American Public Health Association
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Occupational Health and Safety
Section Newsletter
Summer 2005


Michael Silverstein, MD
Clinical Professor
University of Washington School of Public Health and Community Medicine
Department of Environmental and Occupational Health Sciences
Campus Box 357234
Seattle, WA 98195-7234
Ph: (206) 897-1652 Fax: (206) 616-0477

As I am writing this column my desk is full of public health news demonstrating the challenge we face in trying to protect worker health. Asbestos bailout legislation is moving ahead in the U.S. Senate (more on that below), MSHA has announced an indefinite delay in rulemaking on crystalline silica, OSHA has almost abandoned rulemaking altogether, British Petroleum is blaming and firing workers for the Texas City refinery explosion that killed 15 people, and the AFL-CIO is dismantling its occupational safety and health department. And probably worst of all, abuse of science for low political purposes is running rampant at the highest levels of our federal government. Most recently it became front-page news that Phillip Cooney, a former lobbyist for the American Petroleum Institute who was working at the White House Council on Environmental Quality, rewrote key parts of a scientific report on climate change despite the fact that he had no scientific background and obvious partisan bias. While Cooney resigned in the wake of this story, the Bush administration continues to defend his political interference as proper. Thank goodness there are organizations like the Union of Concerned Scientists tracking these abuses and keeping them in the public eye.

It is during times just like these that our Section takes on special importance as a place to share concerns and information with colleagues and to plan ways to advance a positive agenda of worker protection. I am happy to report great progress on OHS plans for the APHA Annual Meeting in New Orleans from Nov. 5 to Nov. 9. The Section’s scientific program is coming together nicely under the leadership of Program Chair Janie Gittleman. Twenty-nine safety and health sessions are listed in the preliminary program, including Moving OSH from Theory to Practice, Quantitative Methods in OSH, Occupational Respiratory Disease Surveillance, Public Health Impact of International Trade Treaties and a special session on the 35th Anniversary of the OSHAct. In addition, there will once again be multiple opportunities to interact more informally, including our awards luncheon, social hour, and dance party. And the bonus this year is New Orleans itself! Not only is the city a great place to enjoy food and music, but it is full of occupational and environmental health history. A history tour is being planned for Saturday with details to be forthcoming – make sure you are on the section listserve and watch for announcements. I urge all members of the OSH Section to attend the meeting this year.

Here are a couple of quick updates on OHS section activity:

• Following some excellent work by Mary Miller and Jonathan Bennett, APHA Executive Director Georges Benjamin sent a letter to the U.S. Senate Judiciary Committee expressing concerns about the asbestos bailout legislation that is moving through the Senate. The bill is now out of committee and moving for a full Senate vote. We expect APHA to send another letter before the vote. Highlights of the letter follow:
o “The Fairness in Asbestos Injury Resolution Act (S.852) will, if enacted, adversely affect those who have been exposed to asbestos and are at risk of dying or becoming sick as a result. Fundamentally, the APHA believes that everyone who has been injured by asbestos exposure should be compensated for the cost of their medical care, for their loss of income, and for all other losses…Anything less than this creates an environment of inequality…
o “The bill creates a new medical standard to define asbestos-related disease, instead of relying on the professional diagnoses of physicians…the bill’s criteria seem to be suited toward administrative expediency, instead of science-based criteria such as those issued by the American Thoracic Society. Our concern is that many legitimate victims of asbestos related disease will be ineligible for compensation based on these criteria…
o “Even for those workers who successfully file a valid claim, the new rules do not provide a fair, full and expedited compensation to victims. Interestingly, the size of the trust fund is determined by the companies who will contribute to it, not by an actuarially valid projection of the cost of compensation…
o “The APHA believes there is an asbestos disease crisis in this country that needs to be treated, not an asbestos litigation crisis. ‘Solving’ the asbestos litigation crisis will do nothing to resolve the disease crisis, and may actually make it harder for victims of asbestos-related disease to recover…”

• A new resolution developed by Sherry Baron, Deborah Weinstock and Mary Miller of our Section on addressing the dangers faced by immigrant workers is moving through the process and hopefully will become official APHA policy. The resolution states the facts regarding the exceptionally high risks faced by increasing numbers of immigrant workers, documented and undocumented, and the barriers they face in obtaining decent medical care or workers’ compensation. For example, “Foreign-born workers, especially foreign-born Hispanics, have a higher occupational fatality rate compared to other workers. Between 1997 and 2001, the occupational fatality rate for all foreign-born workers was 20 percent higher than the rate for all workers, and the rate for foreign-born workers from Latin America was 40 percent highly than for all workers. The cause of this disparity is, in large part, due to the disproportionate distribution of foreign-born workers in high-risk industries, such as construction, agriculture and manufacturing. However, a recent analysis found that Hispanic construction workers (65 percent of whom are foreign born) had an 80 percent greater fatality rate compared to non-Hispanic construction workers.”

