Copyright 1999 Federal News Service, Inc.
Federal News Service
MARCH 23, 1999, TUESDAY
SECTION: IN THE NEWS
LENGTH:
3271 words
HEADLINE: PREPARED TESTIMONY BY
BILL
BORWEGEN
SERVICE EMPLOYEES INTERNATIONAL UNION,
AFL-CIO, CLC
BEFORE
THE HOUSE EDUCATION AND THE WORKFORCE COMMITTEE
WORKFORCE
PROTECTIONS SUBCOMMITTEE
BODY:
Mr. Chairman,
members of the committee, my name is Bill Borwegen, Occupational Health and
Safety Director for the Service Employees International Union (SEIU). I
appreciate the opportunity to testify today to present our views on the
Occupational Safety and Health Administration (OSHA).
We represent 1.3
million workers employed in a variety of occupations both in the public and
private sector. We are the nation's largest organization representing healthcare
workers, with half of our members working as physicians, nurses, nurse's aides,
housekeepers, laboratory assistants and orderlies. We also represent over
100,000 building service workers. Consequently, our members are exposed to a
wide range of workplace hazards.
Our union is strongly committed to
improving workers' safety and health protections, and in seeking protections for
our members under the Occupational Safety and Health Act of 1970. We have worked
hard for effective implementation of the law pushing for protective standards,
meaningful enforcement, programs to provide training and assistance to workers,
unions, and employers, and for increased funding for both OSHA and NIOSH to do
their jobs.
However, we are very concerned that while 58% of all injuries
and illnesses now occur in the service sector, that OSHA has failed to change as
the economy has changed; becoming increasingly irrelevant for growing numbers of
our nation's workers. OSHA has failed to develop a program to focus their
inspections in the industry sectors where the data show most workers are getting
hurt and ill. Likewise, OSHA seems incapable of promulgating the very standards
that would address the major hazards facing today's workforce.Let me state
unequivocally that SEIU strongly supports the mission of the Occupational Safety
and Health Act. We have witnessed, largely from the sidelines, how there can be
a significant improvement in the reduction of injuries and illnesses in the
industry sectors where OSHA has chosen to focus their resources. In
manufacturing and construction, for example, where OSHA conducts almost all of
their general schedule inspections, injury and illness rates have declined by 33
percent and 52 percent, respectively, since 1973.
In stark contrast,
however, in the industry sectors where most of our members work, and where most
workers in this country work, OSHA protections, have been largely lacking or
totally absent. This is why I am here today, and this is what our members want
you to know.
Lack of Coverage for Public Sector Workers. Many public sector
government employees lack basic coverage under the OSHAct. Currently, 8.1
million state and local public employees in 27 states are not covered by this
1970 job safety law. Federal sector workers, while covered by Executive Order,
lack meaningful protection, as OSHA can not issue fines for violations. In a
number of states, the injury rate for public sector workers is higher than for
workers in the private sector. In 1997 alone, 624 public sector workers were
killed on the job. Mr. Chairman, the Bush Administration proposed that Congress
expand coverage to these workers in 1991. Now is the time for Congress to extend
coverage to these workers.
Hazardous Industries Exempted from Recording
Injuries and Illnesses. Window cleaners have one of the more dangerous
professions. Building service workers as a whole experience the third highest
number of back injuries. However, in 1983, OSHA choose to exempt such building
service contractors and scores of other such service sector industries employers
from keeping track of when a worker has an on-the-job injury and illness. This
basic information is fundamental in any effort to prevent such future injuries
and illnesses. OSHA must lift this exemption and require all employers to
maintain this vital injury and illness information.
Healthcare Workers are
Facing an Epidemic of On-the Job Injuries and Illnesses. The industry sector
with one of the largest increases in injury and illness numbers and rates has
been in healthcare. Healthcare workers have experienced a doubling of their
workplace injury and illness rates over the past decade. Healthcare employers
report that their workers suffered 652,800 injuries and illnesses in 1997, more
than any other sector of the economy.
