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Occupational Health and Safety
Section Newsletter
Winter 2009

OHS Section Chair

Celeste Monforton, MPH, DrPH

Dept of Environmental & Occupational Health

School of Public Health & Health Services

The George Washington University

2100 M Street NW, Ste 203

Washington, DC   20037

(202) 994-0774 (phone)

(202) 994-2102 (fax)


OHS Section Newsletter Editor

Ingrid A. Denis, MA

Association of Occupational & Environmental Clinics (AOEC)

1010 Vermont Ave., NW Ste. 513

Washington, DC  20005

(888) 347-2632

Chair's Message

Celeste Monforton, MPH, DrPH


The OHS Section closed out 2008 with gusto.  There were the inspiring sessions presented at the APHA Annual Meeting in San Diego, such as those the Occupational Health Disparities Institute and the Farmworkers Feed Us All photo-journalism exhibit, and the release of our “Protecting Workers on the Job” agenda, a collaborative effort with the National COSH.  This year, 2009, will offer many opportunities for us as APHA members to advance occupational health and safety, and I encourage you to get involved with us. 


In this issue of the Section newsletter, you’ll find a new feature: short articles highlighting the work of OHS Section members.  This time the profiles are of Matt Keifer, MD, MPH, and Lee Petsonk, MD, who each have been members of the OHS Section for at least 25 years.  For those of you who find yourself explaining the value of occupational health and safety research, practice, and policy, we hope these profiles will help you raise public awareness by providing a window into OHS Section members’ work.  The next time someone asks “What is occupational health and safety?” direct them to these profiles.  We’ll be posting them on the Section Web site.  We welcome your recommendations of individuals -- both new members and long-standing ones -- to feature in future newsletters. 


This newsletter would not be possible without the long-standing volunteer service to the OHS Section of Ingrid Denis, MA, our newsletter editor.

Priorities: The Employee Free Choice Act

The Employee Free Choice Act [EFCA] has been identified as the highest priority for organized labor these days. Although it has not yet been reintroduced into this Congress, it promises to be a heated political debate with lots of information [and misinformation] being liberally swung around in all directions. Here is an attempt to clarify some of the issues and facts:

  • EFCA would restore the ability of workers to form unions without the threats, harassment and intimidation that too many employers now routinely use to sabotage union organizing.
  • A Cornell University research team conducted a survey of 400 NLRB election campaigns in 1998 and 1999 and found that 36 percent of workers who vote against union representation explain their vote as a response to employer pressure. The NLRB election process enables management to wage lengthy and bitter anti-union campaigns, during which workers can expect harassment, intimidation, threats and firings.
  • Employer illegal acts pay off big time. The NLRB response to violations by Employers is grossly inadequate. Most guilty findings end up with a posting by the employer on a bulletin board declaring that they will refrain from the practice in the future. When workers win back jobs or back pay, it is often years after the violation occurred when the organizing drive is history.
  • Fighting unionization is big business. Big law firms profit and manipulate. They coach employers how to intimidate and instill fear in their employee’s psyche. They use captive meetings on company time, one-on-one meetings with supervisors and a variety of other threats to make sure employees really “think about” the vote.
  • The alternative is simple. You make the election a private event without fear. Workers can sign a card in the privacy of their own home or wherever they choose. Once a majority of workers sign cards, the employer has to recognize the union. This is especially important for low wage and immigrant workers.
  • The bill would also provide relief for the well-honed management tool of stalling first contract negotiations indefinitely. This can set the stage for the employer mounting a decertification campaign against the union. EFCA would allow for either party to call in a federal mediator. If an agreement is not made in 30 days, binding arbitration could rule for a two year first contract.
  • Employers and their lobbyists are screaming bloody murder over the concept that they may lose their oppressive edge to influence ballot elections. They are claiming the end of the secret ballot process and government intervention into collective bargaining for first contracts.
  • Unionization improves public health. Union members are far more likely than non-union workers to have adequate health insurance coverage as well as effective health and safety programs to resolve hazards in the workplace. When unions succeed in moving the government to regulate employee health and safety, working conditions improve for all workers – union and non-union alike.

I have been honored to work on many union organizing campaigns myself. When workers decide to fight for a union, their courage is incredible. The repressive and oppressive reaction by employers is also incredible. Fueled by consultants, management explodes with fear campaigns that make the Bush years seem peaceful. We are talking Orange Plus here every day and in your face.

