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National Advisory Committee on Occupational Safety Health
Minutes of April 12-13, 2000, Meeting
U.S. Department of Labor
Room N3437 A-D
The meeting of the National Advisory Committee on Occupational Safety and Health (NACOSH) was opened by Chair Byron Orton at approximately 9:10 am Wednesday, April 12. He announced that the Public Member vacancy created by Kathleen Rest's resignation from the committee when she joined the National Institute for Occupational Safety and Health (NIOSH) had been filled by the appointment of Dr. Letitia K. Davis to the committee. Dr. Davis was unable to attend the meeting because of prior commitments as were Safety Representative David Heller and Health Representative LaMont Byrd. About 30 members of the public were present for the opening of the meeting.
The following members were present:
Members introduced themselves to the public and the minutes of the previous meeting were approved. Dr. Linda Rosenstock, NIOSH Director, began her overview of NIOSH activities by announcing the addition of two new senior scientists to the NIOSH Office of the Director: Matt Gillen (previously with EPA) and Anita Schill (previously with OSHA). She also announced that after 28 years of service, Brian Hardin who had previously served as NIOSH support person to NACOSH was retiring. Rosenstock then provided the committee with a copy of the just published "Highlights of the National Institute for Occupational Safety and Health 1995-1999". In reviewing the contents of the document, she reminded the committee of NIOSH's four strategic goals: (1) research; (2) surveillance; (3) prevention through workplace evaluations, interventions and recommendations; and (4) information, training, and capacity building. Rosenstock said that NIOSH will be using FY2000 NORA funds for research on musculoskeletal disorders, asthma, and dermatologic exposures and effects. With regard to surveillance, Rosenstock said that appoximately 400 individuals were involved in developing NIOSH's Surveillance Strategic Plan which is comprised of five goals which seek to achieve a balance between national and state-based activities, as well as a balance between health, injury, and hazard surveillance. Prevention activities in NIOSH include the new healthcare worker initiative, the Health Hazard Evaluations Program (HHE), the Fatal Assessment Circumstances and Epidemiology Program (FACE), and the Firefighter Fatality Investigation and Prevention Program (FFIP) among others. Rosenstock said that with regard to the professional training aspect of their mission that they were about to add their 16th education research center and that there had been a total of 41 training project grants in 26 states in FY 2000. She called the committee's attention to the budget figures covered in the Highlights book and said that their current budget of $215 million would have to have been increased to $249 to keep up with inflation. Hank Lick asked if there was any new money coming in for the FACE program. Rosenstock responded that there had been a little but it had been specifically targeted for the firefighter study which is investigating every single firefighter death which occurred in the line of duty. In answer to a question from Byron Orton Rosenstock confirmed that the study covered both career and volunteer departments. Orton added that they had just suffered another firefighter fatality the previous week in Iowa which brought their total to five fatalities in the past three months.
OSHA Assistant Secretary Charles Jeffress told the committee that the Ergo hearings were going very well and he thanked the committee members individually and also the organizations they represented for their positive support in a number of different ways during the hearing process. He added that some of the critics of the standard who had submitted written comments and requested time to address the hearing had pulled out and that the record that was being built during the hearings was one that was very supportive of moving ahead with an ergonomics standard. Jeffress said that Congress was continuing to hold hearings related to ergonomics. With regard to the recordkeeping, he said that the proposed rule was moving quickly and that he expected to complete work by the end of the month and to forward it to the Office of Budget and Management (OMB) for publication in the Federal Register this summer. He listed three other proposed rules--tuberculosis, personal protective equipment and steel erection--which were on their way to final status that he expected to be published this year. He mentioned OSHA's strategic plan goal of helping 100,000 workplaces achieve a 20% reduction in injuries and illnesses by 2002 and said that OSHA had commissioned two academics to review available information to assess whether OSHA interventions had made any difference and to see whether OSHA was on track with the goal. Interventions used as the basis included consultation visits, OSHA inspections and letters sent to employers with the highest injury/illness rates. He said that he was happy to report that in the first two years of the five-year program more than 50,000 workplaces had achieved at least a 20% reduction following an OSHA intervention. Jeffress then commended the committee for the important study it was conducting of the standards setting process. He said that he had both attended some of the sessions and read material which summarized the sessions and found it very helpful. He said that he agreed with the suggestion that OSHA use of negotiated rulemaking was most helpful and that the recommendation of such a committee should be published as soon as it is completed. But he cautioned the committee to recognize and help others understand just exactly how much time consuming research and study related to technological and economic feasibility had to be done after the recommendation was received. This results in a significant delay between the time the negotiated rulemaking committee makes its recommendations to OSHA for the reg text and the time when OSHA can go forward with a full-blown proposal. Jeffress acknowledged that this was an incredibly frustrating period of time for the steel erection negotiated rulemaking committee members and that a better understanding of the process would have been helpful.
