontrols even in the absence of a subsidy p rogram.Fourth, there would be difficulties in dividing thepu rchase price of equipment betw een features thatare health and safety controls and th ose that arenormally part of the equipm ent for purely pro-

ductive reasons. Finally, each of these programshas its own limitations, and wou ld have d iffer-ing effects on other aspects of business investmentbehavior, as well as on the distribution of wealth,income, and th e burd en of income taxes. All of these would need to be considered before estab-lishing any program.

REINDUSTRIALIZATION AND OCCUPATIONAL SAFETY AND HEALTHSome recent d iscussions of the U.S. economy

have included references to “reindustrialization”and “indu strial policy. ” Comm entators have gen-erally focused on the international competi-tiveness of certain U.S. ind ustr ies—pr incipally inmanufacturing. Little of the discussion has beenabout occupational health and safety policy oreven about regulation. But many proponents talk about using economic incentives—including taxlaw changes and Government financing—to im-plement the new policies. Moreover, some have

suggested changes in health and safety regulationsin ord er to facilitate business reinvestment andplant modernization.

OTA considers the reindustrialization debateto be relevant to this report for two reasons. First,reindu strialization policies might have either a

beneficial or an ad verse imp act on worker h ealthand safety. Second , if the Federal Governmentstimulates economic revitalization through tax,expenditure, or financing programs, it may beadvantageous to incorporate health and safetyconsiderations into those policies. OTA, in thisassessment, is not advocating any form of indus-trial policy. Indeed, industrial policies and moregeneral econom ic policies are areas beyond thescope of this report. But there do appear to beconnections between these policies and possibil-

ities for improving the implementation of controltechnologies.

Reindustrialization and Industrial Policy

The terms reindu strialization and industrial pol-icy often have meaning only in the eye of the



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Ch. 16–Economic Incentives, Reindustrializafion J and Federal Assistance for Occupational Safety and Health q 333

beholder. An enormou s range of suggestions con-cerning U.S. economic productivity and interna-tional competitiveness have been made underthese labels (528). Some think the p roblem is thatthe Governmen t has interfered too mu ch in themarket throu gh existing tax and r egulatory pol-

icies. The solution they propose is to reduce thesize of Government and limit its intervention toproviding certain “pu blic goods,” such as nationaldefense. Others think that economic revitaliza-tion can best be achieved by shifting Governmentpolicies. These commentators want policies thatincrease incentives to work and save and that re-duce incentives to consume. Specifically, theyhave ad vocated across-the-board changes in bu si-ness tax laws to encourage investment. Some of these suggestions were legislated in the EconomicRecovery Tax Act of 1981.

Still another group w ants to see explicit Fed-eral policies that will encourage the growth of “sunrise” industries and that will ameliorate orpr event the d ecline of “sunset” ind ustr ies. Criticsof this position question wh ether the Governmentcan correctly identify sunrise and sunset ind us-tries and some wond er if this is an ap propriaterole for Govern men t at a ll. (See 493 and 528 fora discussion of these views. )

All three groups are attempting to create con-ditions that will lead to economic revitalization,but generally only the third group is advocating

selective or targeted industrial policies. Theseanalysts differ in their explanations of what hasgone wrong and in their prescriptions for new p ol-icies and institutional arrangements. (Some of theleading ad vocates of ind ustrial policies includ eReich (383,384), Magaziner and Reich (283),

Rohatyn (395), Bluestone and Harr ison (62), andEtzioni (167). For contrasting view s, see, for ex-ample, Economic Report of the President (169)and Schultze (426). )

The Congressional Budget Office (CBO) hasoutlined three m ajor strategies that have been pro-posed as alternative industrial policies. The firstis to work with current policy instruments andrely on economic recovery and private-market ad - justments to solve existing problems. A secondstrategy is to “mod ernize existing policies . . . thatmay now have become impediments to growth

and efficiency,“ including changes in antitrust andtrade policy, as well as programs to assist dislo-cated w orkers, and changes in regulatory policythat would assist businesses in achieving economicgrow th (493).

A third strategy for indu strial policy w ould in-volve the creation of new institutions, amongwh ich could be an information and / or consen-sus development agency, an executive branch co-ordinating agency, and a Government financialinstitution. An information/ consensus agencycould gather, synthesize, and disseminate infor-mation on American ind ustry, including assess-ments of U.S. Government policies and of for-eign activities. Several proposals would alsoinclud e creation of a council, composed of rep-resentatives from bu siness, labor, and Govern -ment, to develop a consensus on the goals of an

indu strial policy. An executive bran ch coordinat-ing agency could attempt to coordinate the p ol-icies of the Federal Government toward a particu-lar industry or group of industries, in order toencourage grow th and comp etitiveness. The p ro-posed Government financial institution would bea national industrial development bank or sev-eral regional d evelopm ent banks, often m odeledafter the Depression-era Reconstruction FinanceCorporation (493,527).

As noted, environm ental regulation and work-place health and safety regulation have received

little attention in this debate. Magaziner and Reich(283), for example, devote only one paragraph tothe issue. In it they call for regulations that applyto “emerging” industries that are “harmonized asfar as possible with the needs and requirementsof other nations.“ “Declining” industries, on theother hand, “should only be required to meetstandards that are appropriate to the remaininguseful life of the industry. ” Bluestone and Har-rison (62) note that reindustrialization should bedirected toward several goals, including the cre-ation of safer work environments, but they d o notelaborate on this point.

Some discussions of industrial policy have,however, advocated the relaxation of environ-mental and occupational safety and health regu-lations as part of a plan for industrial modern-ization. For examp le, Etzioni (166) has su ggested




that the United States must choose whether rein-dustrialization or improvements in the “qualityof life” will be mad e the N ation’s “top p riority. ”These discussions assume that Federal regulationshave seriously ham pered the growth of the U.S.economy and improvem ents in prod uctivity and

international competitiveness. However, as dis-cussed later in this chapter, the adverse impacton p rodu ctivity of occupational health and safetyregulation is actually fairly small. Moreover, insome cases OSHA r egulation has p layed a rolein indu cing or facilitating several indu strial inn o-vations that improved both health and safety, aswell as produ ctivity.

OTA analyzed the role of technology in inter-national comp etitiveness in a 1980 assessment ontechnology and th e steel ind ustry an d in a 1981report comparing the competitiveness of three

industries—steel, electronics, and automobiles.These reports examined the general issues of tech-nology and p rodu ctivity in these indu stries, in-cluding the effects of regulator y policies. In thecase of steel, OTA found that several major newsteelmaking processes are not only more efficient,but also create less pollution. Moreover, modesttechnological improvements have resulted fromthe “push” provided by health and safety, and by

environmental regulations, including improvedemissions controls and better door seals for cokeovens (538). More generally, the 1980 report out-lined a number of policy options.

The most critical policy option may be that of a governm ental steel ind ustry sector policy, thatis, for a coherent set of specific policies design edto achieve p rescribed goals. , . . The lack of a sec-tor policy and the d esignation of a lead agencyto implement su ch a policy has led to policies thatoften conflict with one another, create an ad ver-sarial relationship between Government and in-du stry, and fail to add ress critical issues.

In its comparison of the competitiveness of steel, electronics, and aut omob iles, OTA ou tlinedtwo prerequisites for industrial policy (543):

mechanisms for reaching agreemen t on objec-tives that are acceptable to Government an dvarious interest groups; andimproved analytical capability on the part of Government agencies concerned with eco-nomic efficiency and competitiveness.

In add ition to taxation and spend ing policies,Congress and the executive branch have alreadycreated programs that might be considered formsof industrial policy and have considered others.For examp le, there are already a large nu mb er of Federal p rograms that provide grants, loans, loan

guarantees, and economic assistance for variouspurposes (512,529).

The Steel Tripartite Advisory Committee,app ointed by President Carter, consisted of rep-resentatives from Government, labor, and busi-ness wh o d iscussed issues concerning m oderniz-ation of the U.S. steel industry. Among otherrecomm endations, they suggested d elays in sev-eral environmental protection requirements in or-der to facilitate plant modernization (458). In1981, Congress enacted the Steel Compliance Act,wh ich postponed certain d eadlines of the Clean

Air Act for the steel indu stry.

Finally, a number of bills have been introducedin recent sessions of Congress concerning ind us-trial policy (see 534). Hearings have b een held onsome of th e topics add ressed by these bills (513,515,525,534,549).

Reindustrialization and OccupationalHealth and Safety

The continuous process of industrial change (in-cluding the replacement of plant and equipment)

can lead to safer and more healthful workplaces.In fact, a large portion of the imp rovements inworker health and safety during this century maynot have been the result of conscious decisionsto add controls to existing processes, but mayhave occurred coincidentally as new technologies,new processes, and new industries were intro-duced. Unfortunately, it is extremely difficult togather definit ive data on this qu estion.

Industrial and other policies that facilitate theprocess of industrial change might simultaneouslyimprove occupational safety and health. More-

over, regulations can have a favorable impact onthe p roductive efficiency of an in du stry either be-cause they directly spur innovations and changesor because they provide an opp ortunity to chan geproductive aspects of plant operations. But thereis some danger that combining policies that are



Ch. 16–Economic Incentives, Reindustrialization, and federal Assistance for Occupational Safety and Health 335

designed to improve productivity with those thatadd ress employee health and safety will lead toan emp hasis on the former at the expense of thelatter.

Indu strial change does not au tomatically im-

prove worker health and safety, nor are newplants necessarily safer than old ones. What is trueis that it is generally cheaper and more effectiveto control any given health and safety hazardwhen constructing new plant and equipment thanit is to retrofit existing plant and equipment (seebox U).

By stimulating changes in p lant and equipmentfor productivity reasons, new industrial policies

may also present an opportunity to improveworker health and safety. The various tax incen-tives, loan guaran tees, and other subsid ies thathave been suggested to imp rove industrial com-petitiveness might also be used as incentives forhealth and safety improvements. Such policies can

thus m ake compliance with health and safety reg-ulations easier. In add ition, if desired , the oppor -tunity p resented by reindu strialization could beused to achieve greater levels of protection.

It has been argued that health and safety regu-lation h as ham pered economic produ ctivity by re-quiring expenditures for control technologies thatare “nonproductive. ” Money spent for controlscould have been invested in improving plant pro-

Box U.—The Costs of Add-On and New Process Controls

It is widely believed, indeed it is pretty much common sense, that controls are cheaper and moreeffective when designed into new plants than when added or retrofitted. Nearly every control that couldbe included as a retrofit could also be included in the design stage. There is no reason to believe thatit would cost more to purchase a control for a new plant of the same size with the same hazard thanit would b e to buy th e control for an older plant,

Second, in designing the new plant, the architects, designers, and engineers have a greater oppor-tunity to make sure that everything “fits together.” For example, ventilation systems can be designedefficiently rather than having to wind their way around existing equipment, building structures, or otherduct work. Work stations and tasks can b e designed w ith ergonomics in m ind (see ch. 7) to enhanceworker produ ctivity and to be less stressful. Thus the d esign can improve a num ber of different features,including employee health and safety.

Third, installing retrofit controls always involves disruptions-cutting through existing equipment,temporarily closing down portions of the plant (or paying overtime rates to have the work done onweekends or at night), or taking machinery apart-that can be very costly. Fourth, retrofit controls caneasily outlive the rest of th e plant and equip ment, especially in older facilities. Thus the plan t’s life mayend before the firm h as reaped the full life of the control devices. For some devices there will be a salvagemarket, but for many there will not.

OTA has found several examples to support this reasoning. Rollover protection for mining vehiclesis more expensive when retrofitted than w hen p urchased on new equipment (248). In the OSHA vinyl

chloride rulemaking hearings, the Firestone Plastics Co. estimated that reaching a 100 parts per millionstandard would cost 34 percent more in a 25-year-old plant than in an 8-year-old one; meeting a 10parts per million standard would cost twice as much in the older plant (38). Swedish research in the1960s led to “designed -in” noise control for one company th at cost only a fraction of w hat retrofit con-trols would h ave cost (228).

Direct comparisons of th e costs of control in n ew p lants versus retrofitting old plants are often d iffi-

cult, however, because other relevant variables change. For example, the new plant may be larger orhave a different production process. A comparison of the experience of two plants in controlling radia-tion exposures illustrates this. Retrofitting an old uran ium p rocessing plan t to meet new, more stringentradiation exposure standards cost approximately 30 percent as much as the original total cost of theplant. Later a new plant was built to meet the same radiation standards. The control costs for this plantamounted to only 8 percent of the new construction costs. But there were confounding variables: thenew plant was larger and had at least one significantly different type of process equipment (97).




ductivity. In the aggregate, however, this diver-sion is relatively small. Employee health andsafety regu lations have been estima ted as havingled to a 0.4 percent d ecline in trad itional meas-ures of prod uctivity (137). Of cour se, these meas-urements d o not capture any of the health and

safety benefits of regulation (see additional dis-cussion in ch. 13).

But compliance with regulations can also pro-vide an opp ortunity to make changes that im-prove plant productivity. As one group of an-alysts has n oted, “[b]ecause it is less expensive anddisrup tive to make mu ltiple changes simu ltane-ously, rather than ind ividu ally, businessmen nat-urally take the opportunity of regulation to intro-duce other improvements” (31). (See 228 for sev-eral examples for which productivity improve-ments occurred at the same time as health and

safety improvements. )Accordin g to several studies, regulation can

stimulate new research or, more likely, speed upthe tempo of existing research. One group of re-searchers reports that 33 percent of their study’srespondents indicated process improvements spurredby regulatory changes (231), while two otherstudies reported similar conclusions (70,101). Ina five-country comparison of Government activ-ities that affected innovation, the researchers con-clud ed that regulatory requirements concerningenvironmental protection “may be more impor-

tant” for ind ucing innovation than other p rogramsthat w ere designed explicitly to influence the in-novation process (29).

Ruttenberg (412) has p ointed out a num ber of instances in wh ich regu lation h as been a stimulusfor new m arkets, new jobs, and basic produ ct andprocess innovation. “To a surprising degree, reg-ulation is the mother of invention, ” she noted.This occurs because in redesigning products andprocesses to comply with health, safety, and envi-ronm ental regulations, compan ies often fun da-mentally redesign the product or process throughthe u se of new technology. Second, the existenceof Government standards creates “assured mar-kets” for the results of the research efforts.

In the OSHA arena, the stimu lus of the vinylchloride regulation accelerated a then-developingimprovemen t in polymerization technology. Some

of the controls that were ap plied to redu ce vinylchloride exposures also increased production effi-ciency. (See box N in ch. 12. )

Ruttenberg’s case stud y of the OSHA cottondust standard, commissioned for this assessment,

reveals a similar phenom enon. Although a d irectcause-and-effect relationship is difficult to prove,it seems clear that the recent modernization of theAmerican textile industry was at least acceleratedby the OSHA cotton d ust stand ard. Comp liancewith the stand ard involved, in large part, the in-stallation of new and more productive capitalequipment. Some “nonproductive” investments(such as for add itional ventilation) have been re-quired, but process and equipment changes in-clud ed in new designs have substantially loweredcotton dust levels. This new equipment is alsomore productive because it consolidates several

previously separate processes, reduces energy con-sumption, operates faster, and produces cloth of improved quality. Although the n ew technologyhas some limitations, the textile industry has beenable to raise productivity and improve workerhealth an d safety at t he sam e time (413).

A recent report to OSHA concerning the costsof comp lying w ith the lead standard discusses thepotential for new technology simultaneously re-du cing w orker exposures, reducing the costs of controlling exposures, and im proving p rodu ctiv-ity in a prim ary lead sm elter (see box V). It mu st

be noted th at this technology has n ot yet been im-plemented on a large scale and there are u ncer-tainties about its adoption. But what is not seri-ously questioned is that pr ocess redesign is themost effective way of achieving both productivityand employee health and safety goals.

As p reviously n oted, indu strial policies wou ldrequire not on ly agreement amon g the affectedparties, but also analytical capability. The N a-tional Institute for Occupational Safety andHealth (NIOSH) and the Environmental Protec-tion Agency have d eveloped a method ology for

indu stry-specific research plann ing (220). The gen-eral objectives of this work were to improve thecoordination of environm ental and occup ationalregulations and to identify health and environ-mental problems and solutions at an early stage.Although the focus of this project w as research



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Ch. 16–Economic Incentives, Reindustrialization, and Federal Assistance for Occupational Safety and Health “ 337

Box V.—Reducing Lead Exposures: Add-on Controls v. New Processes

The OSHA lead standard sets a limit for oc-cupational lead exposures at 50 micrograms of lead p er cubic meter of air (50 micrograms/m

3).

In a study done for OSHA, Charles River Asso-ciates (103) (discussed by Gobel, Hattis, et al.(184)) examined work exposures and controls ina primary lead smelter with an annual capacityof 225,000 tons. The highest exposures, consid-ering both the number of workers exposed andthe exposure levels, occurred in two depart-ments-the sinter plant and the blast furnacearea. The Charles River Associates report com-pared the costs and emission reductions expectedfrom using each of two methods of moving towardcompliance with the lead standard.

The first method considered w as conventional“add-on” or “end-of-pipe” control technology.

None of the manufacturing process would bechanged, and no new production equipm entwould be installed. Instead, enclosure and ven-tilation systems would b e added to separateworkers from airborne lead or to dilute it toacceptable levels. The second method considereda number of new technologies, which involvednew production machinery, to smelt lead. Install-ing new production machinery would reduceworker exposures more than ad d-on controls

would , and the new machinery also achievessome savings in labor an d materials costs and anincrease in income from the sale of sulfuric acid(a byprodu ct of lead smeltin g). But at th e sametime, the capital costs of new production machin-ery are higher (table 16-1).

The difference in costs might be reduced bycurrent tax preferences for investments. Invest-ment tax credits and rules concerning deprecia-tion for capital investments might offset mom of the costs of new machinery than of add -on con-

trols, but th e quan titative impact of those pref-erences was not calculated. Moreover, changesin the tax laws to encourage health and safetyinvestments might h ave an add itional effect.

If a new smelter is to be constructed, both

health and economic considerations would favorthe new Machinery. Its construction cost and thecost of a conventional smelter would be similar,and its reduced emissions and reduced operat-ing costs would sway the decision. But install-ing the new process in an existing smelter, giventhe economic factors, wou ld requ ire a cardweighing of tax advantages and the other capi-tal and operating costs.




planning for two agencies, the general idea couldbe extended to other Federal financial and regu-latory policies. In p articular, the m ethodology fol-lows the industry breakdown used in the Com-merce Department’s ann ual report, U.S. IndustrialOutlook, and develops a series of indicators that

could be used to coordinate Federal policies.

A Federal Interagency Task Force on Work-place Safety and Health recommended in 1978that OSHA take steps to identify hazards forwh ich en gineering controls could be installedalong with the n ormal replacement of plant an dequipment (228). Both types of analytical workmight be usefully considered in developing indus-trial policies.

OSHA regu lations can also be d esigned to con-sider the capital and in vestmen t cycles of plantsand firms. To some extent, the use of delayed im-

plemen tation schedu les takes these concerns intoaccount. Industries then have some flexibility con-cerning the tim ing of engineering contr ols. Feasi-bility is an important consideration in such cases:something that m ay not be feasible in 6 monthsmay be feasible ins years. On e suggestion, mad ein the OSHA proceeding concerning noise expo-sure rulemaking, is the possibility of different per-missible exposure limits for new and old p lants.Such “grandfathering” may ease the complianceburd en in old p lants but needs to be done cau-tiously lest it create an un wan ted incentive for

continuing the operation of inefficient, olderplants. In addition, it tends to create two classesof protection, with workers in new plants beingprotected m ore than wor kers in older facilities.

As described in chapter 1, this assessment sug -gests several options related to occupational

health and safety, indu strial policies, and r ein-dustrialization. First, if funds or tax incentives arecreated for the building or rebu ilding of indu s-try, app lications for those benefits might be re-quired to includ e a discussion of methods to beused to control expected health and safety haz-

ards. These fund s could be extend ed to expend i-tures for control technologies to reduce thosehazar ds. Second, comp anies receiving reindu stri-alization assistance might be required to designhealth and safety into their new p lant and equ ip-ment, either to m eet existing health and safetystand ard s, or to achieve lower exposu re levels orsafer p rocesses.