It then goes on to recommend several actions, including the following:

o Expand the policy of Region V of the Department of Labor nationally, to create initiatives in each region that permit OSHA and the Employment Standards Administration, two divisions of the U.S. Department of Labor, to collaborate with community, faith-based, and worker organizations that are trusted by immigrant communities to establish outreach centers to train workers about their rights and to identify and forward complaints without fear of identification or retaliation.

o Strengthen whistleblower and anti-retaliation provisions to protect workers who exercise job safety rights and raise job safety concerns.

o OSHA and NIOSH should enhance outreach, training and education programs for immigrant and Hispanic workers and employers to inform them of job safety rights and responsibilities, job hazards and protections. This would include a requirement from OSHA that compliance with existing hazardous training standards be interpreted to mean that employers are required to provide such training in meaningful interactive formats that include training in a language the individual understands and that follow-up measures for training effectiveness be developed and implemented. In addition, the OSHA notice of violations that is posted in the workplace should be in the language(s) spoken by the employees, as well as in English.

o Target enforcement activities among industries, employers and operations where immigrant workers are at high risk of injury or illness and strengthened OSHA criminal and civil penalties; additionally, develop a National Emphasis Program that targets record-keeping and training requirements as applied to temporary agencies and to worksites hiring day laborers.

o Urge that NIOSH expand intramural and extramural research programs to address the safety and health problems of immigrant and Hispanic workers.

o Urge the Department of Labor to continue the National Agricultural Workers Survey (NAWS) so that the public and policy makers are assured accurate information regarding migrant and seasonal farm workers.

o Encourage labor unions and other worker organizations to continue to prioritize training and outreach activities related to protecting the safety and health of immigrant workers.

• The APHA Student Assembly has developed a new scholarship program to assist public health students in attending the APHA Annual Meeting. The OHS section has contributed $300 to the fund this year, enough for one student. This is in addition to the scholarship assistance we will be providing once again for several students and union members.

• Come see the OHS Section booth this year in New Orleans. With the initiative and creativity of Kerry Souza, Janie Gittleman and others, we will be unveiling a banner identifying our Section and bringing attention to the need for worker protection. We will be able to use this banner for years to come, not only at the booth but to identify Section members and others interested in workplace safety and health at other political and scientific events.


Saturday, Nov. 5, 2005

Kick off your experiences in New Orleans with the "Cancer Alley-River Road Reality Tour." This all-day event will take participants through communities along the New Orleans-Baton Rouge corridor to meet neighborhood and labor activists who have struggled for justice against chemical industry giants including Shell Oil and Dow Chemical. The tour is being organized by the OHS & Environment Sections, in collaboration with the Sierra Club. Stay tuned for further details, including the full program agenda, instructions for registering and the fee. For further info contact Celeste Monforton at <>.


Janie Gittleman, PhD, MRP
Associate Director, Safety and Health Research
Center to Protect Workers' Rights
Suite 1000
8484 Georgia Avenue
Silver Spring, MD 20910
Ph: 301-578-8500 xt. 107
Cell: (202) 302-1340
Fax: (301) 578-8572

As the 2005 Program Planning Chair for the Occupational Health Section, I would like to thank the reviewers of this year’s program: Elyce Biddle, John Sestito, Gregory Wagner (all from NIOSH), Hester Lipscomb (Duke University), Katherine Newman (BLS), Gordon Smith (Liberty Mutual), Melissa Perry (Harvard University), and Rosemary Sokas (University of Illinois). Their thoughtful reviews contributed to the selection of abstracts covering a wide range of important topics in the field. Many thanks for your time and effort in helping to develop an excellent scientific program. Also, thanks to Celeste Monforton (George Washington University), and Mary Miller (Washington State Labor and Industries) for passing on their planning wisdom.

OHS Member Receives Award

An illustrious former Chair of the OHS Section, Rosie Sokas, has received the 2005 NIOSH James P. Keough Award! Congratulations, Rosie. Thanks for all your contributions to help protect workers.

Rosemary Sokas Accepts the Keogh Award

The 2005 James P. Keogh Award for Outstanding Service in Occupational Safety and Health was presented April 28 to Rosemary Sokas, Director of the Division of Environmental and Occupational Health Sciences at the University of Illinois at Chicago School of Public Health. Before joining the University of Illinois, Sokas was Lead Medical Officer and then Associate Director for Science at NIOSH. Sokas has made exceptional contributions in occupational safety and health through her work at the University of Pennsylvania, the Philadelphia VA Medical Center, the George Washington University, Occupational Safety and Health Administration, NIOSH, and the University of Illinois. We are delighted to honor Sokas with this award in memory of Dr. James Keogh. For more information on Sokas and her accomplishments visit <>. More information on the James P. Keogh Award can be found at <>.

