John L. Henshaw
American Occupational Health Conference
May 7, 2003
Safety and Health Add Value
- Good morning. Thank you Ed (Dr. Bernacki) and Deborah (DiBenedetto). I'm delighted to join the occupational health care professionals today in Atlanta.
- We're all here because we share the same goal. We want to see all workers go home the same way they came to work. And if someone gets hurt or ill, we want to take care of them so they can return to a full and productive life.
- Today we have nearly 115 million workers at 7 million worksites in this country. We have a lot of responsibility, but we can do it.
- The talent and expertise in this room is immense. With AAOHN and ACOEM and OSHA, our ultimate success is measured by prevention.
- Theodore Roosevelt once said, "Keep your eyes on the stars and your feet on the ground." That's my philosophy. We're going to focus on the long-term vision by using the down-to-earth process of building bridges of cooperation and understanding with those who share our vision and strive to reach the same goals.
- We want everyone to understand one simple truth: Safety and health add value. To your business. To your workplace. To your life.
- The value for business is clear: focusing on safety and health programs is the right thing to do; it saves money and adds value to the organization.
- Safety and health add value to the workplace as well. The benefits include increased productivity, higher quality, increased morale and reduced turnover.
- Clearly safety and health add value to life. For workers, getting hurt or sick is not just physically painful. Injuries and illnesses can significantly reduce income, increase stress and hinder a full family life.
- By any measure ... Safety and health add value ... To your business... To your workplace... To your life.
- As more and more employers and workers understand and appreciate the value of safety and health, I believe we will be increasingly more successful in driving injuries and illnesses down. OSHA has developed three, equally important strategies to move ahead.
- These strategies include: strong, fair and effective enforcement; outreach, education and compliance assistance; and partnerships and cooperative programs. These are the tools we have to encourage employers and workers to make safety and health a core value.
- Today, I want to focus particularly on cooperative programs and our efforts with both your organizations. We've had occupational health nurses on our staff for many years, and the new head of our Office of Occupational Medicine, Dr. Donald Wright, is a board-certified occupational physician formerly with Concentra in Waco, Texas, and active with ACOEM. So, OSHA clearly values the relationship with both AAOHN and ACOEM.
- First this morning, I want to talk a little bit about our standards and guidance effort -- that's both enforcement and outreach. I want to bring you up to date on a number of health issues OSHA is working on.
Important Occupational Health Issues
- OSHA has taken a hard look at its standard setting effort. We've combined safety and health standards and re-named the office "Standards and Guidance."
- We have streamlined our semi-annual regulatory agenda. We're no longer publishing a "wish list." We're publishing a "to do" list.
- We want everyone to know what we're really working on over the next 12 months. And you can hold us accountable for those milestones.
- I'm delighted to report that we're meeting our timetables and completing our commitments. The new regulatory agenda will be out in a couple of weeks, and you can see how much we've accomplished.
- We're also beginning to develop not just standards, but guidance materials -- practical recommendations that employers can implement immediately. Two months ago, we issued final guidelines on ergonomics for nursing homes. By next week, we'll be seeking public comment on similar guidelines for the retail grocery industry. Poultry processing will follow very soon, and shipyards will follow after. And we will identify others.
- Other products -- on a wide variety of safety and health issues -- training programs, detailed information on addressing specific hazards and technical reports -- are also in the works.
- Let me talk about several exciting projects we're working on. First, AEDs -- OSHA is committed to encouraging more employers to provide Automated External Defibrillators or AEDs in the workplace. With the help of Dr. Bernacki and ACOEM, we have developed a list of companies whose medical directors support workplace AED programs. We need their help to foster further use of AEDs in the workplace. We're working on a best practices guide for first aid that will include AED programs.
- We'll also be developing a brief publication, a page on our website and an outreach presentation to promote the use of AEDs. Further, we're looking into installing these devices in our own field offices.
- A hot issue on the minds of medical professionals -- and the rest of us as well -- is SARS -- Severe Acute Respiratory Syndrome. We know that the primary causative agent appears to be the coronavirus and that the disease is spread primarily through close personal contact. SARS is fatal in only about 6% of cases-less than influenza.
- OSHA is providing information on its website on SARS for those at greatest risk of workplace transmission -- health care professionals, workers in the airline industry and those who must handle remains of SARS patients.