Two other options consider the relationship be-tween OSHA regulatory actions and reindustri-alization. Because of the pot ential for impr ovinghealth and safety, as well as productivity, dur-

ing the process of modernization, OSHA regula-tory actions could consider explicitly the capitaland investment cycles of plants, firms, and indus-tries. Information could be developed concern-ing the health, safety, investment , and p rodu c-tivity needs of various ind ustries. In p articular,if studies show th at an indu stry is going to m akemajor changes to improve p rodu ctivity, OSHAmight consider d elaying the required attainmentof a standard through engineering means u ntil themodernization is undertaken. Alternatively,OSHA regulations might be u sed to spu r the d e-velopment of new technologies and accelerate the

process of industrial change. The history of OSHA’s vinyl chloride and cotton d ust regu la-tions shows that, at least in some cases, employerefforts to comply with h ealth and safety stand-ard s can also be associated w ith prod uctivity im-provements.

FEDERAL AID FOR RESEARCH AND INFORMATION DISSEMINATION

Creation of an Occupational cently. Fund ing has been redu ced for two areas

Safety and Health Fund in particular— education and training programs,and research on w orkp lace illnesses and in jur ies.

The advisory p anel to th is assessment expressed One way to provide for more stable and enhanced

concern abou t the large swings in occup ational funding would be to establish an Occupational

safety and health policy that have occurr ed re- Safety and Health Fund . This fund might also pro-



Ch. 16—Economic incentives, Reindustrialization, and Federal Assistance for Occupational Safety and Health q 339

vide a focus for th e enhanced efforts in controltechnology research, edu cation and training, andinformation dissemination.

The Work Environment Fund of Sweden offersa possible mod el for a U.S. fun d (468). Sweden,partly because of its commitment to providing ex-

tensive edu cation and training, as well as fund -ing for research on h azard s and controls, is viewedby many as an international leader in occupa-tional safety and health. Two organizations areparticularly responsible for these activities. Thefirst is the Work Environm ent Fun d itself, estab-lished in 1972, which is fund ed by a p ayroll taxon employers of 0.155 percent. The fund is admin-istered, in typically Swedish fashion, by a tripa r-tite board composed of representatives of man-agement, labor, and Government.

In its first 10 years, over 1,800 research and

development projects and about 1,500 for train-ing and information were funded. The researchand development grants have included fundingof epidemiological and toxicological studies,measurement techniques, and development of control techniques for a variety of hazards. In re-cent years, these have focused on the hazards of working with various chemicals, including sol-vents, metals, minerals, welding and cutting prod -ucts, and ru bb er and plast ics. The fund has alsospon sored work on ph ysical agents, includin gnoise, vibration, rad iation, and in issues concern-ing ergonomic design related to w orking postures

and lifting requ irements (468).

The training and information projects have in-cluded the development of course materials forthe introductory and advanced training of workersafety stewar ds a nd sup ervisors. From 1972 to1981, nearly 400,000 ind ividu als received som eform of training. The Joint Industrial Council,wh ich w as created by an agreement of Swed ishemployers and unions in the 1940s, has producedmost of the educational materials concerningworkplace health and safety used for this train-ing (468).

There are on ly a few U.S. exam ples of cooper-ative labor-management-Government researchand training activities related to health and safety.One example is a set of experiments concerningthe use of “washed cotton” to control the hazards

of cotton dust. This project is funded by bothGovernment and industry, with oversight and di-rection provided by a group of labor, manage-ment, and Government officials. There have alsobeen jointly administered research efforts andtraining programs that have resulted from collec-

tive bargaining.Congress could consider several possible admin-

istrative arrangements if it created a fund. It couldfollow the Swedish m odel by creating a tripar-tite board to adm inister this fund, or it could d el-egate administrative responsibilities to NIOSH orOSHA. It could create this fund and its researchand training p rojects to exist alongside the existingprojects and arrangements at OSHA and NIOSH,or it could consolidate w ith this fund all existingresearch and training, including NIOSH extra-mural research grants, NIOSH training grants,OSHA New Directions grants, and OSHA-fundedconsultation.

Financing could be through a payroll tax onemployers or through a tax or surcharge basedon the level of wor kers’ compen sation prem ium spaid by emp loyers (with some adjustments for thepr esence of health hazar ds in variou s ind ustr ies).For examp le a 0.1 percent emp loyer tax on thetotal U.S. payroll of $1.6 trillion (in 1982) wouldresult in an nu al revenues of about $1.6 billion.A payroll tax of 0.01 percent would raise $160million. A 1.0 percent surcharge on workers’ com-pensation prem ium s (about $25 billion in 1980)

would produce annual revenues of $250 million.

Assessments for health, safety, and environ-mental activities have been used in the UnitedStates in at least two cases. The ComprehensiveEnvironmental Response, Compensation, and Lia-bility Act of 1980 created a “sup erfund ” to p ayfor activities related to releases of hazardouswastes. Most of the fund ing for this is from taxeson oil and chemicals (546). The recently enactedright-to-know law in the State of Washington in-clud es an assessment of 75 cents for each emp loyeein the State, to be pa id by emp loyers (351). One

bill concerning asbestos compensation, now undercongressional consideration, proposes establish-ing an assessment to be used for research (517).

Although creation of an Occupat ional Safetyand Health Fund would enhance the commitment




to research and training in this area, there are dis-advantages to consider. The relationship betweenthis fund and the existing agencies (OSHA andNIOSH) wou ld need to be determined. Moreover,a new tax or surcharge, even though one of mod-est size, runs against recent reductions in business

taxes.

Federal Assistance to Small Businesses

Improvements in employee health and safetycan be d ifficult for smaller bu sinesses, wh ich oftenlack technical expertise in industrial hygiene,safety engineering, and occup ational med icine.Smaller businesses commonly face financial dif-ficulties as well.

As discussed above, from 1971 to 1981, theSmall Business Administration issued a limitednumber of loans to assist small businesses in com-plying with OSHA standards. In 1981 Congresseliminated au thorization for this program. Oneoption wou ld be to stud y the results of this loanprogram , especially to learn w hy it w as used soinfrequently. After such a study, Congress couldconsider reauthorizing the loan program and pro-viding an ad equate level of fun ding.

Other kinds of Federal assistance for small busi-ness could include p rovid ing technical assistanceand facilitating the creation of programs to pro-vide technical assistance. Chapter 12 discussesOSHA consultation, which is the m ajor OSHA

activity for prov iding assistance to small busi-nesses.

SUMMARY

Several appr oaches to improving occup ationalsafety and health h ave not been extensively usedin the United States. These include the use of eco-nomic incentives, tax incentives, and financialassistance. Althou gh in theory th e workers’ com-pensation system provides an economic incentive

to prevent worker injuries and illnesses, in prac-tice it prov ides only a limited economic incentivefor prevention, especially for occupational ill-nesses.

Another possible type of economic incentive in-volves injury or exposure taxes. As a substitute

NIOSH an d O SHA could also encourage thedevelopment of programs to provide industrialhygiene, safety engineering, medical surveillance,and worker health and safety training. Thesecould be established to service industries, regions,and employers who do not offer such services.

Especially helpful w ould b e progra ms for servic-ing small businesses in particular areas.

Because it is inefficient and imp ractical to re-quire each small business to provide a full rangeof safety and health services, programs to pro-vide shared resources might be cost effective. Fed-eral fun ding could be u sed to start such programs.However, there may be difficulties in sustainingthese programs after the startup period. Eventhough the price of shared p rograms should beless than if a compan y w ere to pu rchase the serv-ices entirely on its ow n, some sm all businessesmight find it beyond their means. The steps thatare needed to aid those compan ies are not ad-dressed by providing shared resources.

As discussed in chapter 15, the regu lation of the prod ucts purchased by sm all businesses mayalso be a way of improving, to some extent, thehealth and safety of their w ork forces. This ap-proach could also be applied to nonregulatorytesting programs. For example, NIOSH could con-duct occupational safety and health performancetests of prod ucts used by sm all businesses andpublish the results in a fashion easily accessibleto small businesses, wh ich could th en use the re-

sults of these tests in purchasing d ecisions.

for the regulatory system, which penalizes firmsfor violations of regu lations, an injury tax sys-tem w ould levy a d irect financial penalty on th efirm for each injury. Such an app roach app ealsto many economists, but it p resents a n um ber of difficulties.

Congress could also modify the structure of business taxes to encourage investment in healthand safety control technologies, or it could pro-vide direct assistance to businesses in financinghealth and safety investments. Either decisionwou ld p rovide some level of “social fun ding” for



Ch. 16—Economic Incentives, Reindustrialization, and Federal Assistance for Occupational Safety and Health q 341

investments in occupational safety and health,thus reducing their costs and encouraging firmsto un dertake them. Four kinds of tax and assist-ance programs could be considered: investmenttax credits, accelerated depreciation, Governmentloan programs, and direct subsidies. All have been

used to stimulate adop tion of pollution controls,and loan program s have been used, to a limitedextent, for occup ational safety and health.

Tax incentives and financial assistance pro-grams m ight spur the implementation of controls,assist businesses in compliance, and possibly re-duce the controversy of regulatory proceedingsbecause of th e availability of sou rces of finan ce.How ever, they wou ld cause either a redu ction inFederal tax revenues or an increase in budgetoutlays and could increase the complexity of U.S.tax law or increase administrative burdens. More-

over, these programs can be inefficient, and wouldaffect other aspects of business investmentbehavior, as well as the distribution of wealth,income, and the bu rden of income taxes.

Federal p olicies concerning reind ustr ializationmight have either a beneficial or an adverse im-pact on workplace health and safety. It is possi-ble that many of the improvements in w orkerhealth and safety du ring this century occurred co-incidentally with the introduction of new technol-ogies, new processes, and new industries and notas the resu lt of conscious d ecisions to ad d con-trols to existing processes. A time of reindustriali-zation offers opp ortunities to integrate prod uctiv-ity-improving investments in plant and equ ipmentwith the installation of control technologies, aswell as to exploit the fact that it is cheaper andmore effective to control a hazard when design-ing new p lant and equ ipment than it is to retrofitexisting operations. Reindustrialization also af-fords an occasion to achieve greater levels of pro-tection. How ever, there is also the dan ger thatcombining p olicies that are d esigned to imp roveprod uctivity with those that add ress emp loyeehealth and safety will lead to an emp hasis on pro-

du ctivity at the expense of health and safety.

Health and safety regulation may have nega-tive effects on productivity, by requiring spend-ing for controls that are “nonproductive,” com-pared with trad itional measures of produ ctivity.But in the aggregate, this diversion is relativelysmall, and may, in many cases, be offset by reg-

ulation-ind uced changes that improve p lant pro-ductivity as well as employee health and safetyprotection. Facing the need to redesign productsand process to comp ly with health, safety, andenvironmental regulations, comp anies may fun-damentally redesign product or process throughthe u se of new technology. For both the OSHAvinyl chloride and cotton dust standards, em-ployer compliance w as associated with im prove-ments in productivity. For the lead industry, itis possible that new technology could be intro-du ced that w ould simultaneously redu ce workerexposures, reduce the costs of controlling ex-

posures, and improve prod uctivity.

Financing for research and training activitiesand for assisting small businesses could be pro-vided by an Occupational Safety and HealthFund . The Work Environment Fund of Swed enoffers a p ossible mod el for a U.S. fund that cou ldprovide a new focus for enhanced efforts in con-trol techn ology research, edu cation and training,and information dissemination.

Small businesses face special problems in mak-ing improvem ents for employee health an d safety.They often lack technical expertise in industrialhygiene, safety engineering, and occupationalmedicine, and they face financial difficulties aswell. Assistance to such firms could includ e Gov-ernment loan programs, consultation, and Gov-ernment testing and regulations of products pu r-chased by sm all businesses. In ad dition, OSHAand NIOSH could encourage the development of programs to provide industrial hygiene, safetyengineering, medical surveillance, and workerhealth and safety training to small businesses,especially in regions currently lacking such

services.



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PreventingInjury and Illness

.,

7 .

Work-Relatedin the Future



Contents

Future Trends . . . . . . . . . . . . .Opportunit ies for Prevention

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Energy-Related Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Mod ern izing O ld Industr ies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .New Technology=. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Rapid ly G row ing O ccupa tion s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..,+... ...,

O

. . . . . . . . . . . . . . . . . .Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LIST OF TABLES

Hazards in Coal Liqu efactionRatios Among Coal Miners .

Table

17-1.17-2.

No.

Potential Occup ationalStandardized Mortali ty

Page

348

349

Plants. . . . . .

. . . . . . . . . . . .

. . . . . . . . . . . .

LIST OFFigure

17-1.17-2.17-3.

No.Page

352353

353

Features of Stand ard Fermentor . . . .Features of Contain ed Fermenter . . . . . . . . . . .

. . . . . . ., . . . . . . . .. . . . . . . . . . . . . . . . . .

. . . . . . ....**. . . . . . . . . . . . .Frequency of HealthInvestigations. . . . . .

Complain ts in 55 Office. . . . . . . . . . . . . . . . . . . . . .

Environment

. . . . . . . . . . . . . , . . . . . ...,*O.

.



17 s

Preventing Work-Related Injury andIllness in the Future

Looking ahead in occupational safety andhealth, except in the most general way, is as dif-ficult and open to error as pr edicting the futurein any field. In general, changes in plant and man-ufacturing techniqu es, shifts in typ es of jobs, andattention to controlling hazards are expected toreduce work-related injury and illness. Some newand exotic hazards are certain to accompany newprocesses, but what has been learned from con-trolling or failing to control current w orkplacehazard s can be app lied to recognizing and con-trolling the new ones.

To some extent, the workplace of tomorrowwill be the workplace of today. Some worksitesand industries will change little, and even in thosethat change, seemingly mundane factors will con-tinue to contribute to w orkplace injury and ill-ness. Inad equate guard ing of machinery, poorlydesigned hand an d pow er tools, and inapp ropriatewalking and working su rfaces will not go aw aywithout attention to injury prevention. Somelong-known health hazards remain problems. Forinstance, silica dust in plants, mines, and found-ries continues to cause ill health. The absence of

controls in such situations underlines the impor-tance for policymakers to understand how incen-tives for adopting controls work and do n ot work.

FUTURE TRENDS

There are a few sources of information aboutexpected trends in employment and other sourcesfor pred icting wh ere new technologies are likely tobe used; careful consideration of trends by leadersin health and safety could lead to the develop-

ment of controls to accompany the new tech-nologies.

The 1984 edition of U.S. Industrial O utlook :Prospects For Over 300 Industries (554), preparedby th e Bureau of Ind ustrial Economics, Depart-

The look at the futu re in this chapter is verymuch constrained by knowledge of the present.The changes that are described are evolutionary,not revolutionary. That is not intended to implythat revolutionary changes will not take place, butit acknowledges that revolutionary changes arefar hard er to pred ict. For example, the d raftersof the National Cancer Plan in 1970 failed to men-tion one of the most important biological ad-vances, recombinant DN A (544), for the simp lereason that it had yet to be “invented . ”

The future will present a mix of the problemsof today and tomorrow . The m ix, it can be saidwith some confidence, is bound to change, andcertain new, just emerging problems, are expectedto capture the attention and efforts of safety andhealth professionals in the years ahead. This ex-pectation is in keeping with th e observation m adeearlier in this report that concern about the newsometimes seizes the imagination and attentionof expert and lay person alike. This is particularitylikely to happ en wh en the old p roblems are con-centrated in ind ustries or trades that are seen tobe on the way out and there is little incentive to

invest in them. It is a sure bet, however, that oldproblems in old indu stries will not take care of themselves if attention is diverted from them.

ment of Commerce, estimates that the U.S. popu-lation will grow throughout the 1980s at a ratesimilar to th at of th e 1970s-0.9 percent p er year.The rate remains the same because the effects of changes in fertility, immigration, the age of the

population, and mortality roughly cancel out. Thepredictions for increases in fertility rates and legaland illegal immigration and decreases in m ortal-ity wou ld, by themselves, lead to an exp ected in-crease in the population growth rate. Balancingthose is the fact that wom en born d uring the baby

345




boom of the 1940s and 50S are passing out of theirmost fertile years, reducing the number of womenhaving children. Reduced mortality and aging of the baby boomers w ill prod uce an increase in theaverage age of the pop ulation.

The labor force increased by 23 million (26 per-

cent) between 1972 and 1982. Part of the grow thresulted from the u nprecedented increase in thenu mber of women entering th e work force, theremainder from the entry of young men. Thisspectacular rate of growth will not continue d ur-ing the n ext decade, when 17 million p eople (a16 percent increase) are expected to enter the work force. These projections ind icate tha t p reventionof injury and illness in the n ext 5 years will beaffected by an aging work force including an in-creasing number of women.

Even this very general information can be of

value to health and safety pr ofessionals as theylook ahead to the next decade. For instance, olderwor kers may respond d ifferently to preventiontraining than younger workers. Women will re-quire different considerations in the ergonomic de-sign of jobs and personal protection equipment.

Information about which industries are likelyto grow and which are likely to decline is usefulfor directing research in control technology andfor encouraging compan ies to consider inju ry andillness prevention before a new plant is built andnew technologies installed. Anticipation of prob-

lems in the p lanning stages can h elp prevent seri-ous p roblems later on. Gaining ind ustries citedin the 1984 report include the motor vehicle andelectronic-product-related groups. However, themost rapid growth was expected in the service in-

OPPORTUNITIES FOR PREVENTION

Many new technologies should be inherentlysafer for workers than those of the past, but newpr ocesses will require m odification of old or fab-

rication of new controls. Eight kinds of work-places are discussed h ere as examples of chan gesthat are expected:

q Energy-related industries:Synthetic fuel productionCoal miningOff-shore oil dr illing

dustries. The injury rate in those industries—compu ter, banking, legal, and med ical servicesand related activities—is lower than the all-indus-try average. Nevertheless, the number of peopleemployed in them m eans that attention to safetyand health in those industries will be increasingly

important in the future.The Environmental Protection Agency (EPA),

in cooperation w ith the N ational Institute for Oc-cupational Safety and Health (NIOSH), has con-sidered the production of a document that wouldconcentrate on environment and occupationalhealth and safety. As planned, the outlook wouldhave tw o par ts. In th e first, data ava ilable fromFederal sources about current an d expected em -ploymen t levels, injury and illness rates, com-pliance with Occupational Safety and HealthAdministration (OSHA) regulations and EPA airand water quality regulations, solid waste dis-posal, and energy and w ater use would be pre-sented for each four-digit Standard IndustrialClassification code. Insofar as possible, informa-tion about occupational and environmental meas-ures wou ld be p resented for each ind ustry cov-ered in the Departm ent of Commerce Ind ustrialOutlook. A very useful feature of the EPA/ NIOSH docum ent is that all the d ata are enteredin a comp uter network so that u sers with p ersonalcomputers can carry out their own analyses. Thesecond part of the d ocum ent is a narrative, pro-filing each of the industry groups in terms of envi-

ronmental safety and health, highlighting trendsin the w ork force, the use of new technology, thehand ling of hazard ous substances, and other re-lated matters (220).

• Modernizing old industriesSteelmakingAutomobile manufacturing

• New industriesSemiconductor manufacturingBiotechnology industries

q Rapidly growing occupationsOffice wor k

In terms of expected numbers of workers, theindustries vary. Synthetic fuels may or may not



Ch. 17—Preventing Work-Related Injury and Illness in the Future . 347

become imp ortant in the future an d even if theydo, large-scale production will take time toachieve. Shou ld that h app en, a new w ork forcewill have to be trained, and employment in theindustry could take off. Coal mining and offshoreoil drilling are employing more workers now.

With the introduction of larger, more efficient ma-chinery in mining, the nu mber of miners is ex-pected to p lateau and then d ecline. Oil drillingemp loyment w ill increase or at least remain con-stant so long as th e search for oil fields is prof-itable. Steel and auto manufacture, despite somerecent resurgence, are not expected to employ asmany as they did in the 1970s.

Jobs in the sem icond uctor-related technologiesare expected to increase. Biotechnology is, per-haps, at a point in its development analogous tothat of the semicond uctor business a decade ortwo ago. If some of the new ly created biotech-nology firms are successful, there should be more

jobs in this field, but the maximum number of workers is likely to be small and they will behighly trained.