During comments from the committee, Nancy Lessin asked for a copy of the study that found that 50,000 workplaces had achieved a reduction in injury/illness rate of at least 20% after an OSHA intervention. She also asked how the researchers had controlled for the presence of safety incentive and injury discipline programs that could affect the reporting of injuries/illnesses. Jeffress responded that they had not controlled for that but that there would be no impact unless the presence of such programs had increased during that period of time. Lessin added that some of the information coming out in the Ergo hearings had been very illuminating in this regard and that she did feel that there had been an increase. Jeffress added that another underreporting cause had come out in the Chicago Ergo hearings related to the practice of employees going to their own doctors for treatment for a work-related injury/illness which then never got reported. Hank Lick asked about the rulemaking handbook that was under development within OSHA and wondered if it could be of use to members of negotiated rulemaking advisory committees. Jeffress responded that it would be too comprehensive and voluminous for that particular use. This led to further discussion of the wall chart that Lick had been suggesting for quite some time. Jeffress added that the evaluation of the standards team pilot project had been completed with positive results and that he was proceeding with the steps required to make the structure permanent.
Hank Lick brought up the subject of the need to increase public support for occupational safety and health. Linda Rosenstock mentioned that one of the things NIOSH had done was to focus on healthcare workers and their impact on the general public. She mentioned the joint conference with OSHA and other federal agencies last fall which emphasized the link between how healthcare workers feel and how well patients get taken care of and remarked that they were already seeing an increase in public interest in the safety and health of healthcare workers. Jeffress asked the committee if it was their perception that there had been better public support in earlier years than at present. Lick responded that it may have been better in the beginning because of the newness of the program, but that now many businesses were satisfied with the level of safety and health and felt we could not competitively afford any more. Mike Wright added that at least among industrial workers support for OSHA had actually gone up, but that opposition had gone up dramatically among the people who have the money to influence Congress and public debate. On another subject, Nancy Lessin asked if she could have a copy of the latest Form 33 and wondered whether a new contract had been let with Drs. Smitherman and Weems who had addressed the committee in January. Jeffress said that he did not know the status of the contract but would check. Hank Lick added that much of the confusion and dissension over the Form 33 occurred because the committee had been interested in what evaluative tool would be used to evaluate safety and health programs in the standard under development, and that Paula White had offered the presentation by Smitherman and Weems in answer to that question. He felt that her statement about no more money being available had to do with developing an evaluation tool for the safety and health programs standard. Lessin pointed out that the Preamble to the Ergo Standard mentions Form 33 as a tool to evaluate programs and references the research being conducted on the Form 33.
Bonnie Rogers asked if either agency had been studying the relationship of the human genome project to occupational safety and health, particularly in relation to issues of confidentiality of workers who are identified for gene structures. Charles Jeffress said that Anita Schill had been working on that for OSHA and had been taking part in the White House task force which was looking at issues of confidentiality, how to use the research, and what is permitted. He joked that she could now do that for NIOSH. Linda Rosenstock mentioned that NIOSH had a long history of being concerned about the potential harm as well as the potential insights that could be gained. She said they had held an outstanding symposium at their Morgantown facility about a month ago and had brought in ouside experts dealing with ethical, legal and social implications and had gone through all of their own research that had any genetic base. She said that in terms of research, it was fair to think about genetics as merely another risk factor. She added that NIOSH would be glad to discuss this subject more fully in a future meeting.