OHS Section Commentary

Maggie Robbins

Thoughts on the Loss of the AFL-CIO Health & Safety Department

Our efforts to improve working conditions related to OHS have just become more difficult. With the loss of the small, but dedicated, skilled, and effective H&S Department of the AFL-CIO, we have lost the single clear voice advocating for workers’ health and safety in the United States. (Our colleague Jordan Barab had written well about this at

This loss reinforces the need for the rest of us to create and expand our linkages to each other, and to the broader social justice and human rights causes in the United States and globally. Our country, to survive, needs to create and maintain good jobs. This includes safe jobs, but also jobs with decent pay, decent working conditions, and where workers have the right, and the ability, to speak for their interests on the job without fear of being harassed, fired, or worse. (The ILO has articulated this concept nicely; see <>.) This isn’t just about work for some abstract people somewhere in the United States, it is about each of us at our work, our families at their work, our neighbors, and the people who help us get to work each day, who educate our children, and who help us have food on the table at night.

We must struggle as health and safety professionals, academics, researchers, and workers, to maintain our working conditions, our rights, and our freedoms, as we continue working for the rights of others. We need to keep speaking up about the need for improving OHS research, training, regulations, and enforcement. We need to keep asking the right research questions on causes and solutions for dangerous workplaces. We need to keep reporting the harm we find, even if our employers or funders don’t want to hear it. We need to keep defending our colleagues attacked for their pursuit of safer workplaces. We need to keep talking to the press, to our peers, to the government, to employers, and to workers about the dire need for safer workplaces, for better treatment and compensation for injured workers, for more workers’ control over conditions in the workplace, and for expanding workers’ rights. We can’t shrink from what we know is a hard row to hoe just because the ground is getting still harder.

The debate going on within and about the union movement in the United States right now is important. How can the union movement reverse its numerical and density declines? How can working people, unionized or not, gain or regain influence over the policies and laws of our government and the actions of our employers? How can we create more and better jobs for people without jobs? How can we reverse the power of multinational corporations to direct state, national, and international economic policies in their favor?
(Jordan also collected some of the opining on this debate at

The rises and falls of the U.S. labor movement have been analyzed in great detail by others with more historical perspective than I have. My short-term view of the labor movement since I began paying attention to it about 20 years or so ago tells me this. The crisis in the labor movement has been growing for decades, since before I was born. And this decline is both a cause of and a result of the lack of a movement in the United States that articulates and advocates for the human rights and dignity of ordinary people. Most U.S. workers do not have a clear and broad analysis of why their work and economic life has become more insecure, nor how to change this. It seems like a zero-sum game in which if you win, I lose. If workers in Alabama win a factory, workers in the Chicago lose one. If workers in California demand higher wages and health insurance, workers in India will take their jobs away. If we push for safer, cleaner factories here, we will lose them to some place else that will accept the dirt and danger. The labor movement overall is providing neither analysis nor solutions to these framings of the issue. The solution of voting for the latest union-neutral, free-trade-loving Democrat does not ring true. Or at least not true enough to inspire a movement.

Active worker involvement, judgment, and action are essential to achieve and maintain safe working conditions. Creating and supporting active, confident, self-directed rank-and-file leaders is not familiar to the staff and leaders in many of our unions, and therefore is not a priority. The unions’ week-to-week priorities are focused on the next bargaining session, the next grievance meeting, or the next political fight, not on the long-term work of developing and supporting rank-and-file leaders and self-directed activism. Some unions are really good at “mobilizing” their members to the fights the staff and officers decided upon. These may be important fights, and may even be related to health and safety, but these methods do not organize workers to become activists in their own right. To create a groundswell of support for safer workplaces, we need knowledge and activism at the worksite level across the country. All the expert testimony and well-documented reports in the world do not win us better OHS laws and enforcement unless there is a worker movement to get them through Congress and the President. This is equally true for defending other workers’ rights. The lack of this kind of union movement, on top of the lack of compelling analysis to guide the political demands of workers, was painfully visible as we watched the re-election of the current anti-union, anti-health, pro-corporate administration.

At the end of the day, whether some affiliates leave the AFL-CIO in July or not, it can’t help but underline the crisis we find ourselves in as working people. Whatever comes of it, our job this year and next will not be too different. As one of our own, Linda Rae Murray, has reminded us in the past, “We need to be clear who the enemy is.” It is not John Sweeney of the AFL-CIO or Andy Stern of SEIU, or any of the other union leaders at the top or in the trenches. It is greed in the form of unbridled capital accumulation. It is greed in the form of denying the human rights and dignity of workers in the United States and globally. It is greed that cynically pits one group of workers against another while raking in record profits for the political and corporate elite. This is the enemy. The rest of us are Lilliputians trying to tether this mighty giant. We’ve done it before, and we can do it again.

