Taking Occupational Diseases Seriously

Brooklyn Dodger, another blogger on occupational and public health topics, alerts us to a NIOSH survey of the causes of occupational deaths. According to this study, 1997 US mortality data, the estimated annual burden of occupational disease mortality resulting from selected respiratory diseases, cancers, cardiovascular disease, chronic renal failure, and hepatitis is 49,000. At the same time, the Bureau of Labor Statistics estimates there are about 6,200 work-related injury deaths annually. If you look carefully at the distribution of topics addressed by the OSHA standards, you would get the impression that the greater emphasis on occupational injuries means that they are more severe than occupational diseases. However, the data indicate that doesn’t seem to be the case, if you are looking at death on the job.

Note that this doesn’t factor in occupational illnesses and injuries that don’t kill workers. Examination of the statistics will still probably find that skin diseases/injuries and musculoskeletal injuries are still the more predominant workplace hazards.

These are pertinent when you think about the fact that 12 years ago OSHA’s rule on airborne contaminants, which would have reduced Permissible Exposure Limits (PELs) for hundred of substances, had been set aside by a federal Court of Appeals. OSHA tried to “speed along” the process of revising PELs by "generic" rulemaking, grouping substances into 18 categories by their primary health response, such as neurotoxicity, sensory irritation, and cancer (the backup for OSHA’s revised PELs proposed in their 1989 airborne contaminants rule can be found here). OSHA’s reasoning for this approach was that developing standards on a chemical-by-chemical basis would require several years. The court rejected that reasoning, stating that each PEL had to stand on its own merits.

OSHA had been sued by the AFL-CIO, which means that the labor organization was trying to push the agency towards more scientifically-based, and presumably lower PELs. However, the outcome has been virtually no motion by OSHA to update its PELs, many which are still based on occupational exposure guidelines developed prior to 1968. It is unlikely that OSHA will move forward on this except in response to litigation or prompting by Congress (I heard OSHA representatives say as much at an EPA conference a few years ago). The current OSHA rulemaking for a revised PEL for hexavalent chromium is in response to a lawsuit by the Public Citizen Health Research Group.

In today’s environment where ample information exists regarding workplace hazards from chemical exposure, the absence of scientifically up-to-date standards should not be an obstacle for employers to prevent harmful exposures or control them to the lowest level feasible. Is it really excusable for employers to not take steps to keep employee exposures as low as feasible, even if occupational exposure standards haven’t kept pace with current scientific knowledge about health hazards?

Also, when serious hazards are obvious, controls should be implemented even if there is no quantitative evaluation of exposure or harm. For example, it should be obvious these days not to do something like this with any solvent, particularly trichloroethylene:

Until fall 2003, workers in a Wilkes-Barre special-education school district gave little thought to the chemical they knew only as deglazing solvent.

Used to clean ink from two printing presses in the district's main administration building, the solvent routinely spilled onto the carpet. Its stench drifted through the air ducts. Still, it seemed nothing more than an annoyance -- until Antoinette Dominick was diagnosed with cancer.

Dominick is among roughly two dozen employees who have been diagnosed with non-Hodgkin's lymphoma, lupus, or other diseases that may be associated with TCE exposure -- the solvent used for cleaning, exposing approximately 200 people who worked in the building for upwards of three decades. Though there is still some quibbling about the nature and strength of the evidence, there is enough suspicion, disseminated publicly, that trichloroethylene is carcinogenic to warn even the most poorly-informed employer not to do something like that.

You can argue all you’d like that we don’t “know” that TCE is a human carcinogen, and that it takes a long time to develop scientifically-based occupational exposure standards, and that if the government doesn’t pay attention to this issue, that’s a sign that employers shouldn’t have to either. It’s still inexcusable that these things are happening in the 21st century.