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PubMed1982

Regulating safety. OSHA's "new look".

The Occupational Safety and Health Administration (OSHA) has had a short but stormy history. Over the past 12 years, OSHA has been criticized by labor unions as being insufficiently effective and by companies for being too costly. OSHA's reliance on enforcement of health and safety regulations, combined with inadequate resources to promulgate regulations and enforce them, has limited its ability to improve workplace conditions. The current OSHA leadership has changed directions, reducing enforcement activity and altering existing health standards to reduce their costs. The implications of this new policy are discussed.

Occupational Diseases↗

PubMed1990

Homo quintadus, computers and ROOMS (repetitive ocular orthopedic motion stress).

Inherent conflict exists between computer systems and ocular physiology of Homo quintadus. Adverse ocular side effects of excessive saccades, excyclotorsion, supraduction, excessive field-of-fixation usage, capitas extension, astigmatic changes, otostatic reflex mismatching, and needless orthopedic malfunctions are imposed upon computer operators. Although the orthopedic dysfunctions are commonly grouped under the heading of Repetitive Strain Injuries (RSI), the inextricable linkage to poor ocular-neurological function argues for postulation of a broader schema entitled Repetitive Ocular Orthopedic Motion Stress (ROOMS). Concepts of good tool usage, total tactile familiarity, total proprioceptive familiarity, and visual cone-of-comfort clash with the installed-equipment base and indicate need for an integrated computer work station to facilitate near covisualization of screen/keyboard and to afford freedom-of-choice for optimal hand/eye synchronicity. The advocacy of computer operators' needs by user-welfare groups, universities, labor unions, and government agencies are portents for achieving genuine improvements.

Biological Evolution↗

PubMed1997

Relationships between health behavior, knowledge, and beliefs among Swedish blue-collar workers.

The main objective of this study was to assess the health behavior, risk awareness and beliefs concerning the importance of positive health practices among blue-collar workers, and to examine the relationships between behavior, knowledge and beliefs. Data were gathered from 1359 workers aged 18-65 years using a postal questionnaire to 2493 randomly selected members of two labor unions. A high prevalence of negative health practices was noted among the respondents. While no relationship was found between health behaviors and awareness of risks associated with such behaviors, there was a relationship between positive health practices and strong beliefs about the importance of those practices. Awareness of the influence of a positive behavior on disease risk was associated with a stronger belief concerning the importance of that behavior. Women were characterized by having more positive health behavior, a higher level of risk awareness and stronger beliefs concerning the importance of positive health practices. It was concluded that while relationships were found between behavior and beliefs, and between beliefs and risk awareness, further research to establish the direction of the relationships is warranted.

Adult↗

PubMed1997

A Multisectoral Approach to Prevention of Lead Poisoning in Hungary: Lessons Learned and Potential for Replicability Elsewhere.

Hungarian and American occupational and environmental health professionals are collaborating in a research and demonstration project designed to prevent lead poisoning in Hungary. Using a multisectoral approach, the project has three phases: data collection and review, risk communication, and facilitation of program and policy development. First, the project team reviewed relevant data of many types through a workshop at which commissioned papers were presented, key-informant interviews, and a survey of knowledge, attitudes, and practices. The team then conducted a multifaceted risk-communication program to disseminate information about lead hazards in general and what had been learned about lead exposures and lead poisoning in Hungary. It presented training workshops for workers exposed to lead at work and for groups serving as "mediators" who could affect others' behavior, such as nongovernmental organizations, labor unions, public health nurses, pediatricians, teachers and students, and coordinators of the Hungarian Healthy Cities Project. It also conducted a campaign of "concentrated action," using a variety of communication approaches directed to car owners, pregnant women, mothers of small children, and others, in order to convey knowledge and change attitudes, emphasizing emotional appeals. Project leaders will organize a multisectoral working group to develop, coordinate, and implement an overall activity plan aiming to reduce lead pollution. The approach developed and used in this project provides a model for preventing lead poisoning that may be transferrable or adaptable for use for preventing lead poisoning and other environmental health problems elsewhere.

Journal Article↗

PubMedDate not supplied

The local impact of globalization: worker health and safety in Mexico's sugar industry.

