Is OSHA’s proposed enforcement strategy for noise part of a job-creation agenda? That’s the message that Assistant Secretary of Labor David Michaels seemed to be sending in testimony before the House Workforce Protections Subcommittee on February 15.
The failure to issue sensible regulations endangers not only workers’ health and safety but also hurts American competitiveness. For example, because OSHA has a weak noise standard and weak enforcement, U.S. employers have no incentive to buy modern, quieter machines, which means that U.S. manufacturers don’t build them, and there are few jobs in the U.S. for engineers who could design them. A recent study by the National Academy of Engineering concludes that European manufacturers are way ahead of us in designing and building modern, quieter machinery. Today, when businesses anywhere in the world want to buy quieter equipment, they look not to the United States but to Europe.
The National Academy report (Technology for a Quieter America, October 2010) does in fact say that OSHA’s noise rules are inadequate. It recommends that the permissible exposure limit for workplace noise be reduced from 90 dB to 85 dB, and that it should should “reconfirm that engineering controls should be the primary means of controlling noise in the workplace.” That’s exactly the recommendation that ISEA made to OSHA in 2007 and again in 2009. Both times we were told that there were too many other things on the agency’s agenda, and the recent pullback of OSHA’s proposal to enforce noise controls appears to indicate that this issue is not going to rise to the top, even if it can be identified as a jobs program.
Maybe Dr. Michaels is positioning this OSHA-as-a- jobs-engine message as a way to get some support with the new Republican majority in the House. Good luck on that.
The Occupational Safety and Health Administration has withdrawn its controversial proposal to reinterpret “feasible” engineering and administrative controls for occupational noise. In a January 19 news release, Assistant Secretary David Michaels says it’s become clear that “addressing this problem requires much more public outreach and many more resources than we had originally anticipated.” Employer groups like NAM and the US Chamber were preparing challenges, saying that the new interpretation would add millions of dollars in new compliance costs. Senators Liberman and Snowe, co-chairs of the Senate Task Force on Manufacturing, had written the Secretary of Labor questioning the action, and met with Dr. Michaels. The proposal was cited in news reports as one of the factors supporting President Obama’s Executive Order mandating a top-to-bottom review of federal regulations.
Today’s announcement notes that OSHA will review comments and other information on the issue, hold a stakeholders’ meeting, consult with NIOSH and the National Academy of Engineering, and “initiate a robust outreach and compliance assistance effort to provide enhanced technical information and guidance on the many inexpensive, effective engineering controls for dangerous noise levels.” ISEA will participate in the process, to help the regulators understand the latest hearing protection technologies and their benefits in the workplace.
A new flu season is approaching, and with it come more articles about healthcare workers and respirators. A study reported in the American Journal of Infection Control shows that putting surgical masks on infected patients is a better strategy than having the healthcare worker use a poor-fitting N95 respirator. It’s hard to argue with that conclusion. In fact, it’s an application of the hierarchy of controls – eliminating the hazard at the source is better than erecting a barrier using PPE. But it shouldn’t be interpreted as a failure of respirators; the study was done using mannequins instead of fit-tested subjects. And having suspected flu patients wear surgical masks is part of the CDC recommended practice.
There’s a persistent murmur in the hospital community that respirators can’t be reliably fit-tested. Yet researchers in a large-scale study in Australia found that 83 percent of healthcare workers were able to get a proper fit the first time. This study found that certain facial characteristics were associated with successful fit, and that testers were able to select a suitable respirator based on visual assessment of the user in the majority of cases. Of the more than 6000 subjects in the study who were successfully fit tested, only 214 (4.8%) required testing with three or more models before finding one that fit.
Respirator supply is more of an issue than respirator efficacy. During the 2009 H1N1 pandemic, hospitals in Vancouver used respirators and surgical masks at a rate seven times greater than they’d estimated, according to research reported in Infection Control and Hospital Epidemiology. At one point, they were down to a two-day supply of respirators, and one hospital had run out of masks. Hospitals were supposed to keep a 10-week supply of PPE on hand to prepare for a pandemic, but they found that they were using ten respirators and ten masks per patient per day more than they’d allocated. Protective eyewear use was up 70% over the previous flu seasons. Researchers concluded that hospitals should plan for at least a doubling of mask and respirator use.
Studies like these point out the continuing difficulty in planning for a pandemic, and the need for better data on the use of respirators in healthcare. The CDC office responsible for the Strategic National Stockpile enlisted manufacturers and distributors to track the availability of respirators, surgical masks and antiviral drugs during the 2009 H1N1 pandemic, so that it could anticipate when it needed to deploy products from the stockpile. But because of the way these products are distributed, through state and large municipal health departments, it was hard to collect data on how many of them were actually being used. Healthcare facilities were getting respirators from multiple sources, including commercial channels and state alllocations, but no one knew how many were being used. The Canada study should be required reading for healthcare planners at every level.
Fortunately, funding is still available for pandemic preparation, as Congress rejected the plan to use unspent funds as an offset to pay for a supplemental appropriation. Now it is time to put those funds to work and rebuild the stockpile so that there will be an assured supply of PPE in the next national emergency.
ISEA has joined with a group of public health organizations urging Congress and the Administration not to divert funding for pandemic flu preparation to meet other budget demands. Congress requires that new spending be balanced by recissions from other programs, and there’s $2 billion that’s been appropriated for pandemic preparation but not spent. Those dollars were among the funds listed as available to offset spending in the 2010 Supplemental Appropriations Act, including the wars in Iraq and Afghanistan, funds for the Gulf cleanup, and other programs.
The problem, of course, is that this really isn’t extra money. Up-front funding is essential to plan and prepare for a pandemic, including development of new vaccine production capacity and replenishing stockpiles of antivirals and PPE that were drawn down during the H1N1 flu outbreak. Failure to prepare, by depleting contingency funding, could seriously affect the country’s ability to manage the next flu outbreak.
Fourteen organizations, coming together as the “Working Group on Pandemic Influenza Preparedness,” signed the letters. They were sent to the chairman and ranking minority member of the House Appropriations Committee, the Secretary of HHS and the Director of OMB.
The House passed the supplemental appropriations bill on July 1, before adjourning for the July 4 recess. Members of Congress and Administration officials are loudly trumpeting the survival of programs important to their constutiencies. But there is also a noisy chorus of dissent over the level of increased funding in the measure, and it won’t die down any time soon.