Remarks as prepared for
Acting Assistant Secretary of Labor for Occupational Safety and Health
United States Department of Labor
Keynote address for
AFSCME National Nurses Congress
American Federation of State, County and Municipal Employees, AFL-CIO
12:45 p.m. Tuesday, May 5, 2009
First, I can't tell you how good it feels to be back at AFSCME. Since leaving the union more than 10 years ago, I've had a number of jobs, a number of new homes, but I always tell people that I still bleed AFSCME green.
When I started at AFSCME in 1982, I didn't know much about OSHA or occupational safety and health. I learned by doing - by doing a lot of reading, a lot of training, but most important, by listening to you. You were my teachers and most of what I know now is the result of the lessons that you taught me.
You were my teachers and the lessons most important to me now are the lessons that you taught me in the classrooms, in your union halls and in the endless Hyatts and Ramadas and Holiday Inns where I listened to you tell me about your jobs and the hazards you face on the job every day. I especially remember discussions with you nurses - how you love your job, how you love caring for your patients, the struggles that you had to fight through every day to provide quality care, and how you couldn't have done it without the union. I remember the frustration in too many of you because of the hardships that you faced going to work every day in pain and sometimes in fear.
So, when I was asked a week ago to speak at this conference, I was more than happy to do it. As it turns out, it comes at a good time, because just in the past week, health care workers are facing a new crisis: pandemic flu.
Given the events of the past week and escalating global concern about the threat of a pandemic, our visit together today is timely.
I want everyone in this room to know that OSHA is aware of the crucial role that nurses would play in a pandemic. Nurses at every level of health care would be on the front lines as first receivers in a health emergency that would severely test our resources and our resolve. I, for one, am glad that you stand ready to meet this threat, and OSHA will stand with you and all health care workers to ensure your safety and health on the job.
I know that you are concerned about being prepared with the best information available. In the brief time we have together today, I will tell you about OSHA's strategy for protecting American workers from Influenza A - or H1N1.
Clearly, during an influenza pandemic, transmission can occur anywhere, but OSHA's chief concern is how a pandemic would affect our workforce. A pandemic would disrupt many work operations and conceivably cause major losses to our economy. Because of the preparations that OSHA has made for a possible outbreak of the Avian Influenza - "Bird Flu" - the Agency is fully prepared to address the dangers of our current concern: Influenza A.
OSHA is prepared to direct the full range of its education, enforcement, technical assistance and public outreach programs to combat outbreaks of the virus in American workplaces. When we take a risk-based approach to protecting workers from disease, including pandemic flu, we find that only a small portion of workers are at the highest risk level - and you know who you are.
Clearly those at highest risk and in need of the most protection are front-line health care workers, because you and your colleagues are the foundation upon which our public health is built. This is why we want to protect you and your families - for your sake as well as for the sake of our country's entire public health structure. If our society expects our brave health care workforce to come to work each day during a pandemic, then our Nation has a responsibility to ensure that you have the best personal protective equipment and the latest safety and health information.
Let's not forget the custodians, security guards, administrative employees and maintenance workers who support you. They may not be at high risk themselves during their normal job duties, but if we expect them to come to work each day to carry out critical functions, they must be educated about the virus, their level of risk, what situations increase their risk and how to protect themselves.
As nurses, you will often have the responsibility of educating other health care workers - and, often, even doctors - about how to protect yourselves while continuing to provide quality health care to those stricken by the flu.
In preparing for a possible pandemic, you may have been flooded with contradictory and confusing information. I understand what you're going through, and I want to assure you today that it is OSHA's mission to provide you with the best information that you need - not only to protect yourselves, but to educate others.
OSHA has a great deal of information on protecting workers from pandemic flu and we will be producing more in the coming weeks. This information is targeted at both workers and employers.
The Agency first issued guidelines on pandemic influenza in March 2004 and subsequently published the Guidance on Preparing Workplaces for an Influenza Pandemic. Additionally, we published a document specific to health care workers, titled Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers; a condensed version, specifically designed for frontline workers, provides an excellent way to rapidly capture the essentials of the larger document. OSHA has numerous other sources of information for workers and their employers on pandemic influenza, including booklets and QuickCards written in both English and Spanish, frequently asked questions for health care workers, and copies of OSHA's guidance documents. These resources are available to you at www.OSHA.gov on our Pandemic Influenza page.