There are many examples of campaigns where the employer’s neutrality was enough to level the playing field. I worked on a campaign at a school bus manufacturing plant in North Carolina where health and safety played a major role in unionizing the plant. The workplace of 2,500 workers was organized under a neutrality agreement whereby the employer agreed to recognize the union if a majority of cards were signed. This came about through a collective bargaining agreement with the company’s parent corporation. This workplace had been through several previous NLRB elections that were unsuccessful in unionization.

Because of this agreement, the union organizers were able to show workers the type of benefits we had secured for workers in similar workplaces with the same parent company. These included extensive health and safety contractual provisions including paid protective equipment and significant improvement in safety conditions. Although this process was extremely adversarial at first because the old school management tried to sabotage the process, with time and persistence the union and management sat down and agreed on a first contract which included significant health and safety language. Unfortunately, this scenario is the rare exception to the rule, but it shows what can be done if there is a fair playing field.

Our Section sponsored and wrote APHA policy resolution (#20068, November 2006) which supports the right of all employees to freely choose to form unions, and calls upon the U.S. Congress to legislate the right of employees to freely choose to form unions. We are in a pivotal position to bring rational facts to bear witness in this campaign. The fact that unionization improves health and safety conditions and the formation of truly joint health and safety committees can be the most powerful argument to influence our elected representatives to vote for this legislation. The Section leadership is working with the APHA Government Affairs office to communicate our policy. Please communicate your own message to your legislators when the bill is introduced into the 111th Congress.


OHS Member Profiles


ØLee Petsonk, MD


“Why is Black Lung Back? Tracking an Epidemiological Mystery” was published in early January at the Online Journalism Project, New Haven (CT) Independent.  The article features NIOSH respiratory disease specialist, Edward L. “Lee” Petsonk, MD, who has been a member of APHA and the OHS Section for about 25 years.  He received his medical training at McGill University's Faculty of Medicine in Montreal, with such notable mentors as Drs. Margaret Becklake, Peter Macklem, and Anthony Robbins (who later served as NIOSH director and APHA President).  Dr. Petsonk joined NIOSH as a Public Health Service medical officer in 1979, and over the last 10 years has provided medical leadership for the NIOSH Coal Workers' Health Surveillance Program.  On Jan. 1, 2009, he retired from the Public Health Service. 


Below is an excerpt from “Why is Black Lung Back? Tracking an Epidemiological Mystery” by journalist Carole Bass.


Black lung disease used to be nearly as common as dirty fingernails among American coal miners.  Roughly a third of them got the fatal illness.  Starting in the 1970s, a federal law slashed that rate by 90 percent. But now it’s back.  Dr. Edward L. “Lee” Petsonk was a respiratory disease specialist, but not a coal mining expert, when NIOSH put him in charge of its Morgantown-based black lung program about 10 years ago.  The program offers each underground coal miner a free chest X-ray every five years. That’s how NIOSH tracks rates of the disease.


Although coal production is booming, the number of underground miners has dropped to fewer than 45,000 nationwide.  For a variety of reasons, most miners don’t take advantage of the X-rays.  So when Petsonk took over the black lung program, he decided it was feasible to orient himself by looking at every single new X-ray that came in.


“After a couple of years, something changed,” he recalls. “I began to see the type of disease that was only in the textbooks — this massive fibrosis, where the lung is basically destroyed.  It’s nothing but black scar tissue. I was incredulous.  And it was young people.  It wasn’t the older miners. I thought, something is wrong here. We decided we’d better do some research.”


In September 2007, Petsonk reported that the disease rate had more than doubled among miners who worked 25 years or more underground, from about 4 percent in 1997 to 9 percent in 2006.  The rate among miners with 20 to 24 years’ experience jumped even more, from 2.5 percent to 6 percent.  While those are still small percentages, the trend is going in the wrong direction.  “The statistics are important, and they help us pinpoint and evaluate the problem,” Petsonk says.


But statistics don’t tell the whole story. The federal Mine Safety and Health Act, passed in 1969 and fully effective since 1973, was specifically designed to eliminate the most advanced black lung cases altogether. Even without the statistics,


“what we know is these cases of young people getting sick. And that’s wrong.  That’s a failure of the Act.  The real tragedy,” Petsonk continues, “is that these are hardworking people who are doing a service for their companies and our society, and what they get for it is a really-”


“Raw deal,” interjects Anita Wolfe, Petsonk’s NIOSH colleague. 