As startling as this may sound, today,
it is safer to work in a factory, a mine, or on a construction site, than in a
healthcare institution. In 1996, for the first time, the hospital worker injury
and illness rate of 11.0/100 workers per year actually exceeded the rates for
workers employed in these other industries that have traditionally been viewed
as much more hazardous. Injury and illness rates for nursing home workers are
far worse, reaching as high as 18.2/100 workers per year as recently as 1995.
Yet the actual number of injuries and illnesses healthcare workers
experience may in fact be at least double this figure, as it is estimated that
less than 10% of the 600,000 to one million needlestick
injuries healthcare workers suffer every year ever get reported in these
statistics.
Again, as with the other workers employed in the public and
service sectors, OSHA has largely ignored this silent epidemic affecting our
nation's healthcare providers. However, unlike in many other industries, there
are additional consequences to society when adequate attention is not given to
maintaining an adequate healthcare work environment. The CDC reports that over
60,000 patients die each year from infections which they pick up solely as a
result of being in the hospital. This figure is much greater than the number of
people who die each year from traffic accidents.
Below I would like to
provide the committee with a snapshot of the different hazards facing healthcare
workers, and OSHA's need for action on each issue:
Needlesticks. The most prevalent, least reported and
largely preventable serious risk healthcare workers face which OSHA has not yet
acted upon is the continuing use of inherently dangerous unsafe conventional
needles that transmit HIV and hepatitis to health care workers. OSHA estimates
that over 1,000 healthcare workers contract HIV and Hepatitis C from
needlestick injuries each year. The FDA had approved over 250
safer needle products. The CDC has demonstrated that safer needles can reduce
needlestick injuries by up to 76%.OSHA has collected
information from hundreds of hospitals, describing how safer needles have
dramatically reduced their needlestick injury rates.
Yet,
without OSHA action, it is unlikely that greater than 10% of the needles being
purchased by healthcare employers will have integrated safety features. Use of
conventional needles today without integrated safety features in the healthcare
environment have been compared to the use of unguarded machinery decades ago in
the industrial workplace. Once stuck, hundreds of thousands of healthcare
workers and their families each year must deal with the emotional stress of
waiting a minimum of six months to find out whether they will contract a
potentially life-threatening disease. For healthcare workers advised to take
anti-viral drugs in hopes of preventing HIV transmission, most suffer side
effects severe enough to cause them to cease treatment.
Prior to the
promulgation of the 1991 OSHA Bloodborne Pathogen Standard that required the
free availability of the Hepatitis B vaccine to potentially exposed workers,
hepatitis B was the leading needlestick transmitted bloodborne
infectious disease afflicting health care workers. Known as the "health care
workers disease", CDC estimated that hepatitis B infected up to 17,000 health
care workers as recently as 1983, killing up to 250 of them. The US Senate voted
99 to one to demand action and a final rule was issued by OSHA in December 1991.
Today, CDC estimates that as a direct result of the OSHA standard, requiring
employers to provide the hepatitis B vaccine free of charge, health care workers
now have lower rates of hepatitis B than the general population. Fewer than 400
health care workers annually contract and less then a dozen will eventually die
as a result of their exposures today.
At the time of passage of the 1991
OSHA Bloodborne Disease Standard, safer needles were just beginning to enter the
marketplace and the standard stated that employers were to periodically evaluate
"engineering and work practices" to reduce needlestick
injuries; defining "engineering controls" to include such devices as "self-
sheathing needles." However, OSHA has delayed directing their compliance
officers to enforce this provision of the standard. Furthermore, OSHA has failed
to notify healthcare employers of U.S. Senate Appropriations Report language
adopted in the fall of 1998, finding that potentially contaminated
needlestick injuries should be reported on OSHA 200 logs.In
direct response to this lack of action by federal OSHA, SEIU has mounted a
nationwide campaign to get states to adopt safer needle laws. With strong
bipartisan support, a law was passed last fall in California, bills are
currently pending in a dozen states, and introduction in a dozen more will occur
over the coming weeks.
OSHA must no longer delay in providing direction to
their inspectors on urging healthcare employers to purchase these life-saving
safer needle technologies. OSHA must also inform the healthcare community that
the Congress recommends that employers record all potentially contaminated
needlestick injuries.
