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Health Policy and Ethics: Michael Silverstein Getting Home Safe and Sound: Occupational Safety Health Administration at 38 Am J Public Health 2008; 0: AJPH.2007.117382v1 [Abstract] [PDF]

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Safe, Sound and Educated

Alice Freund   (25 June 2008)

The seventh step.

Rosemary K. Sokas   (11 March 2008)

Safe, Sound and Educated 25 June 2008
Alice Freund, Industrial Hygienist Mt. Sinai School of Medicine Send letter to journal: Re: Safe, Sound and Educated alice.freund{at}mssm.edu Alice Freund	Michael Silverstein outlines excellent proposals to improve the effectiveness of the Occupational Safety and Health Administration so that workers can go to work every day without the fear of being killed or maimed (Getting Home Safe and Sound: Occupational Safety and Health Administration at 38, March 2008). I would like to add one more key recommendation: an OSHA requirement that every worker receive in-depth training on safety and health. Currently there are no requirements for workers to get trained on workplace safety and health unless we are exposed to very specific hazards such as lead or asbestos. Contrast this to Sweden, where every worker receives 40 hours of basic training on topics such as chemical hazards, noise, protective equipment, and ergonomics. Because of this widespread training, work environment issues are widely recognized and supported by Swedish citizens. If every worker in this country received basic training, not only would we be safer, but we would be more aware of hazards and more willing to see our government invest in health and safety oversight, including the recommendations made by Dr. Silverstein.
The seventh step. 11 March 2008
Rosemary K. Sokas, Professor University of Illinois at Chicago School of Public Health Send letter to journal: Re: The seventh step. sokas{at}uic.edu Rosemary K. Sokas	In his thought-provoking review of the policy reforms needed to turn workplace safety and health into a reality for workers in the U.S., Silverstein recommends six new steps: annual third party inspections; safety and health systems; independent employee rights; extension of protections to all workers; framing workplace safety as a human right; and providing appropriate infrastructure support (1). However, given the challenges presented by the globalization of both industry and labor, including downsizing, outsourcing, and the emergence of a shadow economy that functions without regard for governmental regulation, these steps may miss the most disadvantaged workers who are at greatest risk for disproportionate adverse health effects (2, 3, 4, 5). Regulating the supply chain for occupational safety and health is a seventh step that would help reach those in the shadows. Supply chain regulation is an attempt to realign control and responsibility when externalization has resulted in reduced attention to safety (6). The larger entities that shed subsidiaries have done so in the interest of reduced costs, but these cost pressures in a globalized economy have not been balanced by voluntary or regulated safety supports. In a recent policy statement, the American Public Health Association addresses the influx of cheap toys contaminated with lead as a consumer issue in the U.S. as well as a hazard to workers in manufacturing countries that requires “robust and effective monitoring …by both government and the private sector…” (7). In Australia, the state of New South Wales has enacted legislation requiring entities that contract for truck shipping to incorporate measures to ensure appropriate adherence to work/rest requirements as well as cost into shipping contracts, holding the contractor responsible for violations (6). These particular examples integrate supply chain regulation for workplace safety into the broader public safety arena with improved consumer product safety or safer highways. A related approach, implemented in California by the Maintenance Cooperation Trust Fund, targets large retail chains that contract with janitorial services failing to comply with labor laws; in these instances, competitor organizations with an interest in leveling the playing field add their support (8). Supply chain regulation for safety reminds us that the chain is as strong as its weakest link. References: 1. Silverstein, M. Getting Home Safe and Sound: Occupational Safety and Health Administration at 38. Am J. Public Health. 2008;98:416-423. 2. Cummings KJ and Kreiss K. Contingent Workers and Contingent Health: Risks of a Modern Economy. JAMA 2008;299(4):448-450. 3. Quinlan M, Mayhew C, Bohle P. The global expansion of precarious employment, work disorganization, and consequences for occupational health: A review of recent research. Int. J Health Services. 2001;31(2):335-414. 4. de Castro AB, Fujishiro K, Sweitzer E, Oliva J. How Immigrant Workers Experience Workplace Problems: A Qualitative Study. Arch Env Occ Health 2006;61(6):249-258. 5. Cho CC, Oliva J, Sweitzer E, Nevarez J, Zanoni J, Sokas RK. An Interfaith Workers’ Center Approach to Workplace Rights: Implications for Workplace Safety and Health. JOEM 2007;49(3):275-281. 6. James P, Johnstone R, Quinlan M, Walters D. Regulating Supply Chains to Improve Health and Safety. Industrial Law Journal. 2007;36(2):163-187. 7. American Public Health Association Policy Statement Calling for a Global Ban on Lead Use in Residential Indoor and Outdoor Paints, Children’s Products, and All Nonessential Uses in Consumer Products 2007 LB-07-01 http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1348 [Accessed 3/10/08] 8. Selvin, M. Speaking up for exploited workers. Los Angeles Times, 3/2/08 http://www.latimes.com/business/printedition/la-fi- sunprofile2mar02,1,1330673.story [Accessed 3/10/08]