“Trade and Public Health Working Group” in APHA Formed by Section Members

Report on APH Working Group on Trade and Public Health
Ellen R. Shaffer, PhD, MPH

At the Annual Meeting in Washington, D.C., last November, APHA Executive Director Georges Benjamin convened a meeting of several sections (Medical Care, Occupational Health and Safety, and International Health) to consider how APHA can address the public health issues arising in the numerous international trade and investment agreements, including those currently in negotiation. Dr. Benjamin asked the three sections present to take the lead in pulling together an informal working group on this issue. I am representing the Medical Care Section in the Working Group. Other participants include Garrett Brown (who is acting as chair) and Tom Connor from Occupational Health and Safety, Donald Zeigler from Alcohol, Tobacco and Other Drugs, Doug Farquhar from Environmental Health, William Wiist (PHEHP), Janet Gottschalk (Public Health Nursing); International Health reps include Mary Anne Mercer, Sarah Shannon, Beth Rivin and Marty Makinen. Affiliate representatives include Kristen Smith (Southern California Public Health Association – also a Medical Care member), Larry Platt (California Public Health Association-North), Health Will (Florida), Karen Valenzuela (Washington State), and Karla Armenti (New Hampshire).

APHA has a policy resolution of trade issues from 2001 (Policy Resolution 2001-21), submitted by the Medical Care Section, and immediate past president Virginia Caine has been outspoken in her concern about the adverse health effects of NAFTA and its successors. The January 2005 issue of the American Journal of Public Health has an article on the impact of trade agreements on global health, which I co-authored. It is also available on the Web site for the Center for Policy Analysis on Trade and Health at <>. Occupational health-specific impacts of trade agreements have been analyzed by OHS Section members Linda Delp (>) and Garrett Brown (<>).

Since the Annual Meeting there have been several monthly conference calls of the Working Group, and trade and health issues were discussed at the January meeting of the APHA Executive Board. Additional sections and state affiliates are being contacted to join the effort. Written minutes from each call are distributed to WG members, who are asked to send them on to their constituent groups, to leaders of the ISC, COA, Executive Board, and to the Executive Director.

The goals of the Working Group are to educate the APHA membership on the issue, to reach out to and involve more sections, affiliates and individual members, and to have APHA weigh in during the Congressional debates concerning the pending Central America Free Trade Agreement and the many other pacts now in negotiation. Longer-term goals include reaching out to other public health-related organizations for joint legislative and public education efforts.

Kristen Smith and Doug Farquhar (who works for the National Council of State Legislatures) reported on state legislation that has passed in Maryland and is under consideration in several states including California. Here is the issue: Trade agreements can require states to open up their procurement processes to foreign companies, but the states must consent to be included. States often prefer to restrict some contracts and other purchases to local companies or companies that meet certain standards, and they could lose this right if the state is included in the trade pacts. Now, governors typically make the decision about including their states, without consulting with legislators or the public. The Maryland bill requires the governor to consult with the legislature, making the process more democratic and accountable to the public. APHA affiliates in other states may want to work with their representatives on similar proposals.

At the Working Group’s request, at the 2005 APHA Annual Meeting in New Orleans one of the four large “special sessions” on Tuesday morning will address the theme of “Public Health Impacts of Trade Agreements.” The WG investigated how decisions are made about the special sessions, and learned that the Committee at Large plays a role; these people are section program planners, and people appointed by the APHA President; the APHA Executive Director Georges Benjamin, and his chief of staff, Allen Baker; and APHA President Walter Tsou. The WG contacted all of these groups and individuals, proposing the idea for the session and possible speakers.

There will also be a session jointly sponsored by Medical Care, OHS, ATOD, and Environmental Health on the various aspects of the issue, on Tuesday, Nov. 8, at 4 p.m. (Marty Makinen of the International Health Section retracted the IH Section’s offer to co-sponsor); and an organizational/business meeting of the Working Group open to all interested APHA members, on Sunday at 2 p.m.

Any and all interested OHS members are invited to join this effort by contacting Garrett Brown at <> or Ellen Shaffer at <>. Among the tasks that need volunteers from our Section are:

1) Contacting other APHA sections and state affiliates to involve more APHA members in the issue;

2) Mobilizing Medical Care Section members to contact Congress about CAFTA and other trade related issues; and

3) Outreach to other state, national and international health and medical groups.

This issue will be increasingly important during 2005. Please do not hesitate to contact Garrett or me to get involved!


Lessons of a Doctorate
By Sarah-Truclinh Tran
Oregon Health and Science University
MPH Epidemiology/Biostatistics 2006

In early June, I was fortunate to have been selected from a national applicant pool to attend a training called the Minority Training Program in Cancer Control Research (MTPCCR) at the University of California at San Francisco. The program was created in 1998 by a cancer control researcher who was concerned about the increase in the incidence rate of cancers among minority populations. At the same time, she noticed a shortage of scientists from these affected ethnic communities who could lead research to reverse this trend. Thus, the MTPCCCR was founded to encourage minority masters-level students to pursue doctoral training and to choose a career in public health research.