Patient Lifting Injuries. Hospitals
and nursing homes experience a higher number of occupational injuries and
illnesses involving days away from work from back injuries than any other
industry. By occupation, nurses' aides report a greater percentage of their
injuries as back injuries than any other job title. Back injuries continue to
take a huge economic and personal toll within the health care sector. The
nursing home industry alone spends over $1 billion each year in workers
compensation premiums. Yet the healthcare industry has been slow to implement
ergonomic programs which have been shown to dramatically reduce both injury
rates and workers compensation premiums.
For example, a nursing home in
Maine, with 245 residents and 270 workers reported 573 lost workdays in 1991 due
to back injuries, and had an annual workers compensation premium of $1.5
million. The employer then purchased twelve mechanical patient lifts for a total
of $60,000 and implemented a policy banning the lifting of residents unless
there was more than one worker present to assist. In 1996, their lost workdays
dropped to a total of 12 days, with a resultant drop to $770,000 in their annual
workers compensation premium. A recent hospital based study found a reduction of
lost time injuries from 16 to 1 following one year of use of a lifting team
resulting in the savings of $144,000.
OSHA must proceed expeditiously with
the promulgation of an OSHA ergonomics standard. Without such a standard,
healthcare workers will continue to needlessly suffer from crippling back
injuries.Assaults on Workers. BLS statistics indicate that the healthcare sector
also leads all other industry sectors in incidents of non-fatal workplace
assaults. In 1993, 389'0 of all non-fatal assaults against workers that resulted
in lost workdays across all industries occurred in the healthcare sector,
including 27% in nursing homes and 119'0 in hospitals. Among all non-fatal
workplace assaults resulting in lost workdays, nursing aides and orderlies
suffer the highest proportion of assaults, 27% of all attacks, compared to 7 %
for police and guards. Across all industries, in 45 % of reported cases of
nonfatal workplace assault, the perpetrator of the assault is a healthcare
patient.
In 1994, following the murder of a state employee, CalOSHA
published the first set of guidelines describing the components of a
comprehensive workplace violence prevention program. Two years later, federal
OSHA issuing a similar set of guidelines entitled "Guidelines for Preventing
Workplace Violence for Health Care and Social Service Workers". However, since
these guidelines have been issued, OSHA has yet to issue a field directive to
their compliance officers on how to conduct a workplace assault inspection.
Also, since the issuance of the OSHA guidelines, OSHA has not issued a single
citation for even the most egregious situations involving assaults on workers by
patients, residents, and others.
OSHA must no longer delay in issuing a
directive to their inspectors to assist them in responding to workplace assault
incidents, and to be able to evaluate the adequacy workplace violence prevention
programs.
Chemical Hazards. Health care workers are exposed to a wide range
of chemicals known to be harmful to healthcare workers, which OSHA has yet to
regulate. Glutaraldehyde, a cold sterilant has been associated with mucus
membrane irritation, allergic contact dermatitis and reproductive effects.
Anesthetic gases, pose a threat to health care workers when operating room
scavenging systems are poorly maintained. Healthcare workers are also exposed
when patients are transferred to the recovery room and exhale anesthetic gases
into the general workplace atmosphere. Specially designed non-recirculating
general ventilation systems with adequate room air exchanges are necessary in
these departments, but are not required by OSHA. Antineoplastic agents have been
shown to cause reproductive effects and cancer in exposed healthcare workers.
Safe handling guidelines were published in the mid-1980s by the National
Institute of Health and later by OSHA to control dermal and inhalation exposure
associated with the mixing and administration of these drugs. Yet a survey
conducted in the late 1980s found variations in staff compliance with the OSHA
guidelines. Aerosolized medication such as ribavirin, used to treat pediatric
pneumonias and the drug pentamidine, used to treat AIDS patients, pose unique
threats because of how these drugs are administered. Ribavirin is a potential
human teratogen.
OSHA should issue rules to protect workers from a wide
range of unregulated, but highly toxic chemicals which are used in the
healthcare environment.
Tuberculosis. Almost six years ago, when Joe Dear
was the Assistant Secretary of Labor for OSHA, he promised that tuberculosis
would be a "fast-tracked" standard, to respond to the re-emergence of this
disease. Many healthcare workers have become infected with tuberculosis in
recent years.