As the influenza health threat changes, so will OSHA. We plan to post answers to common incoming questions about Influenza A from workers and employers on our Web site.
Along with all the helpful information posted on OSHA's Pandemic Influenza Web page, the Agency offers a link to the Federal Web site at Flu.gov. This site has up-to-the-moment information on the status of the Influenza A outbreak. It also provides advice on individual measures that all citizens can take to minimize the risk of exposure and how best to avoid exposing others.
While we hope that all employers will do the right thing to protect their workforce, OSHA is also prepared, within its existing authority, to use its enforcement tools to ensure that workers are protected.
OSHA fully expects that this Nation's hospitals and other workplaces, where workers are clearly at risk, are working hard now to ensure that they are fully prepared for either a limited outbreak in their area or a full pandemic - including ordering respirators and other personal protective equipment, conducting fit testing, medical evaluation and training workers.
Although OSHA has no specific standard on influenza exposure, the General Duty Clause of the Occupational Safety and Health Act - the "OSH Act," which requires employers to provide employment free from recognized hazards - will be used to protect their workers. OSHA also has standards addressing personal protective equipment, as well as a respirator standard that requires a complete respirator program, including training, medical examination and fit testing.
OSHA will quickly adjust its inspection scheduling priorities as needed to ensure that employers are following the guidelines if a pandemic in the workplace becomes a reality. It is OSHA's responsibility to ensure nurses and other health care workers have the protection and training they need. Workers and employers need to know when it is appropriate to wear a respirator, how to get the respirator fit-tested and how to wear it properly, when to wear gloves, and how to properly put on and take off personal protective equipment.
As H1N1 influenza becomes more prominent in the United States, OSHA will be fully integrated in public communication. We will distribute news releases and public service announcements to media outlets, employers, trade associations and unions - including and most particularly AFSCME - directing people to OSHA's more detailed online resources.
OSHA's consultation program, with offices located throughout our Nation, provides assistance to small businesses; and these offices will also be part of the pandemic flu response. The state consultants are knowledgeable about the mix of workplaces and industries in their states and can determine which worksites most need to be informed. These consultants will deliver advice and information both to individual worksites and to government or business headquarters.
Communicating with hospitals, nursing homes, clinics, nurses' offices in schools, and other heath care-providing facilities will, of course, be a priority.
Since September 11, 2001, the ensuing anthrax attacks and Hurricane Katrina, OSHA has worked closely with other agencies involved in emergency response. Representatives from the Department of Labor are attending daily briefings on Influenza A provided by the Department of Health and Human Services, meeting alongside representatives from the Department of Homeland Security, the Environmental Protection Agency, the Agriculture Department, the National Institute for Occupational Safety and Health, and the CDC. OSHA, working closely with the CDC and NIOSH, has taken the lead in establishing worker protection protocols for pandemic flu. Through the National Response Framework, which coordinates Federal emergency response actions, OSHA is the designated Agency for worker protection. OSHA has convened its Worker Safety and Health Support Annex Coordinating Committee to ensure that all Influenza A information is consistent and distributed widely.
Today I am here to assure you that the numerous exercises we have carried out in emergency planning over the past eight years will pay off. I am confident that we have the ability to work together to combat this challenge. We will do our part, and I have every confidence that nurses in every city and town in America can be ready as well.
Please look to OSHA's Web site for the influenza and emergency response guides that I have mentioned. In addition, OSHA has information about other hazards in health care. For example, we will soon post a new publication titled OSHA's Small Business Guide for Ethylene Oxide, which has hazard exposure information related to sterilization processes that I expect will interest everyone here today. Along these lines, we currently have available a more technical document, titled Best Practices for the Safe Use of Glutaraldehyde in Health Care, which you will find quite useful.
OSHA knows that nurses encounter serious risks from workplace violence, strains from patient handling and biohazards. We have guidance documents, fact sheets and other information on our Web site to show you and your employers how to minimize risks from these hazards. Enforceable standards exist for many of these topics, like bloodborne pathogens and ethylene oxide. For others, such as preventing back injuries and workplace violence, there are no standards, and for the past several years OSHA has not been aggressive in applying its full enforcement powers.
These informational materials were produced with significant input from the nursing community and others in the health care profession, and I want to thank all those who participated in their development.