- We also have a page on our website covering smallpox. While SARS is a naturally occurring disease, we would only face smallpox if it were used as a biological weapon. Our page includes detailed information and numerous links that are helpful for health care professionals.
- We are taking a careful look at respiratory protection and personal protective equipment that workers would need during disaster response and remediation. We plan to develop a guidance document that will cover known hazards. And it will identify additional resources -- like the information on SARS and smallpox -- for issues not covered by OSHA standards or where the standards are outdated.
- We're also moving forward on other issues involving respiratory protection. We'll be sharing our proposal on assigned protection factors with the Advisory Committee on Construction Safety and Health later this month. Once we have ACCSH input and resolve any questions, we expect to publish the proposal in the Federal Register for public comment early this summer.
- OSHA has also been petitioned to add another controlled negative pressure fit testing protocol to its list of acceptable protocols in the respiratory protection standard. This CNP would be an addition -- not a replacement. It would involve three donnings of the respirator and three fit test exercises instead of one donning and eight exercises. We'll also be discussing this approach with ACCSH. We expect to publish this proposal early this summer as well.
- OSHA is currently considering whether or not to update its standard on beryllium. Associated with chronic beryllium disease and lung cancer, beryllium is classified by IARC and NTP as a human carcinogen.
- OSHA developed general guidance information for employers on beryllium in 1999 and more specific information related to dental labs in 2001. Last fall the agency requested comments on whether it should update the standard.
- We received 34 comments, and we are analyzing those now. We've also conducted site visits at several workplaces that use beryllium -- machining shops and a recycling plant -- to investigate typical exposure levels and identify exposure control technologies that might work.
- We're involved in rulemaking on several health issues. Silica poses a problem to workers in many industries. Each year there are still 200-300 deaths from silicosis -- mostly among construction workers. OSHA's standard is about 100 µg/m³ for general industry and about 250-300 µg/m³ for construction and maritime. ACGIH and NIOSH have recommended a PEL of 50 µg/m³ for all industry sectors.
- We're developing a comprehensive standard on crystalline silica that will cover workers in all three industrial sectors. In addition to a lower PEL, it will include provisions for health screening. Our next step in developing the proposed standard is to begin the SBREFA process -- consulting with small businesses -- in June.
- Meanwhile we are working on some guidance materials for construction -- for ten specific construction operations -- that will offer useful information on engineering controls and work practices. Again, this will be information that construction contractors can put into practice NOW -- without needing to wait for completion of the new silica standard.
- Hexavalent chromium, classified as a known human carcinogen, is the final health issue I want to address today. Workers are exposed to hexavalent chromium in a number of operations -- electroplating, welding, and in the production of paints and pigments, stainless steel, colored glass. Those involved in printing and textile dyeing and working with wet Portland cement may also be exposed.
- Last December we announced we would be developing a standard for hexavalent chromium. Soon afterwards, as a result of litigation, the Third Circuit Court of Appeals ordered the agency to complete a proposal by October 4, 2004 and a final standard by January 18, 2006. We're in the process of conducting technologic and economic feasibility analyses and quantitative risk assessment to develop the regulatory text and supporting preamble. We expect to meet the court deadline for the proposal.
Outreach, education, and compliance assistance
- Last April, Labor Secretary Elaine Chao announced a new four-pronged approach to address musculoskeletal disorders. It includes industry-specific guidelines, enforcement through the general duty clause, outreach and assistance and research recommendations with the help of an advisory committee.
- I've already talked about the guidelines OSHA has issued and is working on. In addition to these, we're looking to individual industries to develop guidelines of their own. The printing and graphics industry, the American Furniture Manufacturers and the Society for the Plastics Industry are all actively working on guidelines.
- We have about 10 strategic partnerships focused on ergonomics and 12 alliances, like we signed with ACOEM -- but more on that later!
- We have an extensive webpage devoted to ergonomics, including interactive software to help employers find practical solutions that have worked for others.
- In addition, our new 15-member National Advisory Committee on Ergonomics met for the first time in January and is wrapping up their second meeting today. They'll assist us in many areas, but I've particularly asked them to begin helping us find ways to reduce science to practice in ergonomics. Small employers need practical guidance ... and we need to offer it.