Technologies affecting office work crosscut allsectors, both p ublic and private, and are rapidlygrowing as the U.S. economy becomes increasing-ly information-oriented . It is expected th at thenumber of workers in offices or at least doingwork that is now associated with offices will in-crease over the next few d ecades.

Consideration of futu re employment op por-tun ities is directly related to health and safety. Notonly do different jobs carry different risks, butmore important, work is essential to good health.A nu mber of stud ies have shown th at medicalservices are more heavily used d uring p eriods of unemployment, that mental health problems in-crease in nu mber an d severity, and that suicidesincrease. Working is good for health, and properattention to identifying and controlling hazardsin the workp lace can prevent injur ies and illnesses.

Energy-Related TechnologiesThe fuel crises of 1973 and 1978 led to d ramatic

changes in the production and use of energy inthe United States. The Department of Energy wasformed, and resources were m arshaled for the Na-tion to become energy independent through find-

ing new energy sources and new technologies forconserving energy. Production of liquid fuels fromcoal, oil shale, and tar sands will involve newtechnologies and new hazards, and new controlswill be needed. Increased coal use will stimulatethe purchase and use of new mining machinery

that w ill require app ropr iate controls.

Synfuel Production

Synthetic fuel (synfuel) produ ction m ethodsbreak d own complex molecules of relatively abun-dant and naturally occurring carbonaceous ma-terial such as coal or oil shale to produce simpler,cleaner, m ore efficient fu el. Althou gh these tech-nologies have been used before on a small scale,they have never been economically competitivewith fuel produ ction from crud e oil and h ave re-mained commercially u nd eveloped. These tech-

nologies, though, could eventually be adopted bythe United States to achieve energy independence.

Congress established the U.S. Synthetic FuelsCorporation (SFC) to fund projects that w ouldlead to production of clean and safe energy. TheSFC has prop osed gu idelines to m onitor emissionsin the workplace and to the surrounding environ-ment (653):

Any contract for finan cial assistance shall re-quire the development of a plan, acceptable to theBoard of Directors, for the m onitoring of envi-ronm ental and health-related emissions from theconstruction an d op eration of the synthetic fuelproject (486).

Plans requ esting financial assistance are to in-clud e details of a mon itoring system, listing sub-stances to be m onitored ; the frequency, location,methods, and durations of monitoring; and work-er exposure and health surveillance program s. Aworker registry is required to integrate worker ex-posure data, medical records, demographic infor-mation, an d job classification codes so that anytrend s in work-related injury and illness can beidentified.

Production of liquid fuel from shale oil involvesliberation o f some chemicals that are carcinogenic,and studies of pilot plant w orkers in this countryreport dermatitis, eye irritation, and thermalbur ns from job exposu res. Fire and explosion arehazards because of the operating temperatures andpressures necessary for synfuel production.




Table 17-1 lists the potential hazards that couldbe expected in a coal liqu efaction p lant. Problemsare encountered during coal hand ling and prep -aration, during the process itself, and during wastetreatment. Estimates have been made of the chem -ical products and byproducts that might be found

at each poin t in the process so that w orker pro-tection can be considered du ring d esign (575).

Concern about these hazards has contributedto systematic analysis of plans of future synfuelplants in an effort to anticipate causes of injuryor illness. For instance, NIOSH reports one ex-amp le of the success of this app roach. High pr es-sure vessels for coal liquefaction operate at extremelyhigh pressures and tem peratures and contain flam-mable material. Engineers, recognizing the poten-tial hazard from a h igh-pressure vessel used in abench-scale (labora tory-sized ) coal liquefaction

process, placed protective barriers around it.When the vessel unexpectedly exploded , harm w aspreven ted. In another instance, reinforced con-crete walls between the liquefaction system andthe operating control room protected operatorsfrom injury and operating controls from damage.The unharm ed operators were able to shut d ownthe pr ocess, thu s preventing furth er explosionsand fire. These same techniqu es could be app lied

in future op erations to p revent harm at all levelsof operation (575).

Coal Minin g

Most coal is used in the traditional way to gen-erate power d irectly in steam plants, and its use

has increased during the past decade of uncer-tainty abou t oil supp lies. Use is expected to in-crease further, to d oub le, in fact, by the year 2000,to as m uch as two billion tons per year (536).

Mining and m oving coal are hazardous. Over100,000 coal miners h ave been k illed since 1900),and coal workers’ pneumoconiosis (black lung dis-ease) has taken a high toll. A mortality stud y of 23,233 miners selected randomly from those eligi-ble for United Mineworkers of America health andretirement fun ds as of Janu ary 1, 1959 and fol-lowed throu gh December 31, 1971 with 99 per-

cent followup, reported excess mortality for stom-ach cancer, influenza, asthma, tuberculosis, andaccidents (392) (see table 17-2). Unless steps aretaken to assure prevention of work-related injuryand illness in coal mines, an increase in produc-tion may lead to excess morbidity and mortality.

Changes in technology are introducing newhazards into the mine. For instance, the diesel en-

Table 17-1 .—Potential Occupational Hazards in Coal Liquefaction Plants

System, unit operation

or unit process Potential hazardsCoal handling and

preparation system. . . . . . . . Coal dust, noise, fire, explosion, asphyxia (nitrogen andcarbon monoxide gases), burns

Liquefaction system . . . . . . . . . Phenols, ammonia, tars, thiocyanates, PAH’s, carbonmonoxide, hydrogen sulfide, hydrocarbons, fires,explosions, burns, high pressures, noise, ash, slag,mineral residue, spent catalyst

Separation system . . . . . . . . . . Oils, phenols, hydrogen cyanide, ammonia, hydrogensulfide, burns, fires

Upgrading and gaspurification . . . . . . . . . . . . . . . Light hydrocarbons, phenols, ammonia, hydrogen sulfide,

carbon dioxide, carbon monoxide, burns, fire,explosion, high pressures

Shift conversion . . . . . . . . . . . Tar, naphtha, hydrogen cyanide, fire, catalyst dust, burns,hot gases (carbon monoxide, hydrogen)

Methanationa. . . . . . . . . . . . . . . Carbon monoxide, methane, nickel carbonyl, spent

catalyst dust, fire, burnsWaste treatment facilities . . . . Hydrogen cyanide, phenols, ammonia, particulate,

hydrocarbon vapors, sludges, spent catalyst, sulfur,thiocyanates

alndirect liquefaction

SOURCE: (575),




Table 17.2.-Standardized Mortality Ratios Among Coal Miners a

Deaths

Cause of death Observed Expected SMR b

All causes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,628 7,506.1 101.6All malignant neoplasms . . . . . . . . . . . . . . . . . . 1,223 1,252.2 97.7

Respiratory organs . . . . . . . . . . . . . . . . . . . . . 373 331.0 112.5

Stomach cancer . . . . . . . . . . . . . . . . . . . . . . . . 127 91.9 134.9

b

Major cardiovascular diseases . . . . . . . . . . . . . 4,285 4,501.2 95.2b

Chronic and unqualified bronchitis . . . . . . . . . 26 29.0 89.7Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 14.8 189.6 b

Emphysema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 118,3 143.7b

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 18.3 174.9 b

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 43.3 145.5b

Coal worker’s pneumoconiosis. . . . . . . . . . . . . 187 — —

Accidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408 283.0 144.2 b

%al miners covered by the United Minewotiers of America health and retirement funds The vital statusof 22,998 minerswas verified.bstandartjizedmortafity ratlo(sMR) i s s i g n i f i c a n t l y d i f f e r e n t f r o m 100at the5 p e r c e n t c o n f i d e n c e level

SOURCE (392)

gine is increasingly replacing electrically poweredmine equipm ent. The exhaust emissions from su ch

engines include cancer-causing polynuclear aro-matic hydrocarbons, respiratory system irritants,and asp hyxiating carbon mon oxide and carbondioxide.

Control technologies for diesel engines are wellknown. Diesels operating under ideal conditions,with proper maintenance and operation, produceminimal amounts of contaminants. In under-ground coal mines, ventilation can be increasedto keep contamination at a minimum. Filters, re-circulation of exhaust gases through the engine,catalytic converters, and exhaust scrubbers can

also be used to clean the exhausts (477). Such con-trols are difficult and requ ire high degrees of main-tenance to assure that they are functioning properly.

Other examples of a prod uction technology thatmay increase risk of injury in the mines includecontinuous miners and long-wall mining. Contin-uou s miners are m achines that cut into a coal veinand transfer loose coal back to a conveying mech-anism for transp ort to the sur face. While they in-creased productivity when they were phased intothe mines from 1950 to 1970, the fatality rate rosesl ightly and the d isabling in jury rate continuedat a relatively constant level. Long-wall miningis a mining method in which a machine extractscoal by moving back and forth across a face whileconveying the coal to one of two tu nnels du g par-allel to each other and at right angles with the coalface. The coal is transpor ted to stations for trans-

fer to the surface via conveyors running throughthe tunnel. Supports at the face protect miners

while allowing the roof to cave in behind the face just worked, preventing unwanted roof fall. Long-wall mining may reduce fatalities but not neces-sarily injuries or harm ful du st levels (536).

Outer Continental Shelf Oil Production

Another energy area expected to grow is oil andgas production on the outer continental shelf. De-mand for energy has led to the development of technologies for deep water oil and gas explora-tion in remote locations and und er extreme envi-ronmental conditions. An increasing number of

workers, already at high risk because of the natu reof oil extraction, will face even greater risks of work-related injury and illness. In the period 1970-79 emp loyment in ou ter continental shelf oil andgas exploration grew by 71 percent (to a work force of 61,500) for an av erage an nu al grow th o f 3 percent. Moreover, there was a 20 percent p eryear increase in tw o years, 1978 and 1979 (319).

There are tw o areas of concern. The first is thedesign and stability of drilling rigs. A comb ina-tion of bad weather and in adequate structuralstrength has resulted in major catastrophes, such

as the failure of a mobile offshore drilling unit in1982 in the N orth Atlantic that killed 84 workers.

The second area is the risk to workers from thewor k itself. Drilling is frequent ly continuou s, be-ing done in shifts 7 days a week, under difficult




cond itions. Drill space is cramp ed and pipes, tub-ing, tongs, and other material are heavy and cum-bersome. Walking and working surfaces are slippery from drill fluid s. The work is outside, soweath er is often a factor. The severity of theseconditions is heightened on offshore drill rigs and

may b e expected to be even more severe on off-shore units located in remote areas, where weathermay be extreme.

Modernizing Old industries

U.S. manufacturers are facing intense competi-tion from Japanese and Western European compa-nies, and that sector of the U.S. economy maybe declining. The declines have been attributedto inadequate investment in n ew p lant, changingmarket conditions, rising labor costs, and cost-generating Government regulations. Whatever theexact reasons—and they are a m atter of argu-men t—it is agreed th at the U.S. steel indu stry isno longer the f irst in th e world. Changes in thequ alities of cars that ind uce people to buy an au toresulted in U.S. consumers buying more foreign-built models, and U.S. domination of auto salesis a thing of the past. Both these industries areretooling and retrenchin g to meet the foreignthreats, and th ere will be opp ortunit ies to bu ildin features to prevent w ork-related inju ry andillness.

Steelmaking

Steelmaking is on e older U.S. ind ustry thatmu st change if it is to survive. Increased research,development investment, and the use of new tech-nology are all requ ired to comp ete with steel-maker from other countries (538). Unfortunately,this has become a chronic public policy problem.As mentioned in chapter 16, the Steel TripartiteAdvisory Committee, made u p of steelworkers,steelmaker, and Government officials, was estab-lished b y President Carter in the 1970s to attemp tto revitalize this industry.

The Comm ittee’s Working G roup on Techno-logical Research and Development concluded that(458):

environmental and occupational safety andhealth issues should be considered as an integralpart of technological research and development

in the steel industry. Research in steel technologyshould continue to take into consideration fea-tures for protecting workers and improving theambient environment both with respect to newand to existing steel facilities.

The Working Group went on to recommend

Federal fun din g for research and development andfor demonstration plants. These recommendationswere agreed to in recognition of the high risk of work-related injury and illness in steelmaking, andthe opportunity to reduce costs through develop-ment, demonstration, and adoption of controltechnologies.

New technologies for steelmaking are more pro-du ctive and lik ely to cause fewer w ork-related in-

juries and illnesses. For example, continuous cast-ing is used to produce 80 percent of Japanese steelan d 32 percent of U.S. steel. It requires less

energy, costs less per ton of steel prod uced, andproduces higher quality steel and less pollution.It also eliminates soaking pits and reheating fur-naces and requires less coke making, three stepsin the traditional process that produce emissionsthat are associated w ith d isease. In gen eral, bet-ter workin g cond itions exist in continuou s castingsteelmaking plants.

Another new steel technology is direct reduc-tion of iron ore rather than the current processof blast furnace and coke oven. Since direct re-duction can be done without coke, r isk of lungcancer from coke oven emissions can be elimi-

nated. Other technologies that show promise forthe 1990s and that can be made less likely to causework-related injury and illness include formcok-ing (another process reducing coke oven emis-sions), direct casting of sheet an d strip metal frommolten steel, and one-step steelmaking directlyfrom ore. In the latter two processes, poten tiallyhazardous steps in the process are eliminated, thusreducing risk of worker harm .

The same changes that improve production andreduce risks will cause further shrink ing of thework force. In the late 1970s, 450,000 workers

were employed in steel; in 1983, the number wasless than 250,000, and it cont inu es to decline.

A utom at ing

Automating includes many kind s of industrialoperations, ranging from metalworking in steel-



Ch. 17—Preventing Work-Related Injury and Illness in the Future q 351

works and found ries, to forging and m achinin gof metal parts, to fabrication of plastic parts, and,finally, to assembly. Hazards in the steelworksand foundries include n oise, heat, du st, and gas.Forging and machining are also hazardous. Auto

body painting presents special hazards due to the

large volum es of paint and solvents used d uringassembly. Stress-related illness may result frommonotonous work and shift work.

Conventional controls are available for thesehazards. Local exhaust and dilution ventilation

are widely used in all phases of manufacture andcan be expected to be improved in new processes.

Automated spray painting in booths reduces oreliminates worker exposure. The use of robots inareas of high hazards can red uce risks to workers.

Robots or automated manufacture also intro-du ces hazard s. There have been cases here and

abroad of workers being injured or killed by au to-mated machines. This points to the need for ma-

chines to stop wh en workers inadvertently comein contact with them or to be installed where they

keep workers out of danger zones wh ile the ma-chine is connected.

New Technologies

New technologies that are burgeoning or prom-ise to burgeon into full-scale industries present op-

portunities to prevent work-related injury and ill-ness in the early stages at low cost. The most

Photo credit: NIOSH

This paint spraying line has been automated usingrobots. Future developments in robotics may reduce

worker exposures in other hazardous operations

successful of the new industries is the semicon-ductor industry, and the most glamorous of thepromising ones is biotechnology.

Semiconductor Manufacture and Related Industry

The continuing demand for computer and videodevices for ind ustry and commerce, coupled w ithconsumer electronics and computer technologiesfor microelectronic applications, is expected tofuel the growth of this industry.

Microelectronics has been estimated to have aworld m arket of more than $19 billion an d em -ploy a work force of 500,000 worldwid e (258).

The risk of work-related injury ap pears to belower and illness appears to be h igher in this in-du stry. In 1981 the Bureau of Labor Statistics re-ported the injury incidence rate for semicondu c-

tor and related devices as 4.6 cases per 100full-time workers and lost-workday cases as 2.0per 100 workers, comp ared w ith an all-indu stryaverage incidence rate of 8.3 cases per 100 work-ers and lost-workday cases of 3.8 per 100 full-time

workers (608). The California Department of In-dustrial Relations conducted a survey in 1980 thatshowed workers manufacturing semiconductorshad 1.3 illnesses per 100 workers compared witha rate of 0.4 per 100 workers in the general man-ufacturing ind ustries. Lost time resu lting fromwork-related illness was three times more com-mon among semiconductor workers (18.6 percent

of all lost-workd ay cases) than in general ma nu-facturing industries (6.0 percent of all cases) from1980 to 1982. Almost half (46.9 percent) of allwork-related illness among Californian semicon-ductor workers in this period was reported to re-sult from exposu re to toxic substan ces (258).

Known health hazards include metal fumesfrom soldering, toxic chemicals such as epoxyresins and chloronaphthalene, silica flour used in

making insulating materials and dielectrics,solvents for decreasing solder joints, and acids foretching printed circuits. The volumes of these

chemicals used in California in 1979 were large:Over two million gallons of solvents; more than

two million gallons of sulfuric, hydrofluoric, andother acids; more than one-half million gallonsof sodium hydroxide and other caustics; and overone and one-half million cubic feet of arsine, phos-




phine, diborane, and other toxic cylinder gaseswere used in p rocessing semicondu ctors (258).

Existing technologies, if applied, should be suf-

ficient to control these hazards. Local exhaust ven-tilation is appropriate for soldering and etching

operations. Substitution may be appropriatewh ere solvents are found to be m ore toxic thanexpected. Replacement of carbon tetrachlorideand trichloroethethylene (after they were shownto be carcinogenic amon g laboratory anim als)with perchloroethylene is an example of th is.

Biotechnology

Recombinant DNA technologies, operating atmoderate pressure and temperature, have fewerinherent physical hazards than traditional chem-ical processes, which sometimes operate atdangerously high pressures and temperatures. Fur-

thermore, to the extent that biotechnology usespinpoint production techniques to produce par-ticular chemicals, it will eliminate the currentlyencountered mixtures of chemicals, contaminatedwith unwanted toxic compounds, that are com-mon in conventional chemical synthesis.

Biotechn ology’s h azards center on the possibil-ity that the m icrobes used in it or products pro-duced from them will be harmful to human healthor the en vironmen t. Since some of these orga-nisms are “new,” in that they have been p roducedby gen etic engineering, there is concern am ong

some people that they present significant risks(541,548). Most exper ts in th e field see the orga-nisms being used for or proposed for use as pro-duction organisms as “crippled” and unable to sur-vive outside the laboratory or workplace.

More of a p roblem are “n ew” m icro-organismsdeveloped to be released in to the environmen t.Because they will have to compete with organismsthat occur naturally, they cannot b e crippled. Forthat reason, EPA is now considering regulatingthe intentional release of such organisms, andCongress has expressed interest in a regulatory

scheme.In th e area of using micro-organisms for pro-

du ction, the United States appears to have stud-ied questions of worker health more carefully thanother countries. The U.S. voluntary approach to

worker p rotection is m onitored b y the ResearchAdvisory Committee of the National Institutes of Health, and NIOSH has developed guidelines formedical surveillance of fermentation and biotech-nology plant workers (259a).

NIOSH industrial hygiene surveys of six indus-tr ial laboratories using recomb inant D NA tech-nologies found wide variation in safety and healthpractice among them. Practices ranged from “ex-emplary” plants with health and safety programsfor workers to plants where workers were allowedto smoke and drink in the laboratory and to storebeverages in laboratory refrigerators, and whereprocedures for biological waste-disposal wereundocumented—all unacceptable practices.

Figures 17-I and 17-2 contrast a standard fer-menter with a contained one, which wou ld con-tain organisms and culture media used in biotech-

nology. The contained fermenter provides fordou ble filtering of exhaust gases to control emis-sions, a special mechanical seal at the top to pro-vide extra protection against loss of growth me-dium that contains bacteria, and an alarm to warnoperators of ruptured seals, thus helping preventpossible loss of contaminated broth. These fea-tures of the contained fermenter provide increasedprotection both to workers and the environment.

Figure 17-1 .—Features of Standard Fermenter

Exhaustto atmosphere

unfiltered

Compressed airDip tube

inletharvest and fill

line

Cooling jacket

Agitator

Air sparger

SOURCE: NIOSH




Figure 17-2.—Features of Contained Fermenter

Secondback up Exhaust gas

sterile filter filter system (1)

Special double mechanical

Primaryseal with sterile fluid purge

sterile(2) and loss of pressure air

filter Dip tube

Compressed air harvest and fill

inlet line (3)

Other features

(6) Collection ofcontaminatedcondensate andsterilization beforerelease

(7) System validationbefore operation

(8) Monitoring program(9) Operation with

detailed protocol

et

Agitator

Air sparger

SOURCE: NIOSH

Rapidly Growing Occupations

Office Work

Thirty-three million p eople work in office jobsin this country. The advent of new technologysuch as computers using video displays and ad-vanced copying machines have changed th e of-fice. To some extent, machines can pace the work,introdu cing a new source of stress. Lighting andfurniture, ignored in the installation of the firstcompu ters and word processors, are imp ortantto worker comfort and probably to health andsafety.