After lunch, Byron Orton addressed the group before they started the review of the draft recommendations on the standards development process that had been submitted by several of the members. He referenced Mike Wright's earlier comments and emphasized that the bottom line in occupational safety and health considerations was the protection of workers. He said that he felt that most of the people on the committee and in the room would agree with him that if the standards development process is not broken at this point in time, it is very close to it. He said that we are seeing workers in this nation get seriously hurt, sick and die on a daily basis, and that one of the reasons for this is because the standards development system is not working for workers. He said that he viewed the current NACOSH initiative to study the process the most important activity he had been involved in with NACOSH and thanked the many outstanding panelists who had come before the committee.
The committee devoted the rest of that day and the next, except for a presentation related to needlestick injuries which opened the meeting on April 13, to the completion of recommendations to become part of the report on the standards development process. These recommendations are not attached to the minutes because they are not yet final.
Bill Borwegen, Service Employees International Union, requested and was granted time to address NACOSH on needlestick safety. He said that he felt his presentation was germane to the committee's discussion of the standards setting process because he felt that needlestick injuries represented a case study of how you decide what to regulate and in what order. He discussed the seriousness of needlestick injuries which would result in workers contracting and dying from Hepatitis C and HIV when what he described as "simple actions" by OSHA to require the use of needles with integrated safety features could save hundreds, if not thousands, of lives. He said that he was glad to report that much had happened throughout the country and cited California's law requiring the use of safer needles which the state said had a projected overall savings in excess of $1 million a year due to the decreased need to test and treat injured and ill workers. He added that hospital chains such as Kaiser were reporting significant drops in needlestick injuries. He said that since the passage of the California law, more than two dozen states had introduced bills under both Democratic and Republican sponsorship with laws being signed by governors in Tennessee, Texas, Maryland, New Jersey, and West Virginia the previous week with Governor Ventura signing the bill in Minnesota this past Monday. Borwegen cited a bill at the federal level which had garnered over 175 cosponsors in the House of Representatives and said that Senator Jeffords was contemplating a Senate bill. He expressed his disappointment that OSHA was not taking full advantage of this bipartisan support by amending its bloodborne pathogens standard to require the use of safe needles. He acknowledged that OSHA had released its 68-page compliance directive on November 5th of last year, conducted training in February and was now using the compliance directives to cite employers that don't use safer needles. However, he noted that the new recordkeeping rule with the promised change which would require the recording of all needlestick injuries where the needle was contaminated with the patient's blood or bodily fluid, had not yet been completed and was still within the Department of Labor. Hank Lick asked if the latex glove issue should also be covered if the bloodborne pathogens standard was amended. Borwegen said that of course it would be a good idea but might bring in more opposition and complication. Peg Seminario asked Borwegen why he thought OSHA wasn't moving on a rule. Borwegen said that from his discussions with Charles Jeffress that it appeared to be a matter of insufficient staff. Mike Wright asked if Borwegen thought there would be any opposition from other Federal Agencies if OSHA moved ahead. Borwegen said he thought there would be support from the Veterans Administration, and did not expect any opposition from FDA since they simply approve medical devices, not who uses them. Wright asked if Borwegen thought there was expertise within NIOSH that could assist OSHA in amending the standard. Borwegen said he felt sure there was and that Linda Rosenstock would be in favor of assisting.
After considerable discussion, the committee developed a recomendation on needlestick injuries which was approved unanimously by those present and is attached to the minutes. Before adjourning the meeting on April 13, the committee selected September 13-14 as the date for the first fall meeting.
Recommendation on Needlestick Injuries
Department of Labor - Washington, D.C.
N 3437 A-D
Wednesday, April 12, 2000
Thursday, April 13, 2000
* The meeting will end when the review of the draft report is completed but will not go past 4:00 pm on April 13. If the task is completed at the end of the previous day's meeting, this presentation will not take place and will be rescheduled for a future meeting.
NATIONAL ADVISORY COMMITTEE ON OCCUPATIONAL SAFETY AND HEALTH
April 13, 2000
NACOSH believes that the issue of needlestick injuries is urgent and should be addressed quickly through regulatory action. The committee requests that the OSHA Assistant Secretary address this issue at the June meeting and present an operational plan for acting on this issue.
This recommendation was adopted unanimously on April 13, 2000, by the members present. (Byron Orton, Nancy Lessin, Daniel Hryhorczuk, Henry Lick, Dennis Scullion, Peg Seminario, Mike Wright and Margaret Carroll.)
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