The Future Is Now
Speakers Address Emerging Issues at AIHce EXP 2018
By Kay Bechtold and Ed Rutkowski
The outlook for the American economy, the precarious state of temporary workers, the opioid crisis: these were just a few of the weighty topics explored at AIHce EXP 2018 in Philadelphia, where thousands of occupational and environmental health and safety professionals gathered in May for the largest conference dedicated to the protection of worker health. From Rich Karlgaard’s opening keynote to Colonel Kirk Phillips’ closing address, the speakers at AIHce focused on potentially critical developments for the OEHS professions. A FORECAST FOR SUSTAINED GROWTH The stagnating effects of the Great Recession are wearing off and recent strong growth is likely to continue, according to Forbes magazine publisher Rich Karlgaard, whose keynote address opened AIHce EXP 2018 on May 21. The U.S. economy grew 2.9 percent over the previous four quarters, Karlgaard said, a significantly higher rate than at any point since the Great Recession. Karlgaard asserted that such a level of growth is sustainable based on the American economy’s historical performance and recent surveys that demonstrate an increase in CEO “confidence.” “CEOs are of a mind to invest, and higher growth is dependent on higher investment,” Karlgaard said. Despite these hopeful signs, many economic commentators have been skeptical about the economy’s long-term prospects, Karlgaard said. He attributed these doubts to the lingering trauma inflicted by the Great Recession, the worst downturn the U.S. has experienced since the 1930s. “We see three percent growth and we become kind of afraid: when is the other shoe going to drop?” Karlgaard said.  Karlgaard argued that investors are less constrained by such fears because of the Trump administration’s focus on cutting regulations that inhibit growth. Data-related technologies such as the Internet of Things, artificial intelligence, predictive analytics, driverless vehicles, and augmented reality are becoming the new engine of economic growth, he said.  Karlgaard also asserted that technology is more effective than regulation at constraining bad actors in the marketplace. With nearly half of the global population now carrying smartphones, Karlgaard said, “if you talk about safety and don’t practice it, you get outed pretty quickly in this new world.” CONCERNS ABOUT OSHA, NIOSH Later on May 21, Jordan Barab, who was the deputy assistant secretary of OSHA during the Obama administration, and Peg Seminario, director of occupational safety and health for AFL-CIO, shared their perspectives on how OSHA and NIOSH are faring under the Trump administration. Barab explained the impact on OSHA of two of the president’s executive orders—13771, “Reducing Regulation and Controlling Regulatory Costs,” which is more commonly known as the “one in, one out” executive order, and 13777, “Enforcing the Regulatory Reform Agenda,” which is intended to “alleviate unnecessary regulatory burdens placed on the American people.” “The bad news about OSHA regulations is that they take a long time to be issued,” he said, citing a 2012 Government Accountability Office report that found that, on average, OSHA takes seven years to issue a final rule. “But the good news is that it takes just as long to repeal [these worker protections].” Barab also expressed disappointment that the Department of Labor’s spring 2018 regulatory agenda did not include items such as combustible dust, back-over injuries, noise in construction, welding, injury and illness prevention programs, styrene, 1-bromopropane, and chemical management and permissible exposure limits.  Seminario told attendees that she expects big changes in OSHA policy once the agency has a new assistant secretary. Scott Mugno, currently a vice president at FedEx Ground in Pittsburgh, Pa., was nominated for the position approximately seven months ago.
“OSHA staffing and funding are at the lowest level in decades, and [the agency’s] capacity to provide meaningful oversight is stretched to the limit, even in core industries,” Seminario said. The Trump administration has proposed cutting the budgets for both OSHA and MSHA, and the NIOSH budget is expected to take a “big hit,” Seminario continued. The president’s budget proposal for the 2019 fiscal year would defund all of NIOSH’s Education and Research Centers and stop direct federal funding to support academic salaries, stipends, and tuition and fee reimbursements for occupational health professionals at universities. Trump’s proposal would also consolidate NIOSH’s activities and research within the National Institutes of Health. NIOSH is currently part of CDC. “The proposal here is really to destroy the agency,” Seminario said. She urged AIHce EXP attendees to keep up their strong bipartisan support to fund NIOSH and to leave it as part of CDC for now. HAZARDS FACING TEMP WORKERS Sara Mojtehedzadeh of the Toronto Star, who presented the annual Upton Sinclair Lecture for Outstanding EHS Investigative Reporting at AIHce on May 21, shared what it was like working undercover inside one of North America’s largest industrial bakeries with a history of fatalities among temporary workers.  On a sunny day in April, Mojtehedzadeh turned up at Fiera Foods in the North York section of Toronto posing as a job seeker. She was told that the factory didn’t hire directly, so she’d have to go through a temp agency. Two weeks later, she got a call to report to the factory the following afternoon. She received about five minutes of health and safety training, which she described as “basically telling me not to stick my hands in machines.” “Upton Sinclair’s groundbreaking work The Jungle was exactly how this factory felt to me,” she said, recalling the machinery, forklifts, stacks of trays, slippery floors, and workers being pushed to their limit. She could feel the heat from the ovens and other equipment, but was not shown where the fire exits were located. Mojtehedzadeh learned what it was like to be too busy to think about safety hazards, much less to refuse unsafe work, a right provided by Ontario law. Vulnerable workers in precarious jobs make up one-third of Ontario’s work force, and 52 percent of jobs in Toronto have some form of precarity, Mojtehedzadeh