During the training, we enjoyed guest speakers from UCSF, UCLA, NIH, and the Northern California Cancer Center who discussed such public health issues as the disparities in disease distribution, the challenges of research in multi-ethnic communities, and the current intervention models. In one event, the staff performed a comical skit to illustrate the long and arduous process of selecting the “right” questions for a cross-cultural survey. The underlying message was that, like the survey, a “one size fits all” approach is not an effective way to improve the health outcomes across different cultures. In the course of 5 days, I was exposed to various research opportunities in health research and was given the foundational knowledge and resources to apply to a doctoral program. Even more valuable to me was meeting the 21 other individuals, each from rich and diverse backgrounds, who gave me the moral support and confidence to seriously consider a doctorate degree. The farewell ceremony was emotional, with all of us pledging to continue to support one another well into the future. I decided that even if I choose not to pursue a doctorate degree, I can still help improve the health outcomes in vulnerable populations through public health research.

The three most important lessons that I learned from the MTPCCR that I would recommend to anyone interested in pursuing a doctorate degree are:

1) Do not pay for a PhD - there are many institutions that will waive tuition and offer you a stipend just for attending their school. In addition, plenty of fellowships and grant supports are available to help you pay your way. Take advantage of free money!

2) Networking - Increase your chance of getting into the school of your choice by getting in touch with faculty members that you are interested in working with once there. Not only will this show the selection committee that you’ve done your homework, it gives you a better idea of whether the program is a good fit for you.

3) Support - this is the most important element of the application process. Support does not come only from family and friends, but colleagues, mentors and professors can provide the encouragement and resources to help guide your way.

In the end, it is important to remember that you should choose a doctoral program that fits you, not the other way around.


At the APHA Environment Section Mid-Year meeting on Wednesday, April 5 in Washington, D.C., at APHA Headquarters, we officially adopted our revised Section Bylaws, and also accepted our Strategic Plan for the next two years. Our Policy Committee provided a list of suggested priorities for the next two years, which will also prove to be very helpful to the Section’s future direction.

(Note: For more information on these documents, please contact Chair Nsedu Obot Witherspoon, <>, or Secretary Derek Shendell, <>, and/or visit our Section Web site at: <>.)


Workplace Health and Safety: Global Problems, Global Approaches

Steven Hecker, University of Oregon

A national work security index developed by the International Labour Organization reveals that two-thirds of countries provide unsatisfactory levels of worker protection. The limited labor and environmental provisions in existing trade agreements like NAFTA show little evidence of being effective tools for preserving or enhancing either labor rights or health and safety protections. Trade agreements currently being negotiated or debated in Congress lack even these minimal mechanisms and threaten to further weaken the ability of national or state governments to regulate workplace and public health. This lack of enforceable international standards for occupational safety and health combined with the increasing mobility of capital place tremendous market pressures on working conditions in both developing and developed countries. But even against this daunting backdrop delegates came away from the Workplace Health and Safety in the Global Economy conference in April at the University of Oregon inspired by many stories from the frontlines of global production. Speakers from unions, NGOs, universities, and corporations spanning five continents shared their approaches to improving working conditions in developing and developed countries.

A theme that ran from beginning to end was the inseparability of workplace safety and health from other key elements of security at work, including the basic rights of freedom of association, voice at work, and some measure of economic security. Monina Wong of the Hong Kong Christian Industrial Committee reminded the delegates that while technical help on OHS hazards from individuals and organizations in the industrial countries is useful, it is not enough. Political assistance and support for organizing is essential if progress is to be made on working conditions in China and elsewhere. Garrett Brown of the Maquiladora Health and Safety Support Network reinforced Wong’s view, adding that the Network’s last 10-12 years of support activities in Mexico, Central America, and Asia have taught that work at multiple levels is essential - technical support, yes, but also a rights-based approach to safety and health.

Conference sessions highlighted both differences and similarities in workplaces and issues facing workers in the developing and developed countries. Cathy Walker, OHS director of the Canadian Auto Workers Union, visited several Chinese joint venture auto factories in 2004. She noted that in a GM Shanghai plant the physical operation and safety and health protections were almost indistinguishable from a CAW-represented plant in Ontario. In other cases physical conditions were similar, but the pace of work was much faster than would be found in Canada. These, of course, don’t represent typical conditions in Chinese industry, but they demonstrate the pace at which global industrialization is proceeding and the range of conditions that can be found in the developing nations.

Meanwhile Karen Hui described the dual initiatives of the Guangzhou Occupational Health & Occupational Rehabilitation Center to 1) provide OHS training to improve prevention in the factories of South China’s export zones and 2) deliver social and rehabilitation services to injured workers in these same regions. Many of these workers are migrants from the rural interior to coastal areas with little industrial experience and no support network once they are disabled. While these are projects developed and implemented by her NGO and others, Hui is hopeful that by demonstrating the need and success on a small scale these can become models for government supported programs serving much larger populations.