The energy crisis has resulted in office buildings

being tightly insulated. Unfortunately, improvedinsulation that keeps heat or cooled air in also pre-vents air exchange from cracks and other tinyleaks and increases indoor air p ollution. Becausebuilding air is recirculated to conserve energyrather than directly exhausted to the outside,many ventilation standards are now inadequate.

Formerly unacceptable, the practice of recircula-

tion has been adop ted to reduce the relatively high

costs of heating and cooling. Harmful air contami-nan ts, aerosol can chem icals, tobacco smoke, andpathological micro-organisms m ay reach u nac-ceptable levels. Some building technologies alsocontribute to the contamination. For example, the

irritating and potentially carcinogenic compound

formaldehyde is emitted from plywood, and nat-urally occurring radioactive radon gas may beemitted from certain building sites. Even w hen theexact causes of workers’ health problems remain

un identified, the problems have been reversedwith increased ventilation.

Health effects have been related to indoor air

pollution. At high concentrations, indoor air con-taminants may cause irritation of sensitive tissues,

and acute or chronic illness. Many substances ap-

pear to act p rimarily as irritants at low exposure

levels, inducing local inflammatory reaction in theeyes, nose, lun g, or other sites (25). NIOSH m ade159 health hazard evaluations in response to re-quests betw een 1971 and 1983. Table 17-3 showsthat irritation of eyes and thr oat were reportedin 81 and 71 percent of the cases respectively (661).

Control of indoor air pollution maybe achievedby increasing ventilation rates, eliminating thesource of contamination, and air cleaning (25).Air cleaning is generally limited; although it filtersparticles, it does not remove gases and vapors.

Table 17-3.-Frequency of Health Complaints in55 Office Environment investigations

Percent of buildingsSymptom with complaint

Eye irritation . . . . . . . . . . . . . . . 81Dry irritated throat . . . . . . . . . . 71Headache . . . . . . . . . . . . . . . . . . 67Fatigue . . . . . . . . . . . . . . . . . . . . 53Sinus congestion . . . . . . . . . . . 51Skin irritation. . . . . . . . . . . . . . . 38“Shortness of breath” . . . . . . . 33Odor . . . . . . . . . . . . . . . . . . . . . . 31Cough . . . . . . . . . . . . . . . . . . . . . 24Dizziness . . . . . . . . . . . . . . . . . . 22Nausea . . . . . . . . . . . . . . . . . . . . 15

SOURCE: (661).




Ventilation standard s, if they are to guard againstindoor air pollution under the new condit ions,need to be rewrit ten.

There are reports that office work, especiallywork involving routine use of computers for doc-

ument completion and filing, is being moved fromthe office to the h ome. While working at h omeis attractive to man y peop le, it will also introdu ce

SUMMARY

The ability to anticipate change is fundamen-tal to preventing work-related injury and illness.Knowledge about the sectors of the economywh ere chan ges are likely to take place, wh at thechanges might be, and how they might affect

workers will help responsible officals carry outtheir mandate under the Occupational Safety andHealth Act and to improve occupational healthand safety in other ways.

Changes can be expected in energy-related in-dustries, modernization of older industries, indus-tries relatively new to the economy, and in therapidly growing area of office work. New tech-nologies are being introd uced, some of wh ichcould cause work-related injury and illness. Butthese changes also present opportunities for pre-venting work-related illnesses and injuries.

The p rodu ction of syn thetic fuels also createspossible worker exposures to a number of differ-ent hazardous substances, as well as a potentialfor fires and explosions. Coal mining has alwaysbeen h azardous, not only in terms of injuries, bu tis also associated with increased worker illness.The use of diesel engines and new p roduction tech-nologies introduce new hazards underground.Operations on offshore oil and gas rigs result inrelatively high injury rates.

Modernizing older industries such as steelmak-ing and automating should provide opportunity

for additional protection of workers. Meanwhile,bran d n ew technologies, such as electronics andbiotechnology, are being introduced. Greater at-tention should be paid to worker health problemsin the manufacture of semiconductors because of the use of toxic chemicals. Biotechnology has the

new concerns. Stress may be increased by a senseof isolat ion from the workp lace and coworkers,and opportun it ies for advancement, which are apositive force in most workers’ lives, may not ex-ist. Also, to the extent that office machines b earhazards, those are likely to go unrecognized in

the dispersed workplace and even more likely togo uncontrolled (25).

potential of reducing exposures to inherentlydangerous chemical processes and potentially haz-ardous chemical mixtures. But care must also betaken in hand ling the micro-organisms used inthese processes.

Office work is one of the m ost rapidly chang-ing occupations as new technologies are prolifer-ating. Since one-third of the w ork force are in of-fices, even low rates of work-related injury andillness can be of concern. Three areas where atten-tion is needed in offices are indoor air pollution,stress, and the ergonomic problems associatedwith VDTs.

But the p roblems of the past wil l also remain.It will b e difficult to convince smaller firms to in-vest in control technologies, especially as they willfind the financing difficult. Companies relying on

older techn ologies, such as those found in th ebasic industries, remain reluctant to install con-trols, especially when times are hard. The tortuousprocess of court battles over standards is likelyto continue, leaving the public and workers some-what bewildered about the protection the FederalGovernment at tempts to afford them.

The in centives for control that are discussed inthis assessment deserve careful attention to discernhow th ey work or do n ot work to encourage bet-ter health and safety programs. It is by now clearthat regulations are slow to emerge from OSHA,

that enforcement w ill always be l imited by th esmall corps of inspectors, and that OSH A consul-tation services cannot reach every w orkplace thatcould benefi t from them. Continuing demandsfrom a work force and a pu blic less willing to ac-cept risk of inju ry and illn ess will impose greater



—

Ch. 17–Preventing Work-Related Injury and Illness in the Future q 35 5

pressures on workers’ compensation, liability law interest in the role of the general environment andand the courts more generally, and insurance com- the workplace in health has probably become part

panics and voluntary associations interested in of the overall social consciousness of the Nation.

health and safety. One of the measures of the importance of those

The great interest in environmental health thatideas will be improvements in occupational health

developed in the 1970s remains alive and well, andand safety in the years to come.



Appendixes



.

Appendix A. —Supplemental Information.on OSHA and NIOSH

Other Reports on OSHA and NIOSH

The General Accounting Office (GAO) has exam-

ined a nu mber of aspects of OSHA and NIOSH oper-ations. It has reported on standards-setting activitiesof OSHA and the criteria-setting activities of NIOSHin two different reports (494,501) and generally criti-cized the slow p ace of the developm ent of new stand -ards, and the lack of coordination between the twoagencies. GAO has examined em ergency tempora rystandards (495,496) and the p rocedu res used by OSHAto grant emp loyers variances from stan dar ds (497),and expressed concern that OSHA’s activities were notsufficient to ensu re work er health an d safety. GAOhas a lso criticized OSHA’s ma nagem ent of its consulta-tion program (505), OSHA’s m onitoring of State Pro-gram s (500), as w ell as the ad ministration of N IOSH’s

HHE program (503).GAO has reviewed OSHA’s health inspections

(502), its safety inspections (504), and the proceduresused for scheduling complaint inspections (507), andwas critical of several asp ects of OSHA’s inspectionactivity. GAO has in two reports criticized OSHA’sdata collection efforts, pointing to inadequacies in dataon injuries and health hazard s and O SHA ’s failure touse th e information it collects through accident inv es-tigations (499,508). A 1984 GAO report examinedOSHA’s policies of encouraging the informal settle-ment of citations (511).

Mary Jane Belle, of the Congressional ResearchService, prep ared a rep ort in 1981 on OSHA reform

(530). She has a lso written and u pdated a Congres-sional Research Service Issue Brief on OSHA (533).

Crisis in the Workplace by Nicholas Ashford (30)and Bitter Wages by Joseph Page and Mary-WinO’Brien (361), provid e accoun ts of som e of OSHA’searly history and p resent their evaluations of govern-men tal activities. Other stud ies of occupational h ealthand safety regulation are Robert Smith’s The Occupa-tional Safety and Health Act (44 and John Mend eloff’s

Regulating Safety (300). David P. McCaffrey, OSHAand the Politics of Health Regulation (290) gives a his-tory and analysis of the health standards issued d ur-ing OSHA’s first decade, while Steven Kelman’s Reg-ulating America, Regulating Sweden (245) provides acomparison of OSHA and its Swed ish coun terpart. Inhis collection en titled OSHA : History, Law, and Po/-icy (307), Benjamin W. Mintz provides numerous ex-cerpts from primary source documents related to m anyof the imp ortant disputes about OSHA standards an d

enforcement activity, employee rights, and the historyof State pr ograms,

Three other rep orts on OSHA are of special inter-

est. Two were prep ared by Presidentially appointedgroups. The first, appointed by President Ford andoften referred to a s the MacAvoy Comm ission, exam-ined OSHA’s safety standard s and recommen ded th atOSHA issue performance standards(276). The second,an Interagency Task Force appointed by PresidentCarter, made a large number of recommendations onOSHA inspection activity, creation of economic in-centives for OSHA compliance, establishing cooper-ative programs, and reforming regulatory activity(228). In ad dition, two academic economists, RichardZeckhauser and Albert Nichols, studied OSHA regu-lation at the requ est of the Senate Comm ittee on Gov-ernm ental Affairs, which pu blished their repor t in 1978(685),

OSHA Standards Issued After Rulemaking

As described in chapter 12, OSHA has the author-ity to issue new stan dar ds, and to mod ify or revokeexisting standa rds u sing procedu res specified in the Oc-cup ationa l Safety and Hea lth Act (OSH Act). TablesA-1 and A-2 present d etails of the rule-making p ro-ceedings that have resulted in final standards duringOSHA’s first 13 years. These p roceedin gs can beginwith th e receipt of a Criteria Documen t from N IOSH,the creation of an ad hoc adv isory comm ittee, or th epublication of an Advance Notice of ProposedRulemaking. Althou gh, in theory, both of these lat-ter two might occur in the same proceeding; in prac-tice they have n ot. In fact, in recent years, OSHA h astended to use the Advance Notices, and has not usedad hoc advisory committees. (The exceptions arestandards involving the construction industry, forwhich OSHA is required, by its own regulations, toconsult with the standing Construction Safety Advi-sory Com mittee. ) Moreover, in recent years, N IOSHhas issued few criteria documents. Proceedings arenow more likely to begin with a p etition from an in-terested group, such as a union, for a standard,

The formal Notice of Proposed Rulemaking andpu blication of the Final Stand ard and statement of rea-sons are necessary steps in order to issue a standard.A pu blic hearing is not essential, unless an interestedparty requests it. For major and controversial stand-ards, a hearing is invariably requested.




Und er section 6(f) of the OSH Act, “[a]ny personwh o may be adv ersely affected by a stand ard issued ”by OSHA can challenge the standard in any of the U.S.Courts of Appeal. A column in tables A-1 and A-2 in-dicate if any challenge occurred, the circuit in which

it was filed, and the d ate of the d ecision. Table A-3lists the names and citations for these cases.

Finally, OSHA h as for a num ber of its stand ard s,taken formal steps to reconsider and revise standard sthat h ad been issued in final form. The last colum nof tables A-1 and A-2 list these actions.

OSHA Enforcement Activity

Tables A-4 to A-n present detailed informationconcerning inspection activity by OSHA since FiscalYear 1973 and the State programs since Fiscal Year1976. The data for these tables were provided byOSHA. Table A-4 provides the n um ber of inspections,both for safety hazards and for health hazards. Table

A-s presents these inspections according to OSHA’spriority categories—fatality/ catastrophe investiga-tions, comp laint inspections, program ed insp ections,and follow-up inspections. Table A-6 gives the nu m-bers of inspections by major ind ustry grou ps.

Tables A-7 to A-11 include information on the va-rious types of violations issued by OSHA. The OSHAct specifies that p enalties be imp osed on em ployersfor violations of standards. Except in the case of deminim us violations that have “no direct or imm ediaterelationship to safety or health, ” and other-than-serious violations, OSHA must issue a citation, pro-pose a penalty, and set a “reasonable” abatementperiod.

A “serious” violation is issued for hazard s that pre-sent a “substantial probability of death or serious phys-ical harm” to employees. A fine of up to $1,000 foreach serious citation can be imposed. An other-than-serious violation is not explicitly defined in the Act,but it falls between serious and de minimus violations.These violations have also been term ed “n on-seriousviolations.” OSHA and OSHRC interpret other-than-serious violations to involve conditions that h ave a d i-rect and imm ediate relationship to w orker safety andhealth, but without a substantial probability of deathor serious physical harm. Although a fine of up to

$1,000 could be imposed for these violations, in p rac-tice the proposed fines are substantially smaller.

‘Willful” violations are defined as those that are “in-tentional and knowing, as distinguished from acciden-tal, and d isplay a careless or reckless disregard or plainindifference to the Act or its requirements. ” (333).Employers will usually correct a ha zard after beingfound in violation. Employers who subsequently arefound to violate the same standar d or a similar stand -

ard may be issued “repeated ” violations. Fines of upto $10,000 may be imposed for both willful and re-peated violations. OSHA’s largest penalties usually in-volve an em ployer’s “failure to abate” or correct a haz -ard. The OSH A ct author izes penalties of up to $1,000for each day that the hazard continues beyond the d ayit was supposed to have been abated. In practice, thesehave been limited to a m aximum of 10 day s or $10,000.

The Act also auth orizes criminal p rosecution in sev-eral situations: First, a w illful violation that results inan emp loyee’s death may be pun ished by criminal pen-alties including a fine of up to $10,000, or 6 monthsimp risonment, or both . For a second conviction, thesemaximum penalties are doubled. There have been onlya hand ful of these cases und er the Act. In add ition theAct pr ovides for criminal p enalties for OSHA officialswho give an employer unauthorized ad vance noticeof an inspection, and against anyone who falsifiesOSHA-required records, or uses force to interfere withthe work of an inspector, although there have not beenany cases brought for these last three types. (For amore d etailed discussion, see 307,333,408. )

In p ractice, pen alties are su bstantially lower thanthe maximum penalty amounts outlined above, reflect-ing, in p art, OSHA’s discretion in setting penalties. Inprop osing penalties, OSHA considers th e gravity of the violation, the good faith of the emp loyer, the sizeof the business, and the employer’s previous historyof comp liance.

Activities of Other Federal Agencies

OSHA and the 25 State Programs are directly re-

sponsible for ensuring th e health and safety of mostprivate sector workers in the U.S. However, workplacehealth and safety for some pr ivate sector work ers arethe r esponsibility of other Federal agencies. In general,health and safety conditions for most public sectorworkers are not directly regulated by OSHA, althoughState Programs, at least in theory, cover State andlocal employees in States with State Programs. Finally,the regulations issued by several other Federal agen-cies also affect job safety and health, even thoughworkplace conditions are not the primary focus of these agencies.

The constellation of governmental bodies withworkp lace safety and health respon sibilities is sum -

mar ized in table A-12. The OSH Act directly regulates“employers,” who are d efined as persons and bu si-nesses who have emp loyees and ar e engaged in inter-state com merce (Section 3(s)). This generally coversprivate sector employers, although anyone who is self-employed and who has no employees is not directlysubject to OSHA regulation.



App. A—Supplemental Information on OSHA and NIOSH q 361

In addition, the occupational health and safety of

some pr ivate sector emp loyees is regulated by otheragencies. Section 4(b)(1) of the OSH Act p rovid es thatthe OSH Act does not apply to “working cond itions”for wh ich other agencies “prescribe or enforce stand-ard s or regulations affecting occupational safety orhealth. ” These exclusions are, in some instances, forall aspects of occupational safety and health; in othersonly for certain hazar ds. For instance, the Mine Safetyand Health Ad ministration (MSHA ) is responsible forall safety and health hazar ds associated w ith mining.The Nuclear Regulatory Commission, in contrast, isresponsible for assuring that the workers under their jurisdiction are adequately protected from radiationexposure only; OSHA is responsible for all otherworkplace hazards.

The bound aries of authority are clear in some cases,while in others disputes have arisen. The Federal Avia-tion Adm inistration (FAA) has requirements concern-ing the h ealth and safety of flight crews, but coverage

of aviation ground crews has been a focus of disputebetween the FAA and OSHA.Certain jurisd ictional un certainties have been re-

solved by agreements between OSHA and other agen-cies. The Depar tment of Energy, throu gh a letter of understanding, has responsibility to “prescribe and en-force occupational ra diological and nonrad iologicalsafety and health standa rds” for the workers it cov-ers. That 1974 agreement reaffirmed a 1964 letter of und erstanding between the then Atomic Energy Com-mission and the Department of Labor concerningresponsibilities under the Walsh-Healey Act.

Recently, Congress temporarily transferred jurisdic-tion over stone and gravel quarries from the Mine

Safety and Health Ad ministration to OSHA for sev-eral month s. Inspection authority for this indu stry hasnow returned to MSHA. Current and future jurisdic-tional disputes ma y be resolved thr ough letters of un -derstanding and inter-agency agreements, or throughcongressional and court actions.

The employees of the Federal Governm ent, as wellas of State and local governments, are not directly reg-ulated by OSHA. However, Section 19 of the OSHAct requires that the h ead of each Federal agency pr o-vide an occupational safety and health progr am foragency employees that is “consistent with” the stand-ards issued by OSHA. Three different Presidents haveissued Executive Ord ers concerning th e health and

safety of Federal workers (Executive Order (E. O.)11612, July 26, 1971; E.O. 11807, Sept. 28, 1974; E.O.12196, Feb. 26, 1980). There is a Federal AdvisoryCouncil on Occupational Safety and Health, appointedby the Secretary of Labor, that consists of 16 mem-bers--8 representing Federal agencies, and 8 represent-

ing Federal emp loyee labor organ izations. OSHA alsoprovides technical assistance to other Federal agenciesconcerning th e health and safety of Federal workers.

The health and safety of State and local governmentemployees is the responsibility of the States andlocalities that em ploy them . Any State that establishesa State Program m ust p rovide an occupational safetyand h ealth program for state and local employees thatis “as effective as the standard s” adop ted for privatesector w orkers. But State and local governm ent em-ployees in States withou t State Programs are not cov-ered by this requirement.

In add ition, several other Federal agencies can takeactions tha t affect worker health an d safety. The Envi-ronm ental Protection Agency (EPA) regulates p esti-cides u nd er the Federal Insecticide, Fungicide, andRodenticide Act and regulates toxic substances und erthe Toxic Subs tances Con trol Act. In either case, EPAactions to allow, limit, or proh ibit the use of particu-lar substances may affect emp loyee health and safety.In fact, in m any cases, the exposed w orkers may bethe grou p most affected by these actions. This mayalso happen w ith actions taken by the Consumer Prod-uct Safety Commission in regulating hazardous con-sumer produ cts.

Comparison of Protective Levels

The NIOSH list in Summ ary of NIO SH Recomm en-dations for Occupational Health Standards containsrecommend ations for a total of 163 hazardous sub-stances and wor k conditions. There are 74 substanceswh ich hav e no complications, and th ese are included

on th e compar ison list. There are also 11 group s of 71 separate substances for which NIOSH has made rec-omm endations. Only 43 of these, however, were con-ducive to comparison. In addition, there are six sub-stances in thr ee classes which OSHA or ACGIH treatseparately, but N IOSH tr eats the same. These are cad-mium, which OSHA separates into dust and fume;PCBs, which are d ivided by the p ercent of chlorinepresent; and the explosive nitro compounds, nitroglyc-erin and ethylene glycol dinitrate. Finally, 10 NIOSHrecommen dations cover exposures to general catego-ries of toxic substances or harm ful ph ysical agents,while 5 others cover hazardous working conditions.These are described in chapter 12, but because m ost

of them are not easily comp ared on a nu merical basis,they were exclud ed from th is comp arison. Thu s thetotal num ber of Protective Levels compar ed equ als 74plus 43 plus 6 or 123.