“Well, more than a raw deal,” Petsonk replies. “If you see the suffering of a person struggling to breathe, every minute of every day, this is like a diabolical torture.”


Read the full article at:


(Carole Bass is recipient of a 2008 Alicia Patterson Fellowship to investigate and write about workplace and environmental toxins)


ØMatt Kiefer, MD, MPH


The Migrant Clinicians Network’s Streamline newsletter recently featured an article on the work of Matthew Keifer, MD, MPH, who has been a member of the APHA OHS Section for more than 20 years.  The profile was written by Amy K. Liebman, MPA, another OHS Section member and co-coordinator of the Section’s “Occupational Health Disparities Institute.”


The following is an excerpt from the Streamline article; read the full article online at


Each month for the last 13 years, Dr. Matt Keifer has flown from Seattle to Toppenish, the heart of Washington’s agricultural region, where he runs a half day occupational clinic at the Yakima Valley Farm Workers Clinic. Dr. Keifer deals with the complicated cases regarding work related injuries and exposures, cases no longer manageable in the primary care setting.  Yakima Valley Farm Workers Clinic Executive Director Carlos Olivares feels that offering an occupational medicine clinic on site in a migrant and community health center is critical to quality care and stresses the need to expand this model across the country. “If your mission is truly focused on improving the health of the worker, having an occupational medicine clinic is a no-brainer,” says Mr. Olivares. “Migrant health is generally thought of only from a primary care perspective, but occupational health is almost as critical. Can you imagine how the injured patient feels, knowing that specialty care is needed and having to go to a major metropolitan area for treatment? And how do you think the family doctor feels making this referral? The chances of the patient actually getting the treatment are almost zero. It’s not good care. And it’s certainly not cost effective. We need specialists like Dr. Keifer who can leave the university and come to the workers.”


Dr. Keifer works with the clinicians to help them understand occupational medicine. One key component that primary care providers often overlook is the determination of cause in occupational medicine. While the medical condition is diagnosed with the same certainty applied to any medical condition, the determination of the cause of the condition, whether it is in fact attributable to the workplace, is made on a “more probable than not” basis. In other words, clinicians only need to be more than 50 percent certain that the illness or injury is work related in order to file a claim. Documenting charts to satisfy both the medical and legal systems becomes critical for the patient’s as well as the clinic’s success in obtaining benefits from the worker compensation system.


For Dr. Keifer, his monthly clinics have helped him tremendously in designing relevant, applicable research projects, and more importantly, in gaining access to both the clinicians and the community to be able to do the research. Dr. Keifer is a renowned scholar regarding pesticide health effects and has published extensively in the peer reviewed literature on this topic. Most recently, his research has focused on cholinesterase monitoring of pesticide applicators in Washington, and some of his efforts involve community based participatory research. “When I do work in the community, I have first hand knowledge of what their health concerns and problems are,” says Dr. Keifer. “They know me and trust me. Having credibility is fundamental to doing any kind of research in the community.”


The clinicians in Yakima also have confidence that Dr. Keifer’s research efforts are going to be worthwhile. He feels his work with the health center has helped break down the perception of the “Ivory Tower” as his clinical activities have a track record of benefiting farmworkers. “They (the clinicians) know what they see. They know I know what they see. They know this guy’s out here in the trenches with them.” When he proposes research projects, the clinic tends to be very supportive of his work.


In the end, Dr. Keifer feels his monthly trips to the Yakima Valley have been as beneficial to him as to the patients he cares for. “It’s much more than volunteering. It’s about really doing the work I was trained to do. It’s motivating and it’s interesting. It keeps my Spanish in great shape. More than anything else, it’s my constant reminder that social justice and occupational medicine go hand and hand.”

OHS Section Member News

Michael Morgan Receives Lifetime Achievement Award


Professor Michael Morgan is the 2008 recipient of the Meritorious Achievement Award from the American Conference of Governmental Industrial Hygienists (ACGIH). The award, presented at the American Industrial Hygiene Conference and Expo, recognizes Morgan's outstanding, long-term contributions to the field of occupational health and industrial hygiene.


Morgan earned his doctoral degree in chemical engineering from the Massachusetts Institute of Technology and completed post-doctoral training in respiratory physiology at Harvard University's School of Public Health.


He joined the UW Department of Environmental and Occupational Health in 1974. His research topics focus on human responses to the inhalation of air contaminants, including combustion products (sulfur dioxide and sulfate particles), ozone and volatile solvents.


