From Principles to Practice, Part 2 An International Dilemma in Confined Space Entry
BY ROB AGNEW, MARK KATCHEN, AND JOSEPH ALI
Authors’ note: The eight-step framework discussed in this article was developed by Nancy Kass, Holly Taylor, and Joseph Ali of the Berman Institute of Bioethics at Johns Hopkins University, together with Anant Bhan, a researcher at Yenepoya University in Pune, India.

Part 1 of this article, which appeared in the June/July 2016 Synergist, presented a case study illustrating some of the ethical complexities of practicing industrial hygiene in an international setting. That case study involved a hypothetical United States-based company whose factories in Germany, the U.K., and the U.S. use a production process involving spray application of methylene chloride (Dichloromethane). Since each country has a different exposure limit for methylene chloride, the company needed to decide which exposure limit it should adopt for its facilities.

Like all ethical dilemmas, this situation requires industrial hygienists to look for guidance from familiar sources: the American Board for Industrial Hygiene’s Code of Ethics, cultural norms, legal and regulatory requirements, and human rights. For international practice, we must also consider universal ethical principles such as non-maleficence (the avoidance of harmful acts), beneficence (making the most of potential benefits), respect for individuals and communities, and justice.
The article explored the ethical considerations in the case study through the lens of an eight-step ethical decision-making framework:
  1. determine the ethics principle(s) involved
  2. gather facts
  3. review the standards for ethical industrial hygiene practice
  4. articulate the ethical concern(s)
  5. determine whether any principles are in tension with each other
  6. determine options, including analysis of pros and cons
  7. solicit feedback, including local stakeholders
  8. decide on an approach
By following these steps, the company in our case study ultimately determined to apply the “most restrictive doctrine.” According to this doctrine, fair and ethical treatment for all of the company’s employees required application of the most restrictive regulation so that all would have the same risk of disease.
In this article, we present a second case study that explores different legal definitions of a permit-required confined space (PRCS).
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ETHICS
ROB AGNEW, MS, CIH, CSP, REM, is an assistant professor in the Fire Protection and Safety Engineering Technology Program at Oklahoma State University in Stillwater, Okla. He can be reached at (405) 744-8772 or robert_j_agnew@hotmail.com. MARK KATCHEN, CIH, FAIHA, is managing principal at Phylmar Group Inc. in Los Angeles, Calif. He can be reached at (310) 474-3937 or mkatchen@phylmar.com. JOSEPH ALI is a research scholar at the Johns Hopkins Berman Institute of Bioethics and associate, Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. He can be reached at (410) 614-5370 or jali@jhu.edu.
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DEPARTMENTS
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CASE STUDY: CONFINED SPACE ENTRY A U.S.-based company with operations in Australia is developing a global PRCS entry policy and procedure. The company is committed to following the “most restrictive” doctrine. During the draft development of the PRCS policy, a conflict in the definition of “entry” arises.
OSHA defines entry into a PRCS as:
the action by which a person passes through an opening into a permit-required confined space. Entry includes ensuing work activities in that space and is considered to have occurred as soon as any part of the entrant's body breaks the plane of an opening into the space.
In contrast, the Australian Work Health and Safety Regulations define entry as “the person’s head or upper body [being] inside the confined space or within the boundary of the confined space.”
The different definitions regarding entry pose a quandary for the global policy. The U.S.-based team members feel that the U.S. definition is more conservative and safer. However, the Australian-based team argues that PRCSs in Australia have been designed (through engineering with risk assessment) to allow employees to place their hand or arm into the space to adjust valves or perform other small tasks such as air monitoring. If the U.S. definition were applied, then small routine tasks would require a burdensome administrative process and not necessarily reduce the chance of injury or death to workers.
In consideration of the principles of beneficence and non-maleficence (maximizing potential benefits and minimizing avoidable harm), we must ask, in this case, does the most restrictive option really minimize harm and reduce risk? In addition, would we maximize benefit by using resources for other safety and health hazards rather than retrofitting valve access points or administering additional permits? SHARE YOUR OPINION These two case studies demonstrate the nuanced challenge of applying ethical standards across multiple nations’ boundaries. The precautionary principle on its face is a logical ethical framework to assist the industrial hygienist with ethical decision-making. However, many situations may require an in-depth examination employing additional ethical principles to elucidate the values that matter to different stakeholders and the potential tradeoffs of different approaches to protecting employees and the public. In these instances, data and ethics can work in harmony to inform choices and increase decision-making confidence, even if a thorough assessment ultimately confirms that multiple options are equally worthy of pursuit.
We invite you to submit your solutions to the confined spaces ethical dilemma. The Joint Industrial Hygiene Ethics Education Committee (JIHEEC) will review the submissions and select some of the best responses for publication in a follow-up article in The Synergist.
Send your responses to rob.agnew@okstate.edu.
JIHEEC: Promoting Ethical Practice The Joint Industrial Hygiene Ethics Education Committee (JIHEEC) promotes awareness and understanding of the enforceable code of ethics published by the American Board of Industrial Hygiene (ABIH) as well as the ethical principles of AIHA and ACGIH. It includes representatives from all three organizations.
JIHEEC is not an enforcement group or resolution board. It serves the profession by focusing attention on ethical dilemmas facing the industrial hygienist, and can also serve as a sounding board for challenges facing the professional. The AIHA Board serves as the Secretariat of the JIHEEC and oversees its activities.
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Under strong demand from the automotive industry, the American National Standards Institute (ANSI) published its Z244.1 standard, Control of Hazardous Energy, in 1982. This standard greatly advanced OSHA’s ability to recognize the hazard under the general duty clause and was ultimately used as the template for developing OSHA’s own regulatory language. In 1989, the Control of Hazardous Energy standard (29 CFR 1910.147) was finally adopted as law.
OSHA estimates that 122 fatalities, 28,400 lost workday injuries, and 31,900 non-lost workdays are prevented each year because of the introduction of the Control of Hazardous Energy standard (that is, LOTO). But even with regulation, LOTO injuries still make up approximately 10 percent of serious manufacturing accidents and accounted for 23 percent of the fines assessed to the manufacturing industry in 2016.