Table A-13 presents the numerical Protective Levelsfrom OSHA, NIOSH, and ACGIH that were com-



3$2 q Preventlng Illness and Injury in the Workplace

pared. Alternative chemicals names are not used intable A-13. In most cases, the name used is the oneNIOSH uses. Abbreviations have been included inmost cases for those substan ces which have them, and ,in fact, some substances are seldom referred to by theirchemical names, abbreviations being more convenient.In th is table, all protective levels are listed in mg/m

3

(milligrams substance/cubic meter of air). Generally,the protective levels in the actual recommendationsand standards are given in pp m (parts per million) ormg/m 3 or both. For convenience and ease of compari-son, all ppm concentrations were converted to mg/m

3

using the formula:(MW X (X) ppm)/24.45 = Y mg/ m

3

(at 250 C and 760 mm Hg pressure, wh ere MW = Molecular

Weight).

Table A-13 lists 123 toxic and hazardous substancesand the correspond ing Time-Weighted Average(TWA) and Ceiling permissible exposure limits foreach substance that are recommended by NIOSH andACGIH, and mandated by OSHA. The 123 chemicalsincluded in the comparison are all those that appearon the NIOSH list that also appear on either the OSHAor ACGIH lists. The nam es of the NIOSH list sub -stances that were left out for various reasons are listedin the N otes (No. 36).

When th ere is only one exposure lim it in a protec-tive level the word “none” in small letters indicateswh ich exposure lim it is not part of the standard . Forexample, “none” under the NIOSH Ceiling Limit forcarbaryl means that the NIOSH recommendation doesnot h ave a Ceiling exposure lim it for carbaryl, but itdoes have a TWA exposure limit. When there is no

recommend ation or standard for a particular su b-stance, the word “NONE” is capitalized and presentin b oth exposure l imit columns.

Approaches differ among OSHA, NIOSH andACGIH. For example, many of NIOSH’s recommen-dations are based on a lo-hour w orkday and not an8-hour workday as are OSHA’s PELs. For this com-parison, it was assumed that this difference would haveonly a negligible effect on the level of protection.

For most substances, NIOSH recommends only oneTLV (98 cases out of 131), either a TWA or a CeilingLimit, but not both. OSHA has only one PEL, an 8-hour TWA, for most of the substances it covers. Onthe other hand, ACGIH recommends both a TWA anda Ceiling TLV in over half of the cases included in thiscomparison (73/131). With differing specificationsconcerning the type of Protective Level, it can be dif-ficult to compare them . In add ition, recommend ationsthat no exposure b e allowed for carcinogens is oftennot reflected in the numerical levels recommended by

an organization.There are also differences in defining specific sub-stances since some descriptions are more inclusive thanothers. For example, ACGIH has fou r TLVs for as-bestos (one for each type), while NIOSH has a singleprotective level. A similar problem occurs if the sub-stances being compared are not exactly the same, orif related su bstances are grouped differently, then th estandards limiting exposure w ill differ. An example of this is the different exposure limits for soluble chro-mium, insoluble chromium, chromous salts, andchromic acid. These are detailed in the n otes to tableA-13.



App. A—Supplemental Information on OSHA and NIOSH 363

o

I




0

\



—— . —


Table A-3.—Court Cases Involving OSHA Health Standards*

Access to Employee Exposure arid Medical Records-Louisi-ana Chemical Association et al. v. Bingham et al.—FifthCircuit Court of Appeals remanded this case to the U.S.District Court for the Western District of Louisiana 657F. 2d. 777 (5th Cir., 1981). District Court affirmed the stand-ard, 550 F. Supp 1136 (1982); Fifth Circuit Court of Appealsaffirmed, without opinion, the decision of the DistrictCourt (May 16, 1984).

Acryionitrile— Vistron v. OSHA (6th Cir., Mar. 28, 1978), emer-gency temporary standard contested, request for stay ofstandard was denied, 6 OSCH 1483. The petition for reviewwas then withdrawn.

Arsenic (lnorganic)–ASARCO Inc. et al. v. OSHA, 746 F.2d483 (9th Cir., Sept. 13, 1984)-Court remanded arsenicstandard to OSHA (Apr. 7, 1981). After OSHA developeda risk assessment to comply with the Supreme Court’sruling in the Benzene case, the Ninth Circuit Court of Ap-peals affirmed the arsenic standard.

Asbestos—industrial Union Department, AFL-CIO v.Hodgson, 499 F.2d 467, (D.C. Cir., Apr. 15, 1974)—AffirmedOSHA’s 1972 asbestos standard.

Asbestos— Asbestos Information Association/North Amer- ica v. OSHA, 727 F.2d. 415 (5th Cir., Mar. 7, 1984)-Vacatedthe emergency temporary standard issued on Nov. 4, 1983.

Benzene–American Petroleum Institute v. OSHA, 581 F.2d493 (5th Cir., Oct. 5, 1978); Industrial Union Department,AFL-CIO v. American Petroleum Institute, 448 U.S. 807 (Su-preme Court, July 2, 1980)-Both the 5th Circuit Court ofAppeals and the Supreme Court vacated the OSHA ben-zene standard, although for different reasons.

Cancer Policy—American Petroleum Institute, et al. v. OSHA,et al., Nos. 80-3018, et al. (5th Cir., pending).

Coke Oven Emissions—American Iron & Steel Institute v.OSHA, 577 F.2d 825 (3d Cir., Mar. 28, 1978)—Third CircuitCourt of Appeals largely affirmed the Coke Oven Emis-sions standard. The Supreme Court agreed to review thisdecision, but the request for review was withdrawn beforethe case could be heard. 448 U.S. 917 (1980)

Cotton Dust—AFL-CIO v. Marshall, 617 F.2d 636 (D.C. Cir.,Oct. 10, 1979); American Textile Manufacturers Institute,Inc. v. Donovan, 452 U.S. 490 (June 17, 1981)-D.C. Courtof Appeals and the Supreme Court both upheld the ma-

jor requirements of the cotton dust standard as appliedto the textile industry.

Cotton Dust–Cotton Warehouse Association v. Marshall, 449 U.S. 809 (Oct. 6, 1980)-Supreme Court granted a petitionfor review and vacated the decision of the court of appealswith respect to the warehousing and classing segmentsof the industry.

Cotton Dust—Texas Independent Ginners Association v. Mar- shall, 630 F.2d 398 (5th Cir., November 14, 1980)-Vacatedcotton dust standard as applied to cotton ginning oper-at ions.

Ethylene Oxide—Public Citizen Health Research Group, et al. v. Auchter, 554 F. Supp. 242 (D.C. District Court, Jan.

Court Cases Involving

Lavatories for Industrial Employment-Associated industries of New York State, Inc. v. Department of Labor, et al., 487 F.2d 342 (2d Cir., Oct. 4, 1973)—The Second Circuit Courtof Appeals vacated the OSHA lavatory standard.

Mechanical Power Presses-AFL-CIO v. Brennan, 530 F.2d

5, 1983). Public Citizen’s Health Research, et al,, v.Auchter, et al., 702 F.2d. 1150 (D.C. Cir., Mar. 15, 1983)– Public Citizen requested a court order compelling OSHAto issue an emergency temporary standard. The DistrictCourt decided to issue such an order. The case was ap-pealed to the D.C. Court of Appeals, which refused to or-der that an emergency temporary standard be issued, butdid order that OSHA expedite its section 6(b) rulemaking.

Fourteen Carcinogens —Dry Color Manufacturing Associa- tion v. Department of Labor, 486 F.2d 98 (3d Cir., Oct. 4,1973)—Vacated the emergency temporary standard fortwo of the fourteen carcinogens.

Fourteen Carcinogens-Synthetic Organic Chemical Chem- ical Manufacturers Association v. Brennan, 503 F.2d 1155(3d Cir., Aug. 26, 1974)–Affirmed standard for ethyl-eneimine under the 14 Carcinogens standard (SOCMA l).A petition for rehearing was denied Oct. 6, 1975. The Su-preme Court denied a request for review, 420 U.S. 973 (Mar.17, 1975).

Fourteen Carcinogens-Synthetic Organic Chemical Manu- facturers Association v. Brennan, 506 F.2d 385 (3d Cir.,Dec. 17, 1974)—Third Circuit Court of Appeals vacated thestandard for MOCA (1 of the 14 carcinogens) (SOCMA II).The Supreme Court denied a request for review. Oil, Chem- ical and Atomic Workers International Union, AFL-CIO v.Dunlop, 423 U.S. 830 (Oct. 6, 1975).

Hazard Communication (Labelling--United Steelworkers of America, Public Citizen, State of Massachusetts, Fra- grance Materials Association, People of the State of II- iinois, Flavor& Extract Manufacturing Association, State of New York v. Auchter, Nos. 83-3554, 83-3561, 83-3565,84-3066, 84-3087, 84-3093, 84-3117, 84-3128 (3d Cir.,pending).

Occupational Noise Exposure/Hearing ConservationAmendment —Forging Industry Association v. Sec. of La-bor No. 83-1232 (4th Cir., Nov. 7, 1984)-Fourth CircuitCourt of Appeals vacated the Hearing ConservatonAmendment.

Lead–United Steelworkers of America v. Marshall, 647 F.2d1189 (D.C. Cir., Aug. 15, 1980)-The D.C. Court of Appealsaffirmed the lead standard in part, but directed OSHA todetermine the feasibility of engineering controls for 38 in-dustries and occupations. The Supreme Court denied arequest for review Lead Industries Association, Inc. v.Donovan, 453 U.S. 913 (1981)

Pesticides—Florida Peach Growers Association, Inc. v. De- partment of Labor, 489 F.2d 120 (5th Cir., Jan. 9, 1974)– The Fifth Circuit Court of Appeals vacated the emergencytemporary standard for pesticides.

Vinyl Chloride-Society of the Plastics Industry, Inc. v. OSHA,509 F.2d 1301 (2d Cir., Jan, 31, 1975)—The Second Circuit Court of Appeals affirmed the vinyl chloride standard. TheSupreme Court denied a request for review FirestonePlastics Co. v. U.S. Department of Labor 421 U.S. 992 (May27, 1975).

OSHA Safety Standards

109 (3d Cir., Dec. 31, 1975)–The Third Circuit Court of A p-peals remanded to OSHA for a new statement of reasonsand then affirmed OSHA’s changes to the “no hands indie” standard.

Commercial Diving Operations— Taylor Diving and Salvage



366 qPreventing Illness and injury in the Workplace

Table A-3.—Continued

v. U.S. Department of Labor 537 F.2d 819 (5th Cir.,1976)—Court issued an indefinite stay of the ETS for commer-cial diving.

Commercial Diving Operations– Taylor Diving and Salvagev. U.S. Department of Labor 599 F.2d 622 (5th Cir., July16, 1979)—Vacated the medical requirements section (29CFR 1910,411) of the final standard for commercial diving.

Diving Exemptions-United Brotherhood of Carpenters andJoiners of America, AFL-CIO v. U.S. Department of Labor,No. 82-2509, D.C. Cir,, Apr. 4, 1984)-After oral argument,court remanded case to OSHA for additional information.

Ground-Fault Protectlon--National Constructors Association v. Marshall 581 F.2d. 960 (D.C. Cir., June 28, 1978)—The

Court of Appeals for the D.C. Circuit remanded the rec-ord to OSHA with specific instruction to consult the Advi-sory Committee.

Fire Protection-Fim Equipment v. Marshall 679 F.2d 679 (7thCir., May 27, 1982)-case was dismissed for lack of stand-ing. Request for rehearing was denied (July 22, 1962).

Industrial Slings--Bethlehem Steel Corp. v. Dunlop 540 F.2d,157 (3d Cir., Feb. 11, 1976)—Vacated one paragraph of thestandard (29 CFR 1910.184) and remanded the standardto the Secretary of Labor.

MarineTerminals--National Grain and Feed Association (D.C.Cir., pending).

“NOTES: F.2d—FederaJ Reporter, Second Series.

U. S.–U.S. Supreme Court Reports.F. Supp.—Federal Supplement.

Table A-4.-Safety and Health Inspections

Faderal OSHA: Establishment Safety Safety Health Health Employees coveredinspections inspections inspections inspections inspections by inspections

Fiscal year (number) (number) (percent) (number) (percent) (number)

1973 . . . . . . . . . . . . 48,409 45,225 93.4 ”/0 3,184 6.6% 5,440,3031974 . . . . . . . . . . . . 77,142 73,189 94.9 3,953 5.1 6,448,0671975 ....., . . . . . . 80,978 75,459 93.2 5,519 6.8 6,180,8811976 . . . . . . . . . . . . 90,482 82,885 91.6 7,597 8.4 6,601,7291977 . . . . . . . . . . . . 60,004 50,892 84.8 9,112 15.2 5,285,9461978 . . . . . . . . . . . . 57,278 46,621 81.4 10,657 18.6 4,522,5821979 ......., . . . . 57,734 46,657 80.8 11,077 19.2 4,262,7491980 . . . . . . . . . . . . 63,404 51,565 81.3 11,839 18.7 3,690,9931981 . . . . . . . . . . . . 56,994 46,236 81.1 10,758 18.9 2,672,1291982 . . . . . . . . . . . . 52,818

a 43,609 82.6 9,209 17.4 2,235,8231983 . . . . . . . . . . . . 58,516

b48,269 82.5 10,247 17.5 2,925,049

1984 (Oct. -Mar.) . . 30,606 c25,086 82.0 5,520 18.0 1,552,120

State programs: Establishment Safety Safety Health Health Employees covered

inspections inspections inspections inspec ti ons inspe ct io ns by inspectionsFiscal year (number) (number) (percent) (number) (percent) (number)

1976 d . . . . . . . . . . . 166,612 144,780 86.9 21,832 13.1 7,078,2941977 143,469 130,643 91.1 12,826 8.9 6,000,0091978 . . . . . . . . . . . . 122,761 112,446 91.6 10,255 8.4 5,739,5741979 . . . . . . . . . . . . 107,636 99,509 92.4 8,127 7.6 4,932,3031980 . . . . . . . . . . . . 106,191 98,829 93.1 7,288 6.9 4,340,2661981 . . . . . . . . . . . . 108,376 99,303 91.6 9,073 8.4 4,404,3641982 . . . . . . . . . . . . 92,942 84,570 91.0 8,372 9.0 3,464,1461983 . . . . . . . . . . . . 103,879 e 93,406 89.9 10,473 10.1 3,818,2871984 (Oct. -Mar.) . . 51,072

f 46,065 90.2 5,007 9.8 1,858,114a-s not ~nclude 8,444 “ReCO@i Review” inspections in ftscal Year 1962.

b-s not Include 1(),402 “Records Review” inspections in fiSCa\ Year 19M.

cooes not include 4,9s4 ‘“R~ords Review” inspections during the first 6 months (Oct. -Mar.) Of fisCal year 1964.dNo data available prior to

19

76

estate data d~s not Include 2,554 “Records Reivew” inspections in fiScal Year f~.fstate da t

adogs not include 1 ,~ ‘ , R e c o r d s R e v i e w ” ~ns~ctions during the first 6 m o n t h s (Oct,-Mar.) of fiSCal year 1964,

SOURCE’ Office of Technology Assessment, based on data supplied by OSHA.



— —


Notes to Tables A-4 Through A-11.-State Program Data



Table A-5-Types o f Inspection

State programsEstablishment Fatality/

inspection catastrophe catastrophe Comp laint Complaint Programed Programed Follow-up Follow-upyear (number) (number) (percent) (number) (percent) (number) (percent) (number) (percent)

. . . . . . . . 166$612 4,278 2.6% 13,966 8.4% 119,120 71.5% 29,216 17.5% . . . . . . . . . 143,469 3,652 2.5 14,404 10.0 101,571 70.8 23,842 16.6 . . . . . . . . 122,761 4,609 3.8 15,467 12.6 81,762 66.6 20,923 17.0. . . . . . . . 107,636 5,181 4.8 15,285 14.2 70,762 65.7 16,408 15.2 . . . . . . . . 106,191 5,264 5.0 13,823 13.0 72,899 68.6 14,168 13.3

. . . . . . . . 108,376 5,259 4.9 14,365 13.3 75,839 70.0 12,858 11.9. . . . . . . . 92,942 4,663 5.0 10,721 11.5 68,100 73.3 9,455 10.2. . . . . . . . 103.879 5.366 5.2 11.623 11.2 78.796 76.0 8.094 7.8

Oct.-Mar.).. 51,072 2,849 5.6 5,754 11.3 39,085 76.5 3,384 6.6

8$e88mmt,ba8edoncW88upplledbyOSHA.



App. A–Supplemental In formation on OSHA and N!OSH q 369





App. A—Supplemental Information on OSHA and NIOSH . 371

. . ., . .. , .. . .. . .. . .. . .

. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .

. . . . .. . . , .. . . . .. . . . .. . . . .. . . . .. . . . .

. . . . .. . . . .. . . . .. . ! . ,

. . . . .

. . . . .

. . . . .

. . . . .

. . . . .

. . . . .

.

. . . .. . , .. . , .. . . .. . . ., . . .. . . .

. . , .. . . .. . . .. . . .. . . ., . . .

. .. .. .. .. .. .. .

. .. .. .. .. .. .

, .. .. .. .. .. .. .

. .



372 Preventing Illness and Injury In the Workplace

. . . .. . . .. . . .. , , .. . . .. . . .. . . .

. . . .. . , ., , , ,

. . . .. . , .. . . .. . . .. . , .. . , .. . . .



App. A—Supplemental Information on OSHA and NIOSH 373

U

T-F 7-




Table A-11.--Average Proposed Penalties

Federal OSHAViolations

Other-thanSerious Willful Repeat serious(average (average (average (average Average penalty Average penalty

Fiscal year penalty) penalty) penalty) penalty) per inspection per violation

1973 . . . . . . . . . . . . 631 5,805 1,349 45 78 261974 ......., . . . . 576 2,706 247 41 84 221975 . . . . . . . . . . . . 541 2,538 228 42 93 241976 . . . . . . . . . . . . 545 3,081 207 42 124 301977 . . . . . . . . . . . . 290 2,990 242 61 158 521978 . . . . . . . . . . . . 285 3,460 429 88 259 1111979 . . . . . . . . . . . . 273 3,750 429 94 291 1311980 . . . . . . . . . . . . 255 3,244 478 110 280 1351981 . . . . . . . . . . . . 209 3,660 90 177 911982 . . . . . . . . . . . . 195 4,364 320 86 104 571983 . . . . . . . . . . . . 177 4.555 346 74 179 2571984 (Oct.-Mar.) . . 187 4;977 408 101 211 68

State programs Violations

Other-than-

Serious willful Repeat serious(average (average (average (average Average penalty Average penaltyFiscal year penalty) penalty) penalty) penalty) per inspection per violation

1976, . . . . . . . . . . . 420 3,615 115 33 39 151977, . . . . . . . . . . . 293 2,487 100 39 351978. . . . . . . . . . . . 210 3,174 197 68 511979. . . . . . . . . . . . 239 2,869 251 74 76 301980 . . . . . . . . . . . . 248 3,592 253 63 75 331981 . . . . . . . . . . . . 211 3,156 450 75 65 301982 . . . . . . . . . . . . 201 3,146 230 101 54 261963 . . . . . . . . . . . . 167 3,112 191 139 68 311984 (Oct.-Mar.) . . 176 4,055 213 138 73 34

SOURCEOfflceof Technology Assessment, based on data suppliedby OSHA,



Table A-12.—Occupational Safety and Health: Coverage of Workers

Agency Type of workers covered Number of workers covered Basis for agency authority Comments

Department of Labor Occupational Safety and Health

Administration (OSHA) andState Programs approved byOSHA . . . . . . . . . . . . . . . . . . . . . 75,031 ,OOOa (1979 estimate) Occupational Safety and Health

Act of 1970In some cases, another Federal

agency is responsible for onlycertain aspects of safety andhealth, and the same workersmay be covered by OSHA forthe remaining aspects (see e.g.,NRC in this table)

All employees and working

conditions except: Federal

employees, and those covered

by other governmental

agencies according to other

statutes

Mine Safety and Health

Administration (MSHA). . . . . . . Federal Mine Safety and HealthAct of 1977

Coal, metal and nonmetalmining workers. All employeeson mine property are covered

467,095 (1 2 preliminarybestimate)

Dapartment of Transportation: Bureau of Motor Carrier Safety

(BMCS) (Federal HighwayAdministration) . . . . . . . . . . . . . Approximately 4.5 millionc Interstate Commerce Act Does not include workers in repair

garages, or workers on loadingdocks, who are all covered byOSHA

Employees in, on, or aboutmotor vehicles engaged ininterstate commerce

Federal Aviation Administration(FAA) . . . . . . . . . . . . . . . . . . . . . Coverage of ground crews is the

focus of a dispute between theFAA and OSHA

Approximately 170,000d Federal Aviation Act of 1956All flight crews; ground crewsand mechanics during someactivities

Federal Railroad Administration(FRA) . . . . . . . . . . . . . . . . . . . . . . All operating employees, i.e.,

employees on rolling stockplus certain railroad yardemployees

Seamen on Coast Guard-inspected and certificatedvessels

143,617 (1979 preliminaryestimate)

e

About 100,000f(1963 estimate)

Federal Railroad Safety Act of1970

The Mar ine Safety Laws OSHA has jur isdiction overshipyard workers andlongshoremen

U.S. Coast Guard. . . . . . . . . . . . . .