With the opening of its economy to international trade, the government of Mexico privatized many of its productive holdings, including the state-owned sugar industry. Sugar cane and mill workers had played an important role in the armed struggles of the revolutionary period (1910-1917). Organized into a militant labor union, they had become staunch supporters of the new government in the following decades. Furthermore, in the early years of industrialization, the sugar industry was very important for the Mexican economy, and the union played an active role in the political arena. Since the privatization of the sugar mills, the sugar workers have experienced a dramatic reorganization of the work process, and industry-union relationships are being reshaped. This paper offers an analysis of the impact of the privatization on workers' health and safety. Since the economic and social changes in the work process have a direct impact on the community as a whole, the study also explores these effects.

Food Industry↗

PubMed2005

The changing process and politics of health policy in Korea.

Korea recently introduced three major health care reforms: in financing (1999), pharmaceuticals (2000), and provider payment (2001). In these three reforms, new government policies merged more than 350 health insurance societies into a single payer, separated drug prescribing by physicians from dispensing by pharmacists, and attempted to introduce a new prospective payment system. This essay compares the three reforms in Korea and draws important lessons about the country's changing process and politics of health care policy. The change of government, the president's keen interest in health policy, and democratization in the public policy process toward a more pluralist context opened a policy window for reform. Civic groups played an active role in the policy process by shaping the proposals for reform-a major change from the previous policy process that was dominated by government bureaucrats. The three reforms also showed important differences in the role of interest groups. Strong support by the rural population and labor unions contributed to the financing reform. In the pharmaceutical reform, which was a big threat to physician income, the president and civic groups succeeded in quickly setting the reform agenda; the medical profession was unable to block the adoption of the reform but their strikes influenced the content of the reform during implementation. Physician strikes also helped block the implementation of the payment reform. Future reform efforts in Korea will need to consider the political management of vested interest groups and the design of strategies for both scope and sequencing of policy reforms.

Delivery of Health Care↗

PubMed2006

Nurses respond to healthcare restructuring: the transformation of the Massachusetts Nurses Association.

The most recent period of Massachusetts healthcare system reorganization began in the early 1980s. In part, this has been a response to soaring healthcare costs, countering them with diminished reimbursements. To decrease labor costs and survive in an increasingly competitive and market-driven healthcare environment, hospitals downsized and laid off nursing staff. Patient care and safety has concomitantly suffered. These efforts severely challenged nurses' status. Radicalized rank and file members of the Massachusetts Nurses Association mobilized against the association leadership's weak efforts to protect nurses' social and economic interests and the deteriorating quality of care. They transformed an association whose main focus was supporting nursing's professional image to one which became an activist labor union of professional workers. The history of this often contentious transformation is presented here within the context of these healthcare system changes. The MNA's successes and pending challenges within the Massachusetts healthcare system are also discussed.

Hospital Restructuring↗

PubMed2006

Proportionate mortality among current and former members of the United Farm Workers of America, AFL-CIO, in California 1973-2000.

CONTEXT: To further investigate mortality among farm workers, a proportionate mortality ratio (PMR) analysis was conducted among the membership of the United Farm Workers of America (UFW), a farm worker labor union, for the years 1973-2000 in the state of California. PURPOSE: This report compares proportionate mortality for 118 causes of death in the UFW and the general United States population, adjusting for age, sex, race and calendar year of death. In addition, an exploratory analysis was conducted comparing deaths in the UFW to deaths in the California Hispanic population. METHODS: A roster of members of the UFW was compared to the death certificate master files of the state of California for the years 1973 to 2000. Matches were detected using automated techniques and visual review. PMR and associated confidence intervals were calculated using the National Institute for Occupational Safety and Health Life Table Analysis System using deaths in the U.S. as the standard. A similar analysis was conducted limiting attention to the time period 1988-2000 and using deaths in the California Hispanic population as the standard. FINDINGS: There were a total of 139,662 members of the union included in the linkage that yielded 3,977 deaths in the time period 1973-2000. Proportionate mortality in the farm workers was significantly elevated for respiratory tuberculosis, malignant neoplasms of the stomach, biliary passages, liver and gallbladder, and uterine cervix, diabetes mellitus, cerebrovascular disease, cirrhosis of the liver, and "other diseases of the digestive system." Transportation injuries including motor vehicles deaths, deaths from machine injuries, unintentional poisonings and assault and homicide were significantly elevated as well. Farm workers were at significantly lower risk of death from HIV-related disease, malignant neoplasms of the esophagus, intestine, pancreas, lung, urinary bladder, melanoma, and brain, all cancer deaths, "other diseases of the nervous system," ischemic heart disease, conductive disorder, "other diseases of the heart," emphysema, "other respiratory diseases," and symptoms and ill-defined conditions. These results were similar when using California Hispanic deaths as the standard for the years 1988-2000. There was still excess proportionate mortality from tuberculosis, cerebrovascular disease and unintentional injuries among the UFW members and lowered mortality from HIV related deaths, all cancer deaths combined and diseases of the heart. CONCLUSIONS: These results include some unique findings in regard to both excess and deficits of mortality that may be explained by the Hispanic ethnicity and recent immigration of the cohort.