Richard Hirsh, an industrial hygienist with Rohm and Haas, outlined the global safety and health programs his company has in place and the tools used to implement and monitor standards in far-flung operations. His description sparked questions of how uniform are standards, programs, and conditions on the ground in corporate-owned facilities in countries with different levels of development, regulatory regimes, and resources. Furthermore, what happens when you go beyond the multinational-owned plants with a well-resourced owner to locally operated facilities, and what are mechanisms for getting OHS resources to these more marginal locations?

Following a session on cross-border training and technical assistance programs, Garrett Brown demonstrated that this was more than just talk by presenting industrial hygiene sampling kits to each of the grassroots organizations represented at the conference. The conference itself illustrated the multi-directional and multi-level exchange that can and must take place if we are to make progress on these issues. Julia Quinonez of the Comite Fronterizo de Obreras in Mexico commented on how valuable it was to meet colleagues from Bangladesh, the Philippines, and elsewhere who are engaged in similar work. As an early participant in cross-border projects sparked by NAFTA, she felt inspired to renew relationships with some of their collaborators from that work. She also remarked on the work of the Hesperian Foundation in drawing from the experiences of workers and their organizations in a number of developing countries in preparing and publishing training materials for use in export processing zones.

The conference planners had set as one major goal to insure that the information, strategies, and contacts exchanged at the event form a basis for continuing activity. The closing session on strategies and future activities elicited a number of ideas and themes. Much discussion centered on networking and particularly on the nature of networking in the age of the Internet when so much information is available. The discussion recognized a number of excellent information resources, particularly Hazards and the ICFTU, and that regional and topical networks already exist. We don’t need to reinvent resources, but there is value in linking existing networks to make them as accessible as possible to people needing assistance on particular topics. Networking and resource sharing efforts still must confront and overcome language barriers as well.

Numerous speakers also addressed the issue of terms of exchange between organizations in developing and developed countries. While the disparity in technical resources is obvious and undeniable, Nick Henwood of the Industrial Health Research Group of South Africa reminded us that the conference itself showed that the global south has great resources of its own, among them courageous and inspirational stories of organizing, educating, and making change. Some good examples of north-south collaboration already exist, including the work of a number of international labor federations. Linking academic expertise with grassroots organizations that need it is another priority. Participatory action research is a method that can help bridge these worlds, but it is far from universally accepted in academia. Those of us in academic institutions need to challenge our programs to channel expertise and resources to workers, unions, and community-based organizations, whether they are organizations of immigrant workers in the U.S. or grassroots organizations in developing countries.

There has been progress. Just weeks before the conference, Nike for the first time disclosed the location of all its contract suppliers. Deanna Robinson of Gap, Inc., addressed the conference and described the evolution of Gap’s social responsibility program, which has taken similar measures and has collaborated with NGOs and unions in OHS training. Transparency is one step toward improving working conditions, but much more is needed. And none of these steps has come without aggressive organizing, campaigning, and monitoring in the producing and consuming nations.

The work of the conference will continue into the future. Currently most of the conference presentations are posted on <>, and additional material and links will be added in the future. Comments and suggestions from those who are interested in the issues are welcome to <>.

Are Separate Standards for Occupational and Environmental Exposures Good Public Health Policy?

Jean Rabovsky, PhD
(This article is a summary of a paper that will appear in New Solutions, A Journal of Occupational and Environmental Health)

Public health discussions generally consider workers and community members as two distinct exposure groups. One explanation may lie in the concept of a workplace that is physically isolated from the surrounding community. Regardless of the specific reason, heath assessments are applied to workers and community members in different ways. For the purpose of improved public health policy, a discussion among public health advocates is needed to determine if this distinction is appropriate. Even with physically bounded workplaces, e.g., factories and underground mines, exposures to toxic agents are not confined to interior spaces. Manufacturing plants produce emissions that are released to the outside of the facilities. Mining operations result in tailings that are stored above ground and toxic dusts can be carried to the household after the work shift.

Physically unbounded workplaces add to the problem. Pesticide drift from fields to residential areas occurs during the application of agricultural chemicals. In addition, exposure to farm workers living in adjacent communities may continue after cessation of the workday. This person, who is defined as a worker during the shift, is then defined as a community member after the shift. In the meantime the extended exposure may result in incomplete clearance of the toxin and cause the worker to start the next shift with a toxic load.

Simultaneous exposures occur in non-agricultural outdoor environments. In Brownfield clean-up and road building and repair activities, an important issue is the placement of the "fence line" in order to determine the point beyond which a health assessment is not needed for the exposed worker. Yet beyond the "fence line" are people who live nearby or who travel in close proximity to the sites. Concerns have been expressed about the adverse health effects experienced by soldiers, exposed to toxic agents during the Vietnam and Iraq wars, but the civilian populations in those countries continue to be exposed to the same agents after cessation of hostilities.
The overlapping exposures experienced by workers and community members have implications for the use of protective standards. Occupational standards tend to be higher than environmental standards, based in part on the assumption that exposure duration and frequencies are less for the worker than for the community member. The occupational standard, based on an eight-hour work-day, may underestimate the exposure frequency of farm workers who remain in the fields for long hours during planting/harvest season or industrial workers who work long hours during heavy production times. The extended work day may also delay the clearance of chemicals from the body prior to the next work shift. The situation will be exacerbated if the worker lives in the same community and exposure to the same toxic agent continues.