Other Federal Agencies: Department of Energy (DOE). . . . DOE has adopted OSHA’s health

and safety regulations; DOEdoes not cover employeesduring initial construction offacilities

116,323 g (1962 es timate) Atomic Energy Act o f 1954 , asamended

Employees in Government-owned contractor operator(GOCO) facilities, e.g., thoseinvolved in research in nuclearenergy, weapons research andproduction, production ofenriched uranium.

Nuclear Regulatory Commission(NRC) . . . . . . . . . . . . . . . . . . . . . . NRC covers only radiation

hazards; OSHA is responsiblefor all other safety and healthaspects. NRC licenses Stateplans in some States, similar toOSHA State Programs

327,350h(1979 estimate) Atomic Energy Act of 1954, as

amendedWorkers exposed to radiation

hazards from materialslicensed by the NRC,including: 1) source material(uranium and thorium); 2)special nuclear material(material capable of beingfissioned); 3) by-products of a)fission; and b) tailings fromuranium ore processing



Table A-12.—Occupational Safety and Health: Coverage of Workers-Continued

Agency Type of workers covered Number of workers covered Basis for agency authori ty CommentsFederal Government

departments and independentagencies . . . . . . . . . . . . . . . . . . . Each covers its own federally- 6,271,736

i(fiscal year 1962) Occupational Safety and Health Agency programs must be

employed workers. Act of 1970 “consistent with” occupationalsafety and health standards

Environmental Protection

promulgated by OSHA

Agency . . . . . . . . . . . . . . . . . . . . Mixers, loaders, and applicators Federal Insecticide, Fungicide, For mixers, loaders andof pesticides; farm field and Rodenticide Act applicators, protection fromworkers pesticide exposure is through

labeling requirements. OSHAhas jurisdiction for other healthand safety aspects of thesejobs.

%fflce of Statistical Studies and Analysis, OSHA. Includes all private-sector employees covered directly by Federal OSHA and State Programs.bperwn~ communication, MSHA, Mar. 3, l=.cper~ond communication, BM~.

dpersoal communicati ons:Air Transport Association and Regional Aifllne Associationeyea~k of R & ” / o @ F a c t s , J u n e 1~ .

fperWnal communication, U.S. ~~t GIJWd.

gDOE, R e p @ o f Emp/Oymerrt &@ Labor T u r n o v e r , S e p t . 3 0 , 19E2.

hNRC ‘+occupation~ Radiation Exposure, Twelfth AnnUa/ Repofi, ~gT9 (l~z).Ius, ~epa~menr of L~r, Fadera/ Compliance ActMty Ftepofl, Jan. 4, 1~

SOURCE: Office of Technology Assessment.



—


Table A-13. -Analyses of OSHA, NIOSH, and ACGIH Protective Levels

OSHA OSHA NIOSH NIOSH ACGIH ACGIHTWA ceiling TWA (1) ceiling TWA ceiling

Substance (notes) (36) mg/m3

mg/m3mg/m3 mg/m 3 mg/m3 mg/m 3

Acetylene (10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,662 2,662 NONE NONEAcrylamide (35) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Acrylonitrile (11) . . . . . . . . . . . . . . . . . . . . . . . . . . . .Aldrin/Dieldrin (12,27,35) . . . . . . . . . . . . . . . . . . . . .Alkanes: (14)

Pentane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Hexane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Heptane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Octane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Allyl chloride . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Ammonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Antimony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Arsenic, inorganic compounds . . . . . . . . . . . . . . . .Asbestos (9).... . . . . . . . . . . . . . . . . . . . . . . . . . . . .Asphalt (petroleum) fumes . . . . . . . . . . . . . . . . . . .Benzene (2,16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Benzoyl peroxide . . . . . . . . . . . . . . . . . . . . . . . . . . . .Benzyl chloride . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Beryllium (2,16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Boron trifluoride (13,15) . . . . . . . . . . . . . . . . . . . . . .Cadmium, fume (2,23). . . . . . . . . . . . . . . . . . . . . . . .dust (2,23) . . . . . . . . . . . . . . . . . . . . . . . .

Carbaryl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Carbon black (18) . . . . . . . . . . . . . . . . . . . . . . . . . . .Carbon dioxide (17). . . . . . . . . . . . . . . . . . . . . . . . . .Carbon disulfide (2) . . . . . . . . . . . . . . . . . . . . . . . . .Carbon monoxide . . . . . . . . . . . . . . . . . . . . . . . . . . .Carbon tetrachloride (2,16) . . . . . . . . . . . . . . . . . . .Chlorine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Chloroform (15,16). . . . . . . . . . . . . . . . . . . . . . . . . . .Chloroprene (35) . . . . . . . . . . . . . . . . . . . . . . . . . . . .Chromium (VI), water soluble(3) . . . . . . . . . . . . . .Chromium (VI), insoluble (3) . . . . . . . . . . . . . . . . . .Coal tar products (5). . . . . . . . . . . . . . . . . . . . . . . . .Cotton dust(6).. . . . . . . . . . . . . . . . . . . . . . . . . . . . .Cresol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cyanide (17,35) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .DDT (26,37,35) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .l,2-dibromo-3-chloropropane (DBCP) (16,34) . . . . .Diisocyanates:

Toluene-2,4-diisocyanate (15) . . . . . . . . . . . . . . .Diphenylmethane diisocyanate (13,15). . . . . . . .Isophorene diisocyanate . . . . . . . . . . . . . . . . . . .

Dinitro-ortho-cresol (35) . . . . . . . . . . . . . . . . . . . . . .Dioxane (35)..... . . . . . . . . . . . . . . . . . . . . . . . . . . .Epichlorohydrin (35) . . . . . . . . . . . . . . . . . . . . . . . . .Ethylene dibromide (2) . . . . . . . . . . . . . . . . . . . . . . .Ethylene dichloride (2) . . . . . . . . . . . . . . . . . . . . . . .Ethylene oxide (27,37) . . . . . . . . . . . . . . . . . . . . . . .Fibrous glass, (dust) (29) . . . . . . . . . . . . . . . . . . . . .Fluorides, inorganic(2) . . . . . . . . . . . . . . . . . . . . . .Formaldehyde (2,13,16). . . . . . . . . . . . . . . . . . . . . . .Furfuryl alcohol ........, . . . . . . . . . . . . . . . . . . . .

Glycidyl ethers:Allylglycidyl ether (15) . . . . . . . . . . . . . . . . . . . . .n-Butyl glycidyl ether . . . . . . . . . . . . . . . . . . . . . .Di-2,3-epoxypropyl ether (diglycidyl ether)

(DIE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Isopropyl glycidyl ether . . . . . . . . . . . . . . . . . . . .Phenylglycidyl ether (PAGE ) . . . . . . . . . . . . . . . .

0.34.3

0.25

2,9451,8002,0002,350

3

0.012

NONE32

55

0.002

none0.10.2

53.5

9,000625563

nonenone

900.5

1

0.20.222

50,0096

nonenone

NONE0.2

20154202

9015

2.53.7

none270

none240

60

nonenone21.7

none

nonenonenonenonenonenonenonenone

10NONE

80nonenone0.005

30.30.6

nonenonenone

93none

1573

240nonenonenonenonenonenonenonenonenone

0.140.2

NONEnonenonenone

230405

nonenonenone

6none

45none

2,8nonenone

none0.3

none0.15

3503503503503.1

none0.5

none0.1

nonenone

5none

0.0005

NONE0.040.04

53.5

18,0003

40nonenonenonenone0.025 0.001

0.10.210

none0.5none

0.0350.05

0.0450.2

none2

none

52.5

none

nonenone

nonenonenone

0.34.5

0.25

1,800180

1,6001,450

3

0.22

55

0.002none0.050.05

53.5

9,000305530

35045

0.050.05

0.20.222

51

none

0.04none0.09

0.29010

none40

210

2.51.540

22135

0.5240

6

0.6none0.75

2,250none2,000 1,800

6 27

nonenonenone

1075

nonenonenone

30.20.210

27,000none

1259

225nonenonenonenonenonenonenone

3none

0.150.2

none0.6

20none

60nonenonenone

360

44none

none

none



378 qPreventing Illness and Injury In the Workplace

Table A-13.--Analysis of OSHA, NIOSH, an d ACGIH Protective Levels

OSHA OSHA NIOSH NIOSH ACGIH ACGIHTWA ceiling TWA (1) ceiling TWA

Substance (notes) (36)ceiling

mg/m3 mg/m 3

mg/m3

mg/m3

mg/m3

mg/m3

Hydrszines: (16)Hydrazine (16,35) . . . . . . . . . . . . . . . . . . . . . . . . . .

1,1-Dlmethyl hydrazine (16,35), . . . . . . . . . . . . . .Phenyl hydrazine (16,35) . . . . . . . . . . . . . . . . . . . .Methyl hydrazine (13,15,16,35). . . . . . . . . . . . . . .

Hydrogen fluoride (2) . . . . . . . . . . . . . . . . . . . . . . . .Hydrogen sulfide (2,17) . . . . . . . . . . . . . . . . . . . . . .Hydroquinone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .isopropyl alcohol. . . . . . . . . . . . . . . . . . . . . . . . . . . .Ketones:

Acetone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Methyl ethyl ketone (MEK) . . . . . . . . . . . . . . . . .Methyl n-propyl ketone . . . . . . . . . . . . . . . . . . . .Methyl n-butyl ketone. . . . . . . . . . . . . . . . . . . . . .Methyl n-amyl ketone . . . . . . . . . . . . . . . . . . . . . .Methyl isobutyi ketone.. . . . . . . . . . . . . . . . . . . .Methyl isoamyl ketone (20) . . . . . . . . . . . . . . . . .Diisobutyl ketone . . . . . . . . . . . . . . . . . . . . . . . . .Cyciohexanone . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mesityl oxide... . . . . . . . . . . . . . . . . . . . . . . . . . .Diacetone alcohol. . . . . . . . . . . . . . . . . . . . . . . . .lsophorone (13) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Lead, inorganic (33) . . . . . . . . . . . . . . . . . . . . . . . . .Malathion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Mercury, inorganic (2,4,24). . . . . . . . . . . . . . . . . . . .Methyl alcohol.. . . . . . . . . . . . . . . . . . . . . . . . . . . . .4,4-Methylene-bis-2-chloroaniline (MOCA) (8,27)..Methyl parathion . . . . . . . . . . . . . . . . . . . . . . . . . . . .Methylene chloride (2,19) . . . . . . . . . . . . . . . . . . . . .Nickel carbonyl (27) . . . . . . . . . . . . . . . . . . . . . . . . .Nickel, inorganic and compounds . . . . . . . . .Nitric acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .N i t r ide s :

Acetonitrile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Tetramethyl succinonitrile. . . . . . . . . . . . . . . . . .

Nitrogen, oxides NO2: (15) . . . . . . . . . . . . . . . . . . . .

(Nitric oxide) NO: . . . . . . . . . . . . . . . . . . . . . . . . .Nitroglycerin (15,16) . . . . . . . . . . . . . . . . . . . . .Ethylene glycol dinitrate (15). . . . . . . . . . . . . . . .

Parathion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Phenol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Phosgene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Polychlorinated biphenyls: (35)

Chlorodiphenyl (42%). . . . . . . . . . . . . . . . . . . . . .Chlorodiphenyl (54%). . . . . . . . . . . . . . . . . . . . . .

Refined petroleum solvents (7). . . . . . . . . . . . . . . .Silica (quartz, respirable dust) . . . . . . . . . . . . .Sodium hydroxide (13) . . . . . . . . . . . . . . . . . . . . . . .Sulfur dioxide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sulfuric acid.... . . . . . . . . . . . . . . . . . . . . . . . . . . . .1,1,2,2-Tetrachloroethane (35) . . . . . . . . . . . . . . . . .Tetrachloroethylene (2). . . . . . . . . . . . . . . . . . . . . . .Thiols: (21)

Butyl mercaptan . . . . . . . . . . . . . . . . . . . . . . . . . .Methyl mercaptan (15) . . . . . . . . . . . . . . . . . . . . .Ethyl mercaptan (15). . . . . . . . . . . . . . . . . . . . . . .

Tin, organic compounds . . . . . . . . . . . . . . . . . . . . .o-Toluidine (35) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Toluene (2,17)... . . . . . . . . . . . . . . . . . . . . . . . . . . . .1,1,1-Trichloroethane . . . . . . . . . . . . . . . . . . . . . . . .Trichloroethylene (2) . . . . . . . . . . . . . . . . . . . . . . . . .

1.31

22none2.45

none2

2,400590700410465410

NONE290

140

0.0515

0.1

NONENONE

1,7360.007

15

703

none

30nonenone

0.119

0.4

1

2,9500.098

231

35nonenone

0.122

7531,900

536

none

nonenone0.35

none16

nonenone

nonenonenonenonenonenone

NONEnonenonenonenonenonenonenonenonenone

NONENONE3,476nonenonenone

nonenone

9

none21

nonenonenone

nonenonenonenonenonenonenonenone1,358

none2025

nonenone1,129none1,072

none

nonenonenone

2.5nonenone

984

590590530

446520023014010040

24023

0.115

0.05262

0.0030.2

2610.0070.015

5

34nonenone

30nonenone0.05

200.4

0.0010.001

3500.05

none1.3

1

6.87339

1.811.30.1

none375

none134

0.04

0.150.60.08

5152

1,968

nonenonenonenonenonenonenonenonenonenonenonenonenonenonenone1,048nonenone1,740nonenonenone

none6

1.8

none0.10.1

none

nonenone1,800none

2nonenonenone

678

nonenonenonenone0.02750

1,190none

0.1

none2.514

9 2

1,780590700

20235205240150100

60240none0.15

100.1

2600.22

0.2350

0.350.1

5

7036

300.50.30.119

0.4

1

0.5NONE

0.1none

51

7

335

1.511

0.19

3751,900

270

none

2450.35

521

41,225

2,375885875

none465300

nonenone

400

10036025

0.45nonenone

310none

0.61,740none

0.310

1059

10

45

0.338

none

21

NONEnone

210

none35

1,340

nonenone3

0.2none

2,4501,080







Appendix B. —Working Papers

For this assessment, OTA commissioned a nu mber of rep orts on various top ics concerning occup ationalhealth and safety. These contract reports, as w ell as two pap ers wr itten by OTA staff, are being made availablethrou gh th e Na tional Technical Information Service as Working Pap ers.

The Working Papers hav e been group ed into th ree parts. Part A includ es analyses of available data , his-torical discussions of several topics, descriptions and critiques of the techniques of economic analysis, and a

discussion of nonregulatory incentives. Part B covers descriptions of the personal protective equipment indus-try, theories of injury causation and control, information exchange, and worker training and edu cation, PartC consists of five Case Stud ies of different occup ational hazard s and diseases.

Working Papers

Part A:

#1—Kronebu sch, K., Data on O ccupat iona/ Injuriesand Illn esses, working pap er, December 1984.

#2—Mendeloff, J., An Analysis of OSHA Health In-spection Data, contract report, April 1983.

#3—Corn, J. C., Historical Perspective: The Evo-lution of the Definition of Certain Work-Related

Illnesses, contract report, July 1983.#4—Kent, M., A History of O ccupational Safety and

Health in the United States, contract report,April 1983.

#5—MacLean, D., A Hist ory of t he Considerationof Economic Jmpacts in the Determination of theFeasibilit y of Standards Under the OSH A ct,contract report, April 1983.

#6--Lave, J. R., and Lave, L. B., Decision Frame-w orks to Enhance Occupational Health and Safe-ty Regulation, contract rep ort, February 1983.

#7—MacLean, D., and Sagoff, M., A Critique of Cost-Benefit A naly sis as a Technique for Deter-mining Health Standards Under the Occupation-al Safety and Health Act, contract report, April1983.

#8—Harter, P. J,, Non-Regulatory Legal Incentives for the Adoption of Occupational Safety and Healt h Cont rol Technologies, contract rep ort,April 1983.

Part B:

#9—Gou gh, M., The Personal Protective Equipment and Clothing Industry, working pap er, April1984.

#10—Springborn Management Services, Inc., Report on Workplace Protective Equipment and Cloth-ing, contract report, August 1982.

#11—Purswell, J. L., and Stephens, R., Health and Safety Control Technologies in the Workplace:

Accident Causation and Injury Control, contractreport, July 1983.

#12—Priest , W. C., Computer-Teleconferencing as a Mechanism to Improve Information Transferor W orkplace Safety and Health, contract report,

May 1983.#13—INFORM, Worker Training and Education Pro-

grams in Occupational Health and Safety, con-tract report, N ovember 1983.

Part C:

#14—Arndt, R., and Chap man , L., Potential Office Hazards and Controls, contract report, Septem -ber 1984.

#15—Bleecker , M., Carpal Tunnel Syndrome: A CaseStudy, contract report, May 1984.

#16—Goble, R., Hattis, D., Ballew, M., and Thurs-ton, D., Implementation of the Occupational

Lead Exposure St andard, contract rep ort, No-vember 1983.#17—Hickey, J. L. S., Rice, C. H., and Boehlecke, B.

A., Technologies for Controlling Worker Expo-sure to Silica, contract report, August 1983.

#18–Rut tenberg, R., Compliance With the OSHACotton Dust Rule: The Role of Productivity Im-

proving Technology, contract report, March1983.

381



Appendix C.—Acknowledgments andHealth Program Advisory Committee

OTA would l ike to thank the m embers of the advisory panel w ho commented on drafts of this report andthe contractors who provided material for this assessment. In addition, OTA acknowledges the following indi-viduals and groups for their assistance in reviewing d rafts or furnishing in formation and materials:

Lori AbramsPublic Citizen

Theme AuchterOccupational Safety and Health Ad ministration

Peter BarthUniversity of Connecticut

Cynthia BascettaGeneral Accounting Office

David BellOccup ational Safety and Health Ad ministration

Alfred Blackman

Potomac, MDLeslie BodenHarvard University

Mary Jane BelleCongressional Research Service

Nancy BollingerNational Institute for Occupational Safety

and Health

Queta BondNational Research Council

Patricia Breslin

Occup ational Safety and Health Ad ministrationThomas BrownDepartment of Labor

Sandra ChristensenCongressional Budget Office

Patrick ColemanNational Institute for Occupational Safety

and Health

Geraldine CoxChemical Manufacturers Association

Thomas CraneOffice of Representative Barney Frank

Raymond DonnellyOccupational Safety

Joseph DuBoisOccupational Safety

and H ealth Adm inistration

and H ealth Adm inistration

E. I. du Pont de N emours & Co.Wilmington, DE

Joseph DurstUnited Brotherhood of Carpenters and

Joiners of America

Paul DwyerHouse Committee on Education and Labor

James FosterOccupational Safety and Health Ad ministration

Frank FrodymaOccupational Safety and Health Ad ministration

Sara Garrison-LeoE. I. du Pent de N emours & Co.

Anthony GoldinOccupational Safety and Health Ad ministration

Morris G o r d yLiberty Mu tual Insurance Co.