Accidents↗

PubMedDate not supplied

Working conditions of Chagas' disease patients in a large Brazilian city.

This study evaluated the working conditions of Chagas' disease patients in the city of Campinas, São Paulo, focusing on two-hundred-fifty patients with steady employment and treated at the University Hospital (HC-FCM/Unicamp): 98% were working-age and 77.6% were men. The origin of the patients reflected the migratory process occurring among this population. Most of the patients had limited professional skills, while 63.6% had not finished primary school and 21.6% were illiterate. However, 63.6% were regularly employed under duly processed work contracts. Their jobs were mainly in general services (21.6%) and heavy industry (21.2%). Some 55% of the patients reported a monthly income less than or equal to U$100.00, and 40.4% reported having been fired at least once during the last ten years, in 8.9% of the cases because of a diagnosis of Chagas' disease. Of the patients undergoing pre-hiring physical examinations (57.2%), 9.1% were refused, 92.3% of whom due to positive serology for T. cruzi. Finally, 78.4% reported not belonging to a labor union. The study demonstrated the precarious working conditions and discrimination experienced by workers with Chagas' disease.

Adult↗

PubMed1988

The rising long-term trend in occupational injury rates.

Establishment survey data for the United States as a whole and workers' compensation data for the State of California were used to document long-term trends in occupational injury and acute illness rates. After declining throughout the first half of the century, national rates of disabling injuries in manufacturing, construction, and the trade sector have risen sharply in recent decades. Injury rates in mining show no strong trend either up or down since 1960. Increases over recent years have been especially pronounced for strains and sprains, cuts, lacerations and punctures, bone fractures, and acute illnesses. Injury rates in the manufacturing sector are strongly influenced by general economic conditions--rising sharply with business upsurges and declining during recessions. Increases in the rate of unemployment, which decrease worker and labor union bargaining power, are associated with increases in injury rates within manufacturing.

Accidents, Occupational↗

PubMed1990

Workplace health hazards: analysis of hotline calls over a six-year period.

Between 1981-1986 a state-based occupational health telephone hotline received more than 8,000 inquiries on over 3,000 hazardous agents. Major caller groups were employees (37%), employers (20%), health care providers, primarily physicians (19%), government agencies (12%), and labor unions (6%). Employees were the fastest growing caller group. Callers inquired about general health hazards of chemicals (65%), the relation of symptoms to work (22%), and risks to pregnancy (13%).

California↗

PubMed2004

Tobacco industry targeting of blue-collar workers.

Blue-collar workers, an important segment of the American workforce, smoke at a significantly higher rate than white-collar workers. While much has been written about tobacco industry targeting of other groups, little has been written about the industry's deliberate plan to addict blue-collar workers. For decades, the tobacco industry has targeted blue-collar workers. This article chronicles the industry's concerted drive and reveals some of its strategies to recruit, maintain, and expand its consumer base. It describes one labor organization's efforts to counter the industry's influence on blue-collar workers. This research justifies the continuation of aggressive anti-tobacco efforts by health workers and labor unions involved in tobacco education programs targeting blue-collar workers.

Journal Article↗

PubMed1999

Feeling the heat: displaced tobacco workers in North Carolina.

Tobacco control is a successful public health movement, but little attention is being paid to what this success means for workers and communities who are economically dependent on tobacco. The social context of job loss for these workers remains largely unstudied. We conducted a case study of a cigarette manufacturing facility closure in Reidsville, North Carolina and report on the effects of the closure for workers and the community. Results suggest the need for: 1) worker education directed toward developing skills for jobs that pay family-supporting wages, and 2) community-driven strategies to attract new businesses that offer such jobs. Public health organizations, labor unions, community development groups, business representatives, civic leaders, academic institutions, and others should unite in efforts to assist tobacco-dependent workers and communities to transition to other economic bases. These efforts should be funded by the tobacco industry.