- We will also be involved in enforcement. Does that mean OSHA will be enforcing guidelines? No, definitely not. But what it does mean is that employers who have problems with MSDs in the workplace need to address them.
- A primary focus for inspections will be nursing homes. We announced a national emphasis inspection program for nursing homes last summer. But we are conducting inspections in other industries as well.
- We are not going to focus our enforcement efforts on employers who have implemented effective ergonomic programs or who are making good-faith efforts to reduce ergonomic hazards.
Partnerships and Cooperative Programs
- Now let's talk about another strategy OSHA is using to improve safety and health in American workplaces. That's outreach, education and compliance assistance. We've promised to expand assistance for those who want to do the right thing.
- We have 70 compliance assistance specialists -- one in each of our OSHA area offices -- whose job is to help businesses with safety and health training, guidance and encouragement. We also fund the OSHA Consultation program offers on-site service to small businesses -- visiting more than 17,000 each year. And our 20 Education Centers in 35 locations offer OSHA training -- mostly at community colleges and universities.
- Some of you may be aware of another outreach effort of ours -- QuickTakes -- our e-mail news memo. Launched a year ago, we now have nearly 32,000 subscribers, with more added every day.
- If you haven't signed on, I urge you to do so. It's free and it's fast... just 2 pages every 2 weeks, and in 2 minutes you can keep track of safety and health issues that OSHA is working on. Sign up at www.osha.gov and QuickTakes will come to your email address.
- We also have a new youth page on our website for teen workers, their parents and educators. We're focusing information on issues and hazards most likely to affect teens.
- One of the areas that demand OSHA's attention is the need to reach immigrant workers, particularly Spanish-speaking workers. Even as overall workforce fatalities have fallen, deaths among Hispanic workers have increased... up 12% in 2000 and 9% in 2001.
- We've taken a number of steps to reach out to Hispanic workers ... a toll-free help line ... 1-800-321-OSHA with assistance in English and Spanish ... a Spanish webpage ... many publications in Spanish ... 180 OSHA or state staff who speak Spanish ... partnerships with Hispanic groups ... and more.
- Our other focus for reducing injuries, illnesses and deaths is partnerships and cooperative programs. This effort includes several programs -- our premier employer partnership program -- Voluntary Protection Programs or VPP, OSHA Strategic Partnerships, and Alliances. We're looking to expand all of these programs significantly.
- Our newest partnership effort ... the one ACOEM is participating in and AAOHN joins today is ... Alliances.
- Alliances focus on leveraging resources on one or more elements such as training and education, outreach and communication or promoting the value of safety and health.
- On March 19, Dr. Bernacki and I signed an Alliance committing ACOEM and OSHA to work together on ergonomics. I was especially pleased to have ACOEM step forward as one of the first organizations to join us in an Alliance.
- ACOEM members have agreed to serve as mentors to smaller employers to help implement ergonomic programs. ACOEM will also provide health care providers with information and guidance in recognizing, diagnosing and treating ergonomic injuries.
- OSHA is developing training programs and materials that ACOEM can deliver. In addition, ACOEM is developing its own training modules and educational programs for health care providers on ergonomics.
- Very shortly, I'll be signing an Alliance with AAOHN. Through this Alliance we will work together to address a variety of safety and health issues. Specifically this agreement calls for us to:
- Disseminate safety and health information and guidance directly to businesses through local meetings such as Rotary, Chamber of Commerce and other groups as well as conferences and other events and both our websites.
- Encourage AAOHN's members to act as industry liaisons and resources for OSHA's cooperative programs and compliance assistance specialists.
- Develop electronic assistance tools for OSHA's web page that address safety and health issues including emergency management, musculoskeleteal disorders and workplace violence.
- OSHA has a huge challenge in assuring safety and health at 7 million workplaces in the U.S. We do not take our responsibilities lightly. Nor do we assume that we can handle this challenge alone.
- Rather, our goal is to provide the leadership and the vision to help employers and employees recognize that safety and health add value -- to businesses, to workplaces and to life. And to provide a balanced approach to carrying out our mission of helping employers and employees reduce injuries, illnesses and deaths in the workplace.
- In everything we do, we are looking for ways to partner with those who share our vision. We are particularly pleased to join with ACOEM and now AAOHN in Alliances that will enable us to work together cooperatively to address ergonomics and other safety and health issues that impact American workers.