A number have contracted the multi-drug resistant strains, and
have undergone life-threatening medical procedures to save their lives. Others
have died. Today we understand that a final tuberculosis standard is at least
another year away. Tragically, the length of time and amount of resources that
OSHA has expended to achieve a rule on this relatively non-controversial issue
seriously calls into question whether OSHA can issue a regulation on any hazard
under the current environment.
OSHA needs to release a final tuberculosis
standard as soon as possible.
Latex. The prevalence of latex allergy among
healthcare workers is now estimated to be between 7 and 10%. In 1997, NIOSH
released an "Alert" providing recommendations for preventing allergic reactions
to natural rubber latex in the workplace and recommending the use of powder-less
low protein latex gloves for protection from blood-borne pathogens in health
care and other settings. Some institutions have reduced or eliminated the use of
even powderless latex gloves, instead using gloves made from vinyl, nitrile, and
other nonlatex materials. We understand that OSHA has completed a technical
bulletin on latex, but latex glove manufacturer(s) have mounted an aggressive
lobbying effort to stop OSHA from releasing this important document.OSHA must be
allowed to release this technical document without outside interference from the
latex glove industry.
Indoor Air Pollution Standard. Indoor air pollution is
one of the most ubiquitous hazards facing healthcare workers and workers in many
other industry sectors. The US EPA has concluded that indoor air pollution costs
our economy $50 billion a year in lost worker productivity. However, an OSHA
standard focused on requiring employers to properly design and maintain their
ventilation systems seems to be delayed indefinitely.
OSHA must complete the
rulemaking on an indoor air pollution standard.
Safety and Health
Program Rule. Perhaps the largest obstacle faced when trying to work
cooperatively with employers in the healthcare sector in particular, and the
service sector in general, is their lack of attention to developing the most
rudimentary of health and safety programs. As I mentioned earlier in my
testimony, many employers in service sector industries are not even required to
maintain records of who suffers an on-the-job injury or illness, a necessary
component of any workplace health and safety program designed to identify and
correct workplace hazards. While traditionally recognized hazardous industries
have safety and health programs in place, such an OSHA role will provide much
greater benefits for workers in industries which have been largely ignored by
OSHA. Many argue that this should have been the first standard OSHA ever issued
back in 1971.
OSHA needs to release their proposed safety and health program
rule later this summer.
In closing, I want to mention a member of our union,
Peggy Ferro, a nurse's aide who suffered an on-the-job
needlestick injury in 1990. Safer needle devices existed in the
marketplace back then, but they were not available to Peggy in her workplace.
Peggy contracted HIV as a result of her injury. In 1992, under the alias "Jean
Roe" she testified here at a Congressional hearing behind a special screen to
protect her identity. She urged Congress to direct OSHA and the other
responsible federal agencies to protect healthcare workers from
needlesticks. At that time, many promises were made by OSHA,
FDA, NIOSH, and CDC to do more, much more, to protect healthcare workers from
needlestick injuries. Few promises have been kept, and today,
most healthcare workers continue to be denied these life-saving safer needle
devices. Peggy died from her workplace acquired disease this past November 4th
at the age of 49.
Peggy Ferro did not die because OSHA was too aggressive,
too responsive to her workplace health and safety needs, or the needs of other
workers in the service and healthcare sectors. In fact, Peggy never met anyone
from OSHA except for the representatives who testified at that 1992
Congressional hearing.
In May of 1995, with much fanfare, OSHA released a
report entitled: The New OSHA, Reinventing Worker Health and Safety. The report
stated that "in 1993 six of the ten industries with the largest numbers of
workplace injuries were in the service sector." The report went on to promise
that OSHA would "Develop the design for a coordinated service sector program..,
by December 31, 1995.
This May will mark four years since this report was
issued. No such program has yet been developed to our knowledge.
It is past
time for OSHA to develop a comprehensive program to address the health and
safety needs of workers in the fastest growing sectors of the economy where most
workplace injuries and illnesses occur.
On behalf of Peggy Ferro, I implore
you to direct OSHA to be much more responsive to the needs of workers and
employers in these largely ignored industry sectors, and to fulfill this
unfilled mission as envisioned under the OSHAct of 1970.
Thank you.
END
LOAD-DATE: March 25, 1999