Coming very soon, look for three new OSHA fact sheets on hazards in Very High-Risk Workplaces, Fit Testing Requirement for Respirators, and Use of Surgical Masks for Respiratory Protection.
An excellent way to keep up with all the latest OSHA publications and news is to take advantage of our RSS feed on our Web site. You can sign up to automatically receive news on your computer desktop whenever we issue new information affecting the health care industry.
More than 72,000 people also subscribe to our free, twice-monthly electronic newsletter, QuickTakes, to receive the latest news on "all things OSHA." You don't have to keep checking our Web site; sign up once and we'll automatically let you know when we have news for you and your co-workers.
A NEW OSHA
We mustn't let talk of emergency preparedness take up all our time together this afternoon. I know you are eager for other news in OSHA.
Let's begin by talking about my boss. You may have heard how Hilda Solis, the new Secretary of Labor, has quickly set the tone for her leadership in the Department. She brings to Washington her experience as a labor union supporter and workers rights activist. In the Congress, where she represented the 32nd district in California, her priorities included expanding access to affordable health care, protecting the environment, and improving the lives of working families.
When she started her job in March, she described her approach to the Department of Labor, which will differ from the last Administration, by announcing that "There's a new sheriff in town." Secretary Solis and I believe that the vast majority of employers want to do right by their workers, and through our outreach, training and education efforts OSHA is providing employers with the information they need to comply with workplace standards.
However, recalcitrant employers who fail to meet their obligations under the OSH Act will be targeted for strong enforcement action. About two weeks ago, OSHA sent out letters to nearly 14,000 employers nationwide, including some in health care facilities, putting these employers on notice that their workplace injury and illness rates are considerably higher than the national average. These notifications encouraged employers to take immediate steps to eliminate hazards in their workplaces. We reminded these employers that OSHA offers free assistance programs such as the On-site Consultation Program to help them better protect the safety and health of their workers.
The Department of Labor is taking aggressive steps to bolster our enforcement, including a comprehensive review of our Enhanced Enforcement Program and plans under the new economic stimulus package to hire more enforcement officers for OSHA.
COMING HOME EVERY DAY
These and other actions are all guided by the simple idea that workers should be able to come home from work every day, safe and sound.
Last week, Secretary Solis and I commemorated Workers Memorial Day at a ceremony officially opening the grounds of a workers memorial at the National Labor College just a few miles from here in Silver Spring, Maryland. We joined with faculty, students and union members to dedicate the memorial and our future actions to the memory of fallen heroes - workers who left for work and did not come home.
By virtue of your profession, nurses are especially aware of the precious and fragile nature of human life. ER nurses in particular see the results when employers fail to protect their workers. You see the construction worker brought in with crushed limbs, the maimed pipe fitter, the factory worker with severe burns - and too many other terrible stories that should never have happened.
Under the New OSHA, we will not forget these victims of employer neglect or indifference, and we will not forget you.
This week is North American Occupational Safety and Health Week. More than fifty trade groups and industry organizations who have pledged to partner with OSHA are making time this week to post workplace safety and health information on their Web sites, communicating with workers and employers about the importance of practicing prevention, and reminding every working man and woman to take advantage of OSHA information resources.
I see that our time together is almost up. Before I leave you to your workshops and other activities today, I want to express my admiration, appreciation and sheer awe for everything you do every day.
As our Nation marshals its resources to combat the threat of pandemic influenza, I want you to know that everyone in OSHA and the Department of Labor appreciates the great responsibility of nurses who stand ready on the front lines of emergency response as first receivers and as deliverers of critical health care. We could not hope to manage a health crisis of this proportion without you.
In OSHA's 38-year history, pandemic influenza is a unique challenge. However, I would characterize this situation for the workforce just as the President described it for the Nation: "Cause for deep concern, but not panic."
I am very confident of the expertise of OSHA's medical, scientific, compliance assistance and enforcement personnel. We are prepared to address the threat and we will protect our workforce.
OSHA also recognizes the power of unions to fight for worker protection. I want to express my thanks to AFSCME for your advocacy on behalf of worker safety and health.
My thanks to Kathy Cox and everyone else organizing this conference for giving me the opportunity to speak with you today. I know how hard it is because I organized this same conference about 15 years ago.
Please keep in touch and, while you're taking care of everyone else, please don't forget to take care of yourselves.
As nurses, and as AFSCME members, you make America great.
Thank you for everything you do.