Bengt GustafssonSwedish Embassy

Walter HaagNational Institute for Occupational Safety

and Health

Daniel HamOccup ational Safety and Health Ad ministration

Carmen HarlestonOccupational Safety and Health Administration

Daniel HoeschenOccupational Safety and Health Administration

Thomas HolzmanDepartment of Labor, Office of the Soliciter

John InzanaBureau of Labor Statistics

Daniel JacobyDepartment of Labor, Office of the Soliciter

William JohnsonSyracuse University

John KatalinasOccupational Safety and Health Administration



App. C—Acknowledgments and Health Program Advisory Committee 383

Ruth KnightOccup ational Safety and Health

Akio KonoshimaOccup ational Safety and Health

David LeGrande

Administration

Administration

Commu nication Workers of America

J. William LloydOccup ational Safety and Health Ad ministration

Jeremiah LynchExxon Chemical Co.

Mark MacCarthyHou se Comm ittee on Energy and Comm erce

Judson MacLauryDepartment of Labor, Historical Office

L. M. MagnerE. I. du Pent de Nemours & Co.

Andre MaisonpierreAlliance of American Insurers

J. A. MartinUnited Technologies

J. Donald MillarNational Institute for Occup ational Safety

and H ealth

Minnesota Mining &St. Paul, MN

Benjamin MintzAmerican University

Franklin Mirer

Manufacturing

United Automobile Workers

(3M)

National Institute for Occupational Safetyand H ealth

Atlanta, GA, Cincinnati, OH, andMorgantown, WV

Occup ational Safety and H ealth Adm inistrationWashington, DC

John PageE. I. du Pent de Nemours & Co.

Randy RabinowitzZwerd ling, Schlossberg, Leibig, & Kahn

Knut RingenNational Cancer Institute

Anthony Robbins

Hou se Comm ittee on Energy and Comm erce

Frank RosenthalThe Johns Hop kins University

John RussellTimonium, MD

Herbert SchafferBur eau of Labor Statistics

Lyle SchauerBur eau of Labor Statistics

Scott SchneiderUnited Brotherhood of Carpen ters and

Joiners of Amer icaJack Sn yderMerck & Co.

Kate SommersNational Research Council

Dorothy Strunk House Committee on Education and Labor

John TritschAmerican Textile Manufacturers Institute

Ralph VernonTexas A&M University

Frank W ilcherSafety Equipment Institute

Donald P. WilmesMinnesota Mining & Manu facturing (3M)

Sidney WolfePublic Citizen




HEALTH PROGRAM ADVISORY COMMITTEE

Sidn ey S. Lee, Committee Chair President, Milbank Memorial Fund

New York, NY

Stuart H . Altman*DeanFlorence Heller SchoolBrandeis UniversityWaltham, MA

H. David BantaDepu ty D irectorPan American Health OrganizationWashington, DC

Carrol l L. Estes**ChairDepartment of Social and Behavioral SciencesSchool of Nu rsingUniversity of California, San FranciscoSan Francisco, CA

Rashi FeinProfessorDepartment of Social Medicine and Health PolicyHarvard Medical SchoolBoston, MA

Harvey V. FinebergDeanSchool of Public HealthHarvard UniversityBoston, MA

Melvin A. Glasser***DirectorHealth Security Action CouncilCommittee for National Health InsuranceWashington, DC

Patricia KingProfessorGeorgetown Law CenterWashington, DC

Joyce C. Lashof DeanSchool of Public HealthUniversity of California, Berkeley

Berkeley, CA

Alexander Leaf Professor of MedicineHarvard Medical SchoolMassachusetts General HospitalBoston, MA

Margaret Mahoney*PresidentThe Commonwealth FundNew York, NY

Frederick MostellerProfessor and ChairDepartment of Health Policy and ManagementSchool of Public Health

Harvard UniversityBoston, MA

Norton NelsonProfessorDepartment of Environmental M edicineNew York University Medical SchoolNew York, NY

Robert OseasohnAssociate DeanUniversity of Texas, San AntonioSan Anton io, TX

Nora Piore

Senior AdvisorThe Commonwealth FundNew York, NY

Mitchell Rabkin**PresidentBeth Israel HospitalBoston, MA

Doroth y P. RiceRegents LecturerDepartment of Social and Behavioral SciencesSchool of Nu rsingUniversity of California, San FranciscoSan Francisco, CA

q Until April 19S3.q *Until March 19S4.q **Until October 19S3.

“Until August 19S3.

q *Until April 19S3.



App. C—Acknowledgments and Health Program Advisory Committee 385

Richar d K. RiegelmanAssociate ProfessorGeorge Washington UniversitySchool of MedicineWashington, DC

Walter L. Robb

Vice President and General ManagerMedical Systems OperationsGeneral Electric Co.Milwaukee, WI

Frederick C. RobbinsPresidentInstitute of MedicineWashington, DC

Rosemary StevensProfessor

Department of History and Sociology of ScienceUniversity of PennsylvaniaPhiladelphia, PA



Appendix D.—Glossary of Acronyms and Terms

Glossary of Acronyms

AAIH —American Academy of IndustrialHygiene

ABET —American Board of Engineering and

TechnologyABIH —American Board of Industrial HygieneACGIH —American Conference of Governmental

Industrial HygienistsAEPIC —Architectural and Engineering

Performance Impact CenterAIHA —American Industrial Hygiene

AssociationANSI —American National Standards InstituteA O M A —American Occupational Medical

AssociationASSE —AmericanASTM —American

Materials

ATMI —AmericanInstituteAUPOH S —American

Society of Safety EngineersSociety for Testing and

Textile Manu facturers

University Programs forOccup ational Safety and -Health

BLSCBO

CD CCFRCOSH

CRS

CSHO

DHEW

DHHS

DOLEPAERCGAO

MSHA

NASNCHS

NCINFPANHIS

–Bureau of Labor Statistics (DOL)–Congressional Budget Office (U.S.

Congress)–Centers for Disease Control (PHS)—Code of Federal Regulations–Committee for Occupational Safety

and H ealth–Congressional Research Service (U.S.

Congress)—Compliance Safety and Health Officer

(OSHA)–U.S. Department of Health,

Education, and Welfare–U.S. Department of Health and

Human Services—U.S. Department of Labor—U.S. Environmental Protection Agency—Edu cational Resource Center–General Accounting Office (U.S.

Congress)–Mine Safety and Health

Administration (DOL)–National—National

(DHHS)—National—National—National

(NCHS)

Academ y of SciencesCenter for Health Statistics

Cancer Institute (NIH)Fire Protection AssociationHealth Interview Survey

NIEHS —National Institute of EnvironmentalHealth Sciences

NIH –National Institutes of Health (DHHS)NIOSH —National Institute for Occup ational

Safety and Health (CDC)

NOES —Nationa l Occupa tiona l ExposureSurvey (NIOSH)NOHS —National Occupational Hazard Survey

(NIOSH)NRC –National Research Council (NAS)NSC —National Safety CouncilNSMS —National Safety Management SocietyOMB —Office of Management and BudgetOSHA –Occupational Safety and Health

Administration (DOL)OSH Act —Occupational Safety an d Health Act

(Public Law 91-596)OTA —Office of Technology Assessment

(U.S. Congress)

PEL –Permissible Exposure Limit (OSHA)PH S –Public Health Service (DHHS)SEER –Surveillance, Epidemiology, and End

Results program (NCI)SIC —Stand ard Indu strial ClassificationTLV –Threshold Limit Value (ACGIH)

Glossary of Terms

Acute: Used to d escribe a disease or injury th at is mani-fest soon after exposu re to a hazard .

Add -on controls: Measures for injury and illness pre-

vention which are put into place after the workplaceis built and equipm ent installed [see chs. 5, 6, and16].

Administrative controls: Methods of reducing workerexposures to occupational hazards throu gh ad min-istrative arrangements. For example, rotating awor ker from areas of high exposure to areas of lowexposure reduces that worker’s average exposurelevel. Also includes scheduling of jobs or processesthat generate hazards at times when few w orkersare present. See engineering controls, personal pro-tective equipment, an d w ork practice controls [seealso chs. 5, 6, and 9].

Asbestosis: A restrictive chronic disease of the respi-

ratory system resulting from exposure to asbestosdust.

Asthma: Constriction of the bronchial tubes, in theup per regions of the lun g, in response to irritation,allergy, or other stimuli.



App. D—Glossary of Acronyms and Terms q 387

Bioassay: The use of animals to test chemicals or phys-

ical agents for harmful effects.Bronchitis: Inflammation of th e bronchial tu bes in the

up per respiratory system.Byssinosis: An obstructive chronic disease of the res-

piratory system resulting from exposure to cotton

dust [see ch. 5].Cancer: The unrestrained growth of tissue.Carcinogen: A substan ce or physical agent that causes

cancer.Carpal Tunnel Syndrome: An affliction among work-

ers doing hand work caused by compression of themedian nerve in the carpal tunnel, the passage inthe wrist through which blood vessels and nervespass to the hand from the forearm [see ch. 7].

Chronic: Used to describe a disease or injury th at isman ifest long after exposure to a haz ard. Also usedto d escribe persistent d isease.

Collective bargaining: Negotiation between employersand unions concerning wages, hours, and w orking

conditions [see ch. 15].Complaint inspections: OSHA inspections that re-spond to worker or union complaints about w ork-place hazar ds. See fatality/catastrophe, follow-up,

an d programm ed in spect ions [see also ch. 12].Compliance Safety and Health Officer (CSHO): The

formal title for OSHA inspectors.Consultation: As used in this assessment, an OSHA-

funded program that provides employers with aconfidential evaluation of the health and safetyhazards in their workplaces and recommend ationsconcerning hazard abatement [see ch. 12].

Contaminant: An undesirable chemical constituent of a system or environment.

Control Technology Assessments: The name given toa series of National Institute for Occupational Safe-ty and Health reports assessing measures for pre-venting work-related injury and illness.

Cost-benefit analysis: An analytical technique thatcompares the costs of a project or technological ap-plication to the resultant b enefits, with both costsand benefits expressed by the same measure. Thismeasure is nearly always monetary [see ch. 14].

Cost-effectiveness analysis: An analytical techniquethat compares th e costs of a project or of alterna-tive projects to the resultant benefits, with costs andbenefits/effectiveness expressed b y d ifferent meas-ures. Costs are usually expressed in dollars, but ben-

efits/effectiveness are ordinarily expressed in termssuch as “lives saved,“ “d isability avoided,” “qu ali-ty-adjusted life years saved, ” or any oth er relevantobjectives [see ch. 14].

Criteria Docum ent: A series of N ational Institute forOccupational Safety and Health reports which as-sess available literature to develop th e background

necessary for standards. Upon completion thesedocuments are transmitted to the OccupationalSafety and Health Administration as recommendedstandards [see ch. 12].

Dermatitis: Inflamm ation or irritation of the skin.Dibromochloropropane (DBCP): A chemical used as

a p esticide. In the m id-1970s, a group of male work -ers discovered that their exposure to DBCP had ren-dered them sterile. An OSHA r egulation limitingexposures to DBCP was issued in 1978.

Dose: The amoun t of energy or sub stance absorbedin a unit volume or an organ or individual. Doserate is the dose delivered per unit of time.

Educational Resource Centers (ERC): Fifteen academ-ic centers established by the National Institute forOccupational Safety and Health to provide multi-disciplinary training for industrial hygienists, safetyspecialists, occupational health nurses, and physi-cians. These centers also provide continuing edu-cation and technical assistance for their regions.

Emergency Temporary Standard (ETS): A standard is-sued under section 6(c) of the Occupational Safetyand H ealth Act. Such a stand ard may be issuedwhen OSHA determines that workers are exposedto a “grave d anger” from an occup ational hazardand that an emergency standard is necessary to pro-tect them from that danger.

Emphysema: A condition of the lu ngs characterizedby an increase beyond the norm al in the size of airspaces in the furtherest reaches of the lun g eitherfrom dialation of the alveolii (the tiny sacs in thethe lung w here oxygen from the air and w aste car-bon d ioxide in the blood are exchanged ) or fromthe d estruction of their w alls.

Engineering controls: Method s of controlling w orkerexposure by modifying the source or reducing theamount of contaminants released into the work-place. Engineering controls includ e pr ocess d esignand mod ification, equipm ent design, enclosure andisolation, and ventilation. See administrative con-trols, personal protective equipment, an d work practice controls [see also chs. 5, 6, and 9].

Epidemiology: The study of the distribution of diseasesand their precursors in human populations.

Ergonomics: The study of how hum ans and m achinesinteract. In th e occup ational setting, one goal of er-gonomics is to design the workplace to match work-er capabilities.

Ethylene dibromide (EDB): A chemical used as afumigant and as a gasoline additive. It causes can-cer in mice.

Experience rating: A system for setting work er com-pensation insurance premiums that is based on theemployer’s record or experience concerning injuriesand illnesses.




Exposure: The length of time and dose of chemical orphysical agent to which a worker is subjected.

Fatality/catastrophe inspection: An OSHA inspectionto investigate occupational fatalities or incidentsthat result in the hospitalization of five or more em-ployees. See complaint, follow-up, an d pro-

grammed inspections [see also ch. 12].Follow-up inspection: An OSHA inspection conductedto verify employer abatement of a violation un cov-ered in a previous OSH A inspection. See complaint,

fatality/catastrophe, and programed inspections

[see also ch. 12].General Duty Clause: Section 5(a)(1) of the Occupa-

tional Safety and Health Act. This section p rovidesthat “each emp loyer shall furnish . . . emp loymen tand a place of employment wh ich are free from rec-ognized hazards that are causing or are likely tocause death or serious physical harm to his employ-ees.” OSH A has u sed this clause for workp lace con-ditions that present serious occupational hazards

that are not covered by OSHA’s more detailedhealth and safety standards.

Health and Safety Committees: Groups made up of both management and labor within a plant thatmeet to discuss and take mutual action to resolvehealth and safety problems.

Health Hazard Evaluation (HHE): A hazard identifi-cation service provided by NIOSH. After receiv-ing a request from employees or an employer, ateam of NIOSH researchers evaluate a workplaceto determine the toxicity of substances or processes.

Hierarchy of controls: The preference for using engi-neering controls to reduce or eliminate hazards.This p reference, long a tenet of p rofessional health

and safety practice, has been followed b y OSH A.For example, to reduce exposures to air contami-nants, OSHA requ ires that employers use engineer-ing controls except wh en th ose controls are n ot fea-sible, not capable of reducing exposures to therequired levels, or while they are being designed andinstalled.

Labeling standard: OSHA’s Hazard Communicationstandard w hich requires that certain information beprovided to workers about the identi ty of work-place chemicals and their hazards [see ch. 15].

Loss-control service: Service p rovided by insurers toclient companies. Loss-control specialists visit work-sites and offer advice on the prevention of proper-

ty loss and work-related injuries and illnesses [seech . 15].

Lost-workday case: As defined by OSHA and BLS,a work-related injury or illness that results in an em-ployee missing time from w ork or that restricts theemployee’s work activity [see ch. 2].

Medical Removal Protection (MRP): A program speci-fied by the OSHA lead stand ard . It requiresremov-al of workers from lead-contaminated environmentswhen their blood lead levels exceed specified levels[see ch. 5].

Medical treatment case: As defined by OSHA and

BLS, a work-related injury or illness tha t requ iresmed ical treatment beyon d first aid [see ch. 2].Merit rating: See experience rating.

Mesothelioma: A malignant tumor of the membranethat lines the internal organs of the body.

Monom er: A chemical substance that can u ndergo pol-ymerization. See polymer.

Mutagen: A substance that causes mutations—changesin the genetic material of. cells.

New Directions Program: An OSHA program to pro-vide grants to employee, employer, educations, andnonprofit organizations for the purpose of provid-ing workplace health and safety training, education-al materials, and services.

Permissible Exposure Limit (PEL): The maximum air-borne concentration of a toxic substance permittedby OSHA stan dard s [see ch. 13].

Personal protective equipment: Equipment and cloth-ing designed to control hazards. It includes hardhats, safety shoes, protective eyewear, protectiveclothing and gloves, hearing protectors, and vari-ous types of respirators, such as du st and gas masks.Se e administrative, engineering, an d work practicecontrols [see also ch. 8].

Polymer: A chemical substance formed by the join-ing together of m any simple m olecules or mono-mers. For instance, many vinyl chloride monom ersare chemically joined to form polyvinyl chloride

(PVC). See monomer.Positive pressure mask: Respirators in which air pres-

sure insid e the facepiece exceeds th e outsid e airpressure.

Programed inspection: Programed or general scheduleinspections are those OSHA inspections that arescheduled using the injury experience or compliancehistory of an ind ustry. See also complaint, fatal-ity/catastrophe, an d follow -up inspections [seech. 12].

Protection factor: The ratio of measured concentra-t ions of an airborne contaminant inside and out-side the facepiece of a respirator, A measure of theeffectiveness of th e respirator.

“Records review” inspections: After arriving at a work-place, an OSH A insp ector examines the employer’sinjury and employment records. The inspector cal-culates the lost-workday injury rate for the employ-er. If that rate is below the n ational average formanufacturing, the inspection will usually be ter-



App. D—Glossary of Acronyms and Terms q 389 —

minated. For this assessment, these insp ections h ave

been termed “records review” inspections. Current-ly, this policy applies only to pr ogram ed safety in-spections [see ch. 12].

Repetitive motion disorders: Diseases caused by

repetitive movement of part of the body. See Car-

pal Tunnel Syndrome.Retro-fit controls: See add-on controls,

Right-to-know laws: State and local laws r equiringcompan ies to identify the chemical nam es and h az-ards of their products to workers and the com-munit y.

Rulemaking: The adm inistrative pr ocess by w hichOSHA and other regulatory agencies set standards.

Silicosis: A restr ictive chronic disease o f the resp ira-tory system resu lting from exposure to airborne sil-ica du st,

Stand ard s issued after rulemaking: Health and safetystandards issued by OSHA using the procedures es-tablished by section 6(b) of the Occupational Safety

and Health Act. These procedures require thatOSHA provide notice of intended changes and anopportunity for public comment.

Startup standards: The initial group of standardsadop ted by OSHA u nd er section 6(a) of the Occu-pational Safety and Health Act. These consisted of established Federal standards and consensusstandards.

State Program : Under section 18 of the Occup ationalSafety and Health Act, States may set and enforceworkplace health and safety standards. In thisassessment, these programs are term ed “State Pro-grams” [see ch. 12].

Teratogen: A chemical or p hysical agent that causes

ph ysical d efects in offspring.Threshold Limit Value (TLV): Maximum airborne con-

centrations of toxic substan ces set as guid elines by

the Am erican Conference of Governm ental Indu s-trial H ygienist [see ch. 13].

Tort liability: A legal basis for compensation whenproperty has been damaged or a p erson has beeninjured . For occup ational injuries and illnesses, mostlawsuits between employees and employers are

barred by State workers’ compensation law s, al-though suits against “third parties, ” such as manu-facturers of machinery or producers of asbestosprod ucts, are generally perm itted [see ch. 15].

Toxicology: As used in this repor t, the testing of sub-stances for toxic effects in an imals.

Vinyl chloride monomer (VCM): The basic buildingblock chemical for polyvin yl chloride p lastic. Seemonomer.

Voluntary Protection Program s: OSHA p rograms de-signed to recognize the achievements of employersand to provide ad ditional opportun ities for OSHA-employer consultation and cooperation. The threeprog rams a re called “Star,” “Try,” and “Praise.”

Voluntary standards: Protective limits developed bycompan ies, trad e associations, and p rofessional or-ganizations, but which do not have the force of law.

Walsh-Healey Pu blic ContractsAct: This Federal law ,enacted in 1936, directed th e Departm ent of Laborto issue requirements for safe work by Federal Gov-ernment contractors and to “blacklist” contractorswho did not comply with these requirements.

Work practice controls: Methods of controlling haz-ard s that involve only chan ges in job procedu resand housekeeping. See administrative controls, en-

gineering controls, an d personal protective equip-

ment [see also chs. 5, 6, and 9].Worker’s compen sation: State-required insu rance pr o-

grams w hich pay for med ical costs and r eplace aportion of emp loyees’ wages lost du e to work-re-lated injury and illness.



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U.S. Congress, General Accounting Office,Slow Progress Likely in the Development of Standards for Toxic Substances and HarmfulPhysical Agents Found in Workplaces, B-163375

(Washington, DC: U.S. Government Printingoffice, Sept. 28, 1973).U.S. Congress, General Accoun ting Office, Answers to Questions on the Issuance of An Emergency Temporary Standard for CertainChemicals Considered to be Carcinogens,MWD-75-33 (Washington, DC: U.S. Govern-ment Printing Office, Jan. 6, 1975).