Journal Article↗

PubMed1995

The role of organized labor in combating the hepatitis B and AIDS epidemics: the fight for an OSHA bloodborne pathogens standard.

The United States is experiencing a hepatitis B epidemic that has until recently received relatively little public attention. Many groups of workers are at risk of infection, death, or chronic carriership because of workplace exposure to blood; those at risk include not only health care professionals but police, fire fighters, life guards, hospital-based laundry and cafeteria workers, park rangers, sanitation workers, etc. One of the most important victories against the hepatitis B pandemic in the United States occurred when the Occupational Safety and Health Administration issued a Bloodborne Pathogens Standard that required employers to protect 5 1/2 million workers from infection by offering those at risk free hepatitis B vaccination, and forced employers to bear the costs of providing equipment (e.g., gloves, gowns, masks, puncture-proof containers) to maintain "universal precautions" for employees handling bodily fluids. While most people assume the new standard was primarily aimed at fighting the AIDS epidemic, it was actually based on the more significant risk posed by hepatitis B infection. The standard resulted not from leadership provided by the experts in the Public Health Service mandated to control infectious disease, but rather from pressure applied by labor unions--providing a clear example of the continued importance of unions for worker protection in our supposedly post-union era.

Acquired Immunodeficiency Syndrome↗

PubMed2005

A review of data on the U.S. health sector: fall 2004.

This report presents information on the state of the U.S. health sector in late 2004. It includes data on the uninsured and underinsured and their access to health care, underinsurance for long-term care and mental health, and the rising costs of health insurance and health care. The author presents data on the increasing social inequalities in health and access to health care; the role of corporate money in health and health care; and the hospital and pharmaceutical industries. The article also includes updates on the consequences of the Medicare prescription drug bill and the state of Medicare spending, and seniors' spending, on drugs; the results of some recent public opinion polls on health care; information on labor, labor unions, and health insurance; and some international comparisons of health insurance. The article concludes with some useful sources of information on single-payer, universal health care.

Drug Industry↗

PubMed2002

A global strategy for labor.

The rules of the global market were established to protect the interests of investors at the expense of workers and they shift benefits to investors, costs to workers. Globalization is measured by the interests of investors. But 20 years of investor protectionism show that growth has slowed and equality has gotten worse. The purpose of neo-liberal policies has been to discipline labor to free capital from having to bargain with workers over gains from rising productivity. But such bargaining is the essence of a democratic market. Uncontrolled globalization puts government's domestic policies on the side of capital. In an economy whose growth depends on foreign markets, rising domestic wages make it harder to compete internationally. There has been a general deterioration of labor's position relative to capital's. A global marketplace implies a global politics, and the real work happens when representatives of multi-national business privately negotiate the rules. Labor must change the framework in which the investor class pursues its interest across borders, while workers are constricted by borders. Labor unions are critical; they can deny the human resource necessary for profits. The strike is the ultimate threat to investors. One solution: a "grand bargain" linking development with broadly increased living standards connected to planning for sustainable development to create a global social contract. Workers have advantages: they are the majority and they are indispensable.

Journal Article↗

PubMed1986

Attitude and personality correlates of hallucinogenic drug use.

Personality, attitude, and hallucinogenic drug use data were obtained from 298 male and female adult members of labor unions. Multiple regression and canonical correlation analyses of drug use, personality, and attitude data revealed that: the use of hallucinogens was significantly related to needs for novel or unconventional experiences and negative attitudes toward conventionally defined social values, and marijuana use scores were more strongly associated with the set of predictor variables than were other drugs reported.

Adolescent↗

PubMed2003

The balancing act. Collaboration between frontline forensic staff and hospital administration.

1. Flexibility, creativity, and consistency are critical characteristics for both frontline staff and administrators in the delivery of treatment and care for complex forensic patients who may be difficult to manage. 2. Through collaborative efforts and ongoing communication, plans can be identified and implemented that enhance patient and staff safety and facilitate positive behavioral and rehabilitation outcomes for patients. 3. Effective partnerships among frontline staff, administration, patients, their families, labor unions, and communities contribute significantly to the effective resolution of conflicts and dilemmas in the provision of holistic care to forensic patients.

Adult↗