The use of distinct occupational and environmental standards also requires a definition of work. Work is generally considered an activity that takes place away from the home, and this definition requires some thought. Scenarios exist where work takes place within the home environment. One example is work in the visual arts, where toxic agents are a part of the materials. The identification of domestic work also needs discussion. In some cultures, domestic activity, carried out in close contact with the ambient environment, has been considered by some authors as an occupation, and occupational standards have been applied to evaluate the potential for adverse health effects. Within more industrialized cultures, people who are hired to perform domestic or maintenance activities in someone else's home are considered workers. This definition, however, is not applied to the person who carries out the same activity within her/his own domicile. Under the conditions of this scenario, different standards will be applied to different people, who are exposed under the same conditions in the same place.

The stated purpose of this article is to initiate a discussion on the ramifications of a strict separation between occupational and environmental exposures and standards. The issues are not easy to resolve. However, by focusing on some specific points or questions, a beginning can be made towards a more equitable public health policy for all populations. For example, is it appropriate to permit higher exposures to workers than to community members? What are the assumptions that are used for the analyses of occupational exposures and development of occupational standards? When public health advocates, representing different constituencies, come together to address these issues, progress can be made towards enhanced public health policies for all exposure populations.

BOOK REVIEWS – “Triangle: The Fire That Changed America”

David Von Drehle (2003). Triangle: The Fire that Changed America. New York: Grove Press. $14.00 paperback. ISBN 0-8021-4151-X.

Katherine H. Kirkland, MPH
Association of Occupational and Environmental Clinics
1010 Vermont Ave., NW #513
Washington, DC 20005
(202) 347-4976
(888) 347-AOEC (2632)

If there is anyone in the Occupational Health Section who doesn’t know the basics of the 1911 Triangle Fire they absolutely need to read this book. However, even those of us who think we know the story can benefit greatly by reading David von Drehle’s account. Von Drehle gives the tragedy faces, a prelude and follows the aftermath. Perhaps as important to all of us with more work and more articles to read than we have time for, this is not just a book we should read, this is a book that is very well written.

The book starts with a short prologue for those who have no idea what the Triangle Fire was but then moves to set the stage for the tragedy that follows. Von Drehle provides the context explaining the political atmosphere at the time, how the trade unions had been working to organize the Triangle Factory, and where the workers came from and how they ended up in New York City. Von Drehle tells of the intermingling of the suffragette movement with the burgeoning labor movement among women workers. While well intentioned, there was an overwhelming clash of priorities between the elite of New York society and poor immigrants with strong socialist politics.

Von Drehle gives a good description of all the major characters that were involved directly in the tragedy, the workers who died, the owners of the factory, the workers who survived and the people who tried to help on that fateful day. Much of the biographical information on the workers comes from “Report of the Joint Relief Committee.” He was also able to read the one known remaining transcript of the trial of Isaac Harris and Max Blanck, the owners of the Triangle Factory. He also gives great credit to Leon Stein, author of “The Triangle Fire” who based his book not only on the trial testimony but the series of interviews he had conducted with 25 survivors of the fire still alive in the 1950s. Blanck and Harris were not good employers by even the low standards of the time. However, in von Drehle’s story, they are portrayed as humans with their own problems and views.

The book also delves into the political actions following the fire. A number of then-young politicians worked after the fire to promote worker safety. Frances Perkins, who became Secretary of Labor in the Roosevelt Administration, was a witness to the fire. She worked with Al Smith, later governor of New York and presidential candidate. Finally, for those who follow politics, what story of turn of the century politics in New York would be complete without the movers and shakers of Tammany Hall?

As with any book about a tragedy, it isn’t a “fun” read, but it is what my favorite English teacher referred to as a “good” read.

Book Review: OH&S laws were born in flames by Kathy Hall

Many of today’s occupational safety and health standards can trace their heritage to a spring day in 1911 when 146 workers – mostly young women – perished in the Triangle Shirtwaist Fire. It was the worst workplace disaster in New York City history until Sept. 11, 2001.
Von Drehle’s vivid writing weaves the lives of immigrant workers and greedy bosses, the media, a nascent labor movement, machine politics, and the horrific fire into a reform movement that gave birth to national standards.