U.S. Congress, General Accoun ting Office, Emergency Temporary St andards on Organo-

phosphorous Pest icides, MWD-75-55 (Washing-ton, DC: U.S. Governm ent Pr inting O ffice, Feb.24, 1975),

U.S. Congress, General Accounting Office,Worker Protection Must Be Insured When

Employ ers R equest Permission to Deviate FromSafety and Health Standards, IvIWD-76-19

(Washington, DC: U.S. Government PrintingOffice, Dec. 31, 1975).U.S. Cong ress, General Accoun ting Office,Fed-eral Efforts to Protect the Public From Cancer-




499.

500.

501

502,

503.

504.

505.

506.

507.

508.

509.

Causing Chemicals Are Not Very Effective,MWD-76-59 (Washington, DC: U.S. Govern-men t Pr inting Office, Jun e 16, 1976).U.S. Congress, General Accounting Office, Z3et-

t er Data or I Severity and Causes of Worker Safety and Health Problems Should be Obtained From W orkplaces, HRD-76-118 (Washington,

DC: U.S. Government Printing Office, Aug. 12,1976).U.S. Congress, General Accounting Office,States’ Protection of Workers Needs Improve-ment, HRD-76-161 (Washington, DC: U.S.Government Printing Office, Sept. 9, 1976).U.S. Congress, General Accounting Office, De-lays in Setting Workplace Standards for Can-cer Causing and O ther Dangerous Substances,HRD-77-71 (Washington, DC: U.S. Govern-ment Printing Office, May 10, 1977).U.S. Congress, Gener al Accountin g Office,Spo-radic Workplace Inspections for Lethal and Other Serious Health Hazards, HRD-77-143

(Washington, DC: U.S. Government PrintingOffice, Apr. 5, 1978).U.S. Congress, General Accounting Office,

Health Hazard Evaluation Program Needs Im-provement, HRD-78-13 (Washington, DC: U.S.Government Printing Office, May 18, 1978).U.S. Congress, General Accounting Office,Workplace Inspection Program Weak in Detect-ing and Correcting Sen”ous Hazards, HRD-78-34 (Washington, DC: U.S. Government Print-ing Office, May 19, 1978).U.S. Congress, General Accounting Office, La-bor Needs t o M anage Its W orkplace Consulta-tion Program l?etter, HRD-78-15s (Washington,DC: U.S. Government Printing Office, Dec. 18,1978).U.S. Congress, General Accoun ting Office,Grain Dust Explosions-An Unsolved Problem,HRD-79-1 (Washington, DC: U.S. Governm entPrinting Office, Mar. 21, 1979).U.S. Congress, General Accounting Office,How Effective are OSHA’S Complaint Proce-

dures?, HRD-79-48 (Washington, DC: U.S.Government Printing Office, Apr. 9, 1979).U.S. Congress, General Accounting Office,How Can Workplace Znjuries Be Prevented? The

Answers May be in OSHA FiZes , HRD-79-43

(Washington, DC: U.S. Government PrintingOffice, May 3, 1979).

U.S. Congress, Gen eral Accoun ting O ffice, “Re-view of Small Business Ad ministration’s occupa-tional safety and health loan program, ” HRD-79-82, letter to Ray Marshall and A. VernonWeaver from Gregory J. Ahart, June 6, 1979.

510.

511

512.

513.

514.

515.

516

517

517a.

518.

U.S. Congress, General Accounting Office, im -

proved Qualit y, Adequate Resources, and Con-sistent Oversight Needed lf Regulatory Analy-sis Is To Help Control Costs of Regulations,PAD-83-6 (Washington, DC, N ov. 2, 1982).

U.S. Congress, General Accoun ting O ffice, Zn -

formal Settlement of OSHA Citations: Comm-

ent s on the Legal Basis and Other Selected Issues, HRD-85-11 (Washington, DC: October26, 1984).U.S. Congress, House Committee on Banking,Finance, and Urban Affairs, Subcommittee onEconomic Stabilization, Catalog of Federal Loan

Guarantee Programs, Committee Print 97-10(Washington, DC: U.S. Government PrintingOffice, January 1982).U.S. Congress, House Com mittee on Banking,Finance, and Urban Affairs, Subcommittee onEconomic Stabilization, Industrial Policy, Hear-ings, 1983-84, Parts 1-6 (Washington, DC: U.S.Government Printing office, 1983, 1984).

U.S. Congress, House Committee on Banking,Finance, and Urban Affairs, Subcommittee onEconomic Stabilization, An Industrial Policy for

America: Is It Needed?, Committee Print 98-2(Washington, DC: U.S. Government PrintingOffice, April 1983).U.S. Congress, Hou se Comm ittee on Banking,Finance, and Urban Affairs, Subcomm ittee onGeneral Oversight and Renegotiation, Hearingon Establishment of a National Development

Bank and Related Mat ters, Sept. 15, 28, 1982,

Serial No. 97-89 (Washington, DC: U.S. Gov-ernm ent Pr inting Office, 1982).U.S. Congress, House Com mittee on Ed ucationand Labor, Report No, 91-1291, July 9, 1970(Washington, DC: U.S. Government PrintingOffice, 1970).U.S. Congress, House Com mittee on Edu cationand Labor, Subcomm ittee on Labor Standard s,Occupational Health Hazards Compensation

Act of 1982, Hearings, Mar. 4, Apr. 21-22, 1982(Washington, DC: U.S. Government Printing

Office, 1983).U.S. Congress, House Com mittee on Ed ucationand Labor, Subcommittee on Health and Safety,OSHA Oversight–Review of 116 llorrnant

Rulemaking Projects, Hearing, Oct. 4, 1983(Washington, DC: U.S. Government PrintingOffice, 1984).U.S. Congress, House Committee on Energyand Commerce, Subcommittee on Oversightand Investigations, Capital Formation and in -dustrial Policy (Washington, DC: U.S. Govern-men t Prin ting Office, July 1981).






540.

541.

542,

543.

544.

545.

546.

547.

547a.

548.

ment, The Implications of Cost-Effectiveness Analysis of Medical Technology (Washington,DC: U.S. Governm ent Prin ting Office, Augu st1980).U.S. Congress, Office of Technology Assess-ment, The Implications of Cost-Effectiveness

Analysis of Medical Technology, Background

Paper #I: Methodological Issues and Lit erature Review (Washington, DC: U.S. GovernmentPrinting Office, September 1980).

U.S. Congress, Office of Technology Assess-ment, Impacts of Applied Genetics: Micro-Organisms, Plants, and Animals, OTA-HR-132(Washington, DC: U.S. Government PrintingOffice, April 1981).U.S. Congress, Office of Technology Assess-ment, Assessment of Technolo~”es for Determin -ing Cancer Risk s From t he Envi ronment, OTA-

H-138 (Washington, DC: U.S. GovernmentPrintin g Office, June 1981).U.S. Congress, Office of Technology Assess-

ment, U.S. Indust rial Competit iveness: A Com - parison of Steel, Electronics, and Automobiles(Washington, DC: U.S. Government PrintingOffice, July 1981)

U.S. Congress, Office of Technology Assess-ment, Technology Transfer at the National in -

stitutes of Health, OTA-TM-H-1O (Washington,DC: U.S. Government Printing Office, March1982).U.S. Congress, Office of Technology Assess-ment, Strate~”es for Medica2 Technology Assess-ment (Washington, DC: U.S. GovernmentPrintin g Office, September 1982).U.S. Congress, Office of Technology Assess-ment, Technologies and M anagement Strate~”esf o r Hazardous Waste Control (Washington,DC: U.S. Government Printing Office, March1983).U.S. Congress, Office of Technology Assess-ment, The Role of Genetic Testing in the Pre-vention of O ccupational Disease, GPO Stock No. OTA-BA-194 (Washington, DC: U.S. Gov-ernment Printing Office, April 1983).U.S. Congress, Office of Technology Assess-ment, The Informat ion Content of Premanufac-

ture Not ices, Background Paper, OTA-BP-H- I7

(Washington, DC: U.S. Governm ent Pr inting

Office, April 1983).U.S. Congress, Office of Technology Assess-ment, Commercial Biotechnology: An Interna-

t iona l Analysis, GPO Stock No. OTA-BA-218(Washington, DC: U.S. Government PrintingOffice, January 1984).

549,

550.

551.

552.

553.

554.

555.

556.

557.

558.

U.S. Congress, Senate Com mittee on Finan ce,Subcommittee on Savings, Pensions, and Invest-ment Policy, Promotion of High-Growth Indus-tries and U.S. Competitiveness, Hearings, Jan.19-20, 1983 (Washington, DC: U.S. Govern-men t Prin ting Office, 1983).U.S. Congress, Senate Committee on Labor and

Human Resources, Occupational Safety and Health Improvements Act of 1980, Hearings,Apr. 15, 17, and 25, 1980 (Washington, DC:U.S. Government Printing Office, 1980).U.S. Congress, Senate Com mittee on Labor andPublic Welfare, Report No. 91-1282, Oct. 6,1970 (Wash ington , DC: U.S. Governm ent Prin t-ing Office, 1970).

U.S. Department of Commerce, “Opportunities

and Strategies for U.S. Textile Machinery M an-ufacturers to Imp rove Their Comp etitive Posi-tions in D omestic and Foreign Textile Markets,1980-1985, ” September 1980.U.S. Department of Commerce, Bureau of the

Census, County Business Pat terns, 1981: United

States (Washington, DC: U.S. GovernmentPrinting Office, 1982).U.S. Department of Commerce, Bureau of In-dustrial Economics, U,S. Industrial Out look:Prospects For Over 300 industries, 25th ed .

(Washington, DC: January 1984).U.S. Department of Health, Education, andWelfare, “Estimates of the Fraction of Cancerin the United States Related to OccupationalFactors, ” typescript (Bethesda, MD: N ationalCancer Institute, National Institute of Environ-mental Health Sciences, National Institute forOccupational Safety and Health, Sept. 15,

1978), reprinted in Quantification of Occupa-t ional Cancer: Banbury Report 9, R. Peto andM, Schneiderm an (eds. ) (Cold Spring H arbor,NY: Cold Spring Harbor Laboratory, 1981).U.S. Departm ent of Health and H um an Serv-ices, Promoting Health/Preventing Disease—

Objectiv es for the Nat ion (Washington, DC:Govern men t Print ing Office, 1980),U.S. Department of Health and Hu man Serv-

ces, Committee to Coordinate Environmentalm d Related Program s (CCERP), The Occupa -

t ional Cancer Risk Subcomm ittee, On Occupa-

tional Cancer Estimation: Report of the O c-

wpa t i ona l Cancer Risk Subcommittee of the Department of Health and Human Services~ommi t t e e to Coordinate Environmental and ?elated Programs, typescript (Cincinnati, OH:WOSH, Nov. 4, 1984)J.S. Department of Health and Hu man Serv-






576.

577.

579.

580.

581

582.

Control, National Institute for OccupationalSafety and H ealth, Occupational Hazard Assess-ment: Coal Liquefaction, Vol. Ii—Assessment,D H H S (NIOSH) Publication No. 81-132 (Wash-ington , DC: U.S. Governm ent Pr inting Office,1981).U.S. Department of Health and Hu man Serv-

ices, Public Health Service, Centers for DiseaseControl, National Institute for Occup ationalSafety and Health, Symposium Proceedings:Control Technology in the Plastics and ResinsJndustry, D H H S (NIOSH) 81-107 (Washington ,DC: U.S. Government Printing Office, January1981),U.S. Department of Health and Human Serv-ices, Pub lic Health Service, Center for DiseaseControl, National Institute for OccupationalSafety and H ealth, Proceedings of Symposiumon Occupation Health Hazard Control Technol-ogy in t he Foundry and Secondary N on-ferrousSmelting Industries, D H H S (NIOSH) Publica-tion No. 81-114, August 1981.U.S. Department of Health and Human Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and Health, Mission Statement: N ationalInstitute f o r Occupational Safety and Health

(Atlanta, GA: Centers for Disease Control,1982).U.S. Department of Health an d H um an Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and Health, “Respirator InformationNotice on MSA Powered Air Purifying Respi-rator, Mine Safety Appliance Co., Pittsburgh,PA, Model Nu mbers: 463354, 466607, 466608,

Approval Number TC-21C-M6° (Atlanta: Na-tional Institute for Occupational Safety andHealth, Nov. 15, 1982).U.S. Department of Health an d H um an Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for Occup ationalSafety and Health, Report on OccupationalSafety and Health for FY 1982–Under Public

Law 91-596 (Washington, DC: GovernmentPrinting Office, 1983).U.S. Department of Health and Human Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and Health, Division of Physical Sciencesand Engineering, Overview-The Division of Physical Sciences and Engineering, NIOSH in -ternal document (Cincinnati, OH: 1983).

583.

584,

585.

586.

587.

588.

590.

591.

U.S. Department of Health an d H um an Serv-ices, Publ ic Health Service, Centers for DiseaseControl, National In stitute for Occup ationalSafety and Health, “Leading Work-related Dis-eases and In juries,” Morbidity and MortalityW eek l y Report, 32:24-26, 32, Jan. 21, 1983.U.S. Department of Health and Human Serv-

ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and Health, NZOSH Program Plan byProgram Areas: Fiscal Year 1983, GPO stock No. 661-089 (Washington, DC: U.S. Gover-

nment Printing Office, February 1983).U.S. Department of Health and Human Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and Health, “Comments to OSHA forDocket H-160: Health Standard s: Methods of Compliance,” typ escript, Jun e 1983.U.S. Department of Health and Human Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and H ealth, Registry of ‘Toxi c Effects of

Chemical Substances: 1981-82 Edition, D H H S(NIOSH) Publication N o. 83-107 (Cincinnati,OH : NIOSH, June 1983).U.S. Department of Health and Human Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and H ealth, Engineering Control of Oc-cupational Safety and Health Hazards: Recom-mendations for Improving Engz”neen”ng Practice,

Educatio n, and Research, Sum mary Report of the Engineering Control Technology WorkshopTechnical Panel (Cincinnati, OH: NIOSH, July1983).U.S. Department of Health and Human Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and H ealth, N IOSH Report on Occupa-ti onal Safety and Healt h for Fiscal Year 1982Under Public Law 91-596, GPO stock No. 659-096-1026 (Washington, DC: U.S. GovernmentPrinting Office, September 1983).

U.S. Department of Health and Human Serv-ices, Public Health Service, Centers for DiseaseControl, National Institute for OccupationalSafety and Health, NZOSH Program Plan byProgram Areas: Fiscal Years 1984-89, D H H S

(NIOSH) Publication No. 84-107, February1984.U.S. Department of Health and Human Serv-ices, Public Health Service, National Center for



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Index



Index

American Conference of Governmen tal Indu strialHygienists, 9, 86, 206, 257-261

American Ind ustrial Hyg iene Association, 9American N ational Standard s Institute (ANSI), 9,

71, 206, 300American Occupational Medical Association, 205assessment of OSHA an d NIOSH activities, 257

comparison of recomm endations and stand ards,257-262

impacts of NIOSH, 269impacts of OSHA, 262

B. F. Goodrich, 81

Bureau of National Affairs, 314

Carter, President Jimmy, 280Centers for Disease Control, 22o

Congress:House Committee on Energy and Commerce, 4

Senate Committee on Labor and Human

Resources, 4Council on Wage and Price Stability, 280, 282,

283

data on occupational injuries and illnesses, 29-38occupational illnesses, 37

occupational injuries, 30

sources of information, 29

decisionmaking for occupational safety and health,

275-294

general issues, 275

OSHA decisionmaking on standards, 278

uses and limits of economic analysis, 289Departm ent of the Interior

Bureau of Mines, 145Department of Labor

Bureau of Labor Statistics (BLS), 4, 5, 17, 29,

30, 36, 132, 167Mine Safety and Health Ad ministration, 219

dissemination of health and safety information, 11

Du Pent Co., 117, 155

economic incentives, re indust r ia l iza t ion , an dFederal assistance for occupational safetyand h ealth, 327

economic incentives and financial assistance, 327injury/exposure taxes, 327

tax progr ams and financial assistance, 329

Federal aid for research an d informationdissemination, 338reindustrialization and occupational safety and

health, 332

Educational Resource Centers (ERC), 10, 195

Environmental Protection Agency (EPA), 9, 63,157, 280

ergonomics and human factors, 123

applying ergonomics to VDT design, 135

classification of ergonomics, 124

prevention of musculoskeletal injuries, 127

back disorders, 132-135

carpal tunnel syndrome (CTS), 127-132

Ford, President Gerald, 280

General Accounting Office, 220, 238, 287, 331

governmental activities concerning worker healthand safety, 219-254

current Federal/State framework, 219

assistant Secretaries and Directors, 221

Federal spending, 221

separation of research and regulation, 22o

National Institute for Occupational Safety and

Health, 242-253development of controls, 247

dissemination, 249

identification, 243

priorities, 251

Occupational Health and Safety Administration,

224-242

enforcement, 232

public education and service, 237

standard-setting, 224

State programs, 239

health hazard identification, 41-64

occup ational d isease, 42

cancer, 45musculoskeletal disorders,

necrologic disorders, 49

reproductive disorders, 48

respiratory disorders, 43

skin disorders, 49

known and unknown heal th

identified hazards, 52

45

hazards, 52

method s for detection of pr esent, unidentifiedhazards, 54

new hazards, 62

hierarchy of controls, 175-185

advantages and disadvantages of, 178

advantages of engineering controls, 179

problems with engineering controls, 181problems with personal protective equipment,

179

description of, 175

423




consensus standards, 176controls for safety hazard s, 177Government standards, 177views of health professionals, 175

OSHA’S policy, 182actions by the curren t ad ministration, 183

identification of occup ational hazard s, 6incentives, imperatives, an d the d ecision to

control, 297

assessment of existing incentives, 297

Government regulation, 320

labor market forces, collective bargaining, and

worker’s rights, 313

provision of information, 301

tort liability, 309

voluntary efforts, 297

workers’ compensation and insurance, 302

Internal Revenue Service (IRS), 16, 331

legislation:

Clean Air Act, 237

Coal Mine Health and Safety Act, 212, 219Federal Mine Safety and Health Act of 1977,

145, 212

Flood Control Act of 1936, 277

Metal and Non-Metallic Mine Safety Act of

1966, 219

Mine Safety and Health Act of 1977, 219

Noise Control Act of 1972, 157

Occupational Safety and Health (OSH) Act, 4,

12, 23, 29, 36, 86, 145, 177, 195, 213, 219,

220, 224, 239, 242, 276, 278, 284, 314

Toxic Substances Control Act (TSCA), 58, 63,64

Walsh-Healey Act, 86, 213

National Cancer Institute, 238

National Center for Health Statistics (NCHS), 5,

16, 30National Death Index (NDI), 16, 58

National Electronic Injury Surveillance System

(NEISS), 32

National Highway Traffic Safety Administration,

Occup ational Safety and Health Ad ministration

(OSHA) , 6, 10, 11, 13, 14, 19, 20, 22, 23,25, 29, 34, 35, 45, 86, 90, 92, 93, 104, 110,145, 189, 197, 219, 220, 224-242, 257, 271,275, 278-288, 298, 359-380

enforcement, 232inspection an d enforcement, 14regulation, 13standard-setting, 224, 281

occup ationally associated d eaths, injuries, andillnesses, 4-6

Office of Management and Budget (OMB), 13,280, 281, 287

options for controlling w orkplace hazard s, 16-26creation of Occup ational Safety and Health

Fund, 24data and hazard identification, 16edu cation, training, and information

dissemination, 19improved control technologies, 18incentives and imperatives, 21needs of small businesses, 25

role of OSHA, 22

personal protective equipment, 143-172

hearing protectors, 154-158

acceptance of, 156

conservation programs, 155

field testing, 158

noise redu ction r atings, 157respirators, 143-154

deficiencies in programs, 152

dust masks, 148

field testing, 149

fit testing, 145Los Alamos Scientific Laboratory studies, 147

NIOSH certification, 1s3

third-party testing, 1s4

personal protective equipment, other types of,159

NIOSH tests, 159

protective eyewear, 163

tests of gloves against chemical hazards, 166

third-party laboratory testing, 170