His research program in pharmacokinetics and biological monitoring of organic solvents is funded by the National Institute of Environmental Health Sciences.


Morgan has won several teaching awards and has supervised the graduate research projects of 65 students in industrial hygiene and toxicology.


He is editor in chief of the Journal of Occupational and Environmental Hygiene and author of more than 65 peer-reviewed publications.


(Reprinted from Environmental Health News, Spring/Summer 2008, University of Washington Department of Environmental and Occupational Health Sciences)


Northeast Regional Public Health Leadership


Karla Armenti, ScD, recently completed a year-long program with the Northeast Regional Public Health Leadership Institute (  Her final project was to develop a stakeholder approach to performing occupational health surveillance in New Hampshire.  As a result of this initiative, they have pulled together key occupational health stakeholders and are working on a report documenting occupational injuries and illness in New Hampshire.  Included in this report will be an occupational poisoning study done by a student from the University of Massachuestts, Lowell (David Skinner), Work Environment Program.  An MPH student from the University of New Hampshire (Owen David) is helping to write the report and plan a one-day conference/workshop to be held in March.  At this meeting, the report will be rolled out and efforts will be made to engage key stakeholders in a discussion about how the data can inform their efforts in developing effective interventions to reduce work related injuries and illness. For more information and/or comments Dr. Armenti can be reached at

Announcements, Conferences, Trainings




New Solutions is one of the few journals entirely devoted to occupational and environmental health policy. It publishes research articles, interviews with activists, documents and reports. All editors are long-time members of the OHS Section.  A new issue is now available on the Baywood Publishing Web site at

This issue contains:

On the Road to a Healthy Environment

 p. 411

·         James Celenza

Employment Discrimination in Hungary and Its Effect on Health

 p. 415

·         Zsuzsanna Fuzesi, Csilla Busa, Ivett Varga, Laszlo Tistyan

Characteristics of Effective Job Health and Safety Committees

 p. 441

·         Tim Morse, Jeanette Goyzueta, Leslie Curry, Nicholas Warren

Productive Reorganization, Outsourcing, and Work Relations in the Offshore Oil Industry in the Campos Basin, Rio de Janeiro

 p. 459

·         Marcelo Figueiredo, Denise Alvarez, Milton Athayde, José Diego Suarez, Renata Pereira, Leonardo Soares

Freedom Isn't Free: Voices from the Truck Driving Industry

 p. 481

·         Julia Wenger

OSHA Recordkeeping: "How We Got to This Point"

 p. 493

·         Bob Whitmore


 p. 499

·         Kate Davies


 p. 507

New Solutions: Index—Contents of Volume 18, 2008

 p. 509

Conferences, Trainings, Meetings...



Oregon Governor's Occupational Safety & Health Conference

Oregon Convention Center (Portland) March 9 -12. For more information, see the 2009 Oregon Governor's Occupational Safety & Health Conference at


3rd National Healthcare Ergonomics Conference (Portland)

March 9-12.  For more information, visit the conference Web site at


29th Triennial Congress of the International Commission on Occupational Health (ICOH 2009), March 22–27, 2009, Cape Town, South Africa (




American Association of Occupational Health Nurses 2009 Symposium and Expo, April 17–23, 2009, Orlando, Fla. (

Comprehensive Industrial Hygiene Review (Vancouver, BC) April 20-24. For more information, call (604) 822-9599 or visit the Continuing Education Web site at


Occupational Hygiene 2009: Promoting a Healthy Working Environment. April 28–30, 2009, Eastbourne, UK (


58th Annual Governor's Industrial Safety and Health Conference (Tacoma) Oct. 7-8. For more information, call (888) 451-2004 or visit the Conference Overview Web site at



Other APHA Announcements

19th Annual APHA Public Health Materials Contest

The APHA Public Health Education and Health Promotion Section is soliciting your best health education, promotion and communication materials for the 19th annual competition. The contest provides a forum to showcase public health materials during the APHA Annual Meeting and recognizes professionals for their hard work.


All winners will be selected by panels of expert judges prior to the 137th APHA Annual Meeting in Philadelphia.  A session will be held at the Annual Meeting to recognize winners, during which one representative from the top materials selected in each category will give a presentation about their material.


Entries will be accepted in three categories; printed materials, electronic materials, and other materials.  Entries for the contest are due by March 27, 2009.  Please contact Kira McGroarty at for additional contest entry information.