said. Temp agencies have increased by 20 percent in the province over the past decade, and the workers they employ are increasingly being placed in non-clerical workplaces, including industrial warehouses. Mojtehedzadeh described how her investigation helped her see “the way that companies use temp agencies to cut costs and avoid responsibility for injuries.” “The company’s record was almost perfect because injuries would show up on temp agencies’ records, not Fiera Foods,’” she said. Since the publication of articles detailing the investigation, Mojtehedzadeh said the Ontario government has made both temp agencies and client companies responsible to the workers’ compensation board when workers are injured on job. The province has also mandated equal pay for equal work when temp agency workers are doing work comparable to that of full-time employees. Mojtehedzadeh’s stories are available via the Toronto Star website. OPIOIDS AND FIRST RESPONDERS AIHA Past President Steven E. Lacey set the tone for the May 22 general session on mitigating opioid exposure risks to first responders with some sobering statistics. In 2016, 65,000 Americans died of drug overdose, more than the number killed in the entirety of the Vietnam War. Two-thirds of those deaths were attributed to opioids. The opioid crisis carries an economic burden as well: Lacey noted that in 2015, the U.S. spent 2.8 percent of its GDP to fight the opioid crisis. Lacey then introduced a panel of experts to discuss the precautions first responders must take when responding to medical emergencies and investigating illicit drug activity. The panel comprised Philadelphia Fire Commissioner Adam K. Thiel; Kemp Chester, associate director of the White House Office of National Drug Control Policy; NIOSH Director John Howard; and AIHA Board member Donna S. Heidel. In Philadelphia, the firefighters and emergency medical technicians in Thiel’s department will likely have to administer naloxone, a drug that reverses opioid overdoses, at least 5,000 times this year. Thiel said that his department treats fentanyl “like a hazmat incident,” sometimes going so far as to decontaminate ambulances that carried victims of fentanyl overdose. “Our work environment is not a controlled situation,” he said. “We never have home field advantage, and we never know where we’re going.” “These are nonroutine operations for firefighters, EMTs, and law enforcement, and they’re very unpredictable in nature,” Heidel said. When responding to a possible fentanyl overdose, responders must realize that activities such as disturbing clothing or gathering up bedding can cause airborne concentrations of fentanyl that could result in health consequences. Cleaning and standard vacuuming could also cause adverse effects to workers in that environment. Howard said that workplace investigations conducted by NIOSH’s Health Hazard Evaluation Program have shown that mucus membrane contact is the number-one cause of opioids exposures to first responders. But he cast doubt on media reports of first responders accidentally overdosing on opioids. NIOSH personnel have never seen any of the typical opioid overdose symptoms in any first responder, Howard said. Chester outlined some recent achievements in the fight against the opioid crisis. President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis has issued recommendations that meet the need for consistent, science-based guidance across the federal government, he said. The administration is focused on reducing the availability of opioids, doing a better job of bringing in the postal inspection service to address drugs being shipped by mail, and increasing the availability of naloxone across the country. “This opioid crisis is affecting all of our workplaces,” Heidel said. “We have to make sure that our people in our workplaces who deliver first aid understand the signs and symptoms of overdose, how to render aid to those people, and how to protect themselves.” TOWARD INDIVIDUALIZED WORKER PROTECTION At the closing session on Wednesday, May 23, retired Air Force Colonel Kirk A. Phillips, BSC, praised the potential of Total Exposure Health, a holistic approach to occupational health and safety that proposes to create individualized protections for all workers.  Phillips developed TEH in 2014 while serving as an associate chief in the office of the Air Force Surgeon General. At AIHce, he described TEH as a “revolutionary way to think of exposure and primary prevention” that acknowledges the contributions of environmental and lifestyle exposures to worker health.  Historically, Phillips explained, OHS professionals developed interventions to protect specific populations of workers, with the knowledge that some workers—those who were genetically predisposed to certain diseases, for example—would slip through the cracks. But advances in the study of the human genome, the ability of sensors to measure a range of personal and environmental exposures, and the predictive powers of Big Data will soon allow OHS professionals to develop protections targeted to specific individuals. The proliferation of sensors through the Internet of Things—a term that refers to the burgeoning network of internet-connected devices, from industrial equipment to home appliances—will generate additional layers of data that can inform decisions about how best to protect an individual’s health throughout their lives. For example, parents who discover, through genetic screening, that their newborn child doesn’t process organophosphates as well as most people will be able to receive specific advice from their pediatrician about the kinds of foods their child should and shouldn’t eat. Data about their food purchases available from their online account with their grocery store will be shared with health professionals and used to further personalize care. “That predictive nature is something we don’t provide at all today, but I think is going to be demanded in the future,” Phillips said. FROM PHILLY TO MINNY Next year, AIHce returns to the City of Waters, Minneapolis, Minn., May 20–22. Visit the conference website for more information.  KAY BECHTOLD is senior editor of The Synergist. She can be reached via email.
ED RUTKOWSKI is editor in chief of The Synergist. He can be reached via email.