The reforms came too late for the 146 young women and men who leapt to their deaths or burned alive in a ninth-floor sweatshop in New York’s Greenwich Village. Many were immigrants who had never practiced a fire drill. When they tried the front stairway, they found the door locked. The fire escape collapsed under their weight. The fire department’s tallest ladder trucks reached only to the seventh floor. Von Drehle outlines the Tammany Hall politics that led the New York legislature to create The Factory Commission of 1911. Sen. Robert Wagner and Assemblyman Alfred E. Smith – the “Tammany Twins” – headed the commission. They pushed through 25 bills recasting the labor law of the nation’s largest state. Automatic sprinklers were required in high-rise buildings. Fire drills were made mandatory. Doors had to be unlocked and had to swing outward. Other laws enhanced protections for women and children. The state Department of Labor was completely reorganized. The national Democratic Party incorporated the commission’s reforms into its platform.

It is easy for us to forget the tragedies that gave birth to today’s occupational safety and health legislation. Von Drehle’s well-researched historical account provides a needed reminder.


Submitted by Claire Barnett, Member, APHA Environment Section
Executive Director
Healthy Schools Network, Inc.
Coordinator, Coalition for Healthier Schools
Phone: (212) 482-0204

APHA's Occupational Health Section strongly supported the successful APHA Policy Resolution (# 200010) "Creating Healthier School Facilities." Section members may now take their activism to the federal and state levels with a new national POSITION STATEMENT 2004/05 issued by the Coalition for Healthier Schools. This calls for federal, state and local actions to improve school environments, from design, construction, and maintenance. Please consider adding your support and communicating your support to elected officials.

Visit <> to learn more and to subscribe to NewsSlice, use Guides-factsheets.

Support the Healthy Schools Agenda!


Kathy Hall
Communication Director
University of Washington
Dept. of Environmental & Occupational Health Sciences
F-461C Health Sciences Center
Box 357234
Seattle, WA 98195-7234
Phone: (206) 685-6737
Fax: (206) 543-9616
Web sites - departmental: <>
editor's corner: <>

The University of Washington's Northwest Center for Occupational Health & Safety is offering several interesting continuing education courses this summer and fall, including one on a cruise ship to Alaska. To confirm this schedule or find more information about these courses, call (206) 543-1069 or visit the Continuing Education Web site, <>.

Courses are in Seattle unless noted.

July 18-19 Oil Spill Response and Prevention
July 20, 21 Annual Hazardous Waste Refreshers
July 22 Annual Hazardous Waste Refresher (Olympia, Wash.)
July 23 Supervising Hazardous Waste Operations
Sept 11-18 A Small Dose of Toxicology (Alaskan cruise)
Sept 27 As Workers Grow Older: Achieving Safety & Productivity (Tacoma, Wash.)
Oct 5 Annual Hazardous Waste Refresher
Oct 6 Occ & Env Medicine Grand Rounds
Oct 12 Risk Communication Unplugged (Bellingham, Wash.)
Oct 19 Wood Smoke: Burning Health Issues
Nov 2-3 Clear Writing for Safety and Health Professionals
Nov 10 Occ & Env Medicine Grand Rounds
Nov 16-18 2nd Intl Scientific Conference on Occ and Env Health (Hanoi, Vietnam)

Section chair Michael Silverstein is directing the Sept. 27 course on aging workers, which is being held in conjunction with the Washington Governor's Industrial Safety & Health Conference, and Section member Kathy Hall is directing the Nov. 2-3 writing workshop.

Section member Sharon Morris is organizing the 2nd International Scientific Conference on Occupational and Environmental Health, Nov. 16-18, 2005, in Hanoi, Vietnam. Submit abstracts by July 29 to <>. Direct questions to <>.


Announcing the 'You Can!' Celebration

The Administration on Aging encourages 'You Can!' partners to join in celebrating ways for older adults to be active and healthy this September. Holding a local 'You Can!' celebration can help you spread the word about the importance of healthier lifestyles...and it can be fun!

During any seven-day period of September, AoA invites 'You Can!' partners to create 'You Can!' celebration activities. These are activities where participants can make a pledge and engage in healthier lifestyle activities. If they see how easy and enjoyable it can be, hopefully they will continue the nutrition and physical activity behaviors and help others to improve their health, too.

All community partners that sign up and complete the contest entry form have a chance to receive awards. The contest will culminate with a ceremony in the Washington, D.C., metro area in October, where the best entries in leadership categories will be recognized.

For more information visit: <>.

If your organization wants to participate and is not yet a 'You Can!' partner, you can enroll at <>.

Kay Loughrey
Aging Program Specialist
U.S. Administration on Aging
(202) 357-0142

Newsletter Information and Accessibility

You might have noticed that the OHS Section newsletters are automatically “published” on-line shortly after each issue’s deadline.

The most common reason people might not be receiving this notification is that their e-mail address is not in the APHA database. You can update your member records on the APHA Web site or call the membership department at (202) 777-2400.

Although we realize the importance of receiving the newsletter notifications, they aren't needed to access the newsletters, so members can visit the Web site at any time to view their newsletters at

If members are still concerned they aren't receiving the notification, they can contact APHA Manager of Section Affairs Sharon McCarthy at (202) 777-2483 or <>.