On April 15, due to safety concerns stemming from the COVID-19 pandemic, AIHA’s Board of Directors announced that AIHce EXP 2020 would not be held in Atlanta as planned. Instead, the conference would be transformed into a fully virtual event to be broadcast online June 1–3, the same days attendees were supposed to gather in Atlanta. 

The decision spawned a mammoth effort from staff, volunteers, and presenters to convert the conference program from face-to-face to virtual in a matter of weeks. Eighty-some sessions were prerecorded, while plans were made to accommodate about 20 live broadcasts. Committee meetings and professional development conferences were rescheduled. (See the Community section of this issue for more information about the transformation of AIHce EXP 2020.)  Despite technical glitches that affected the submission of course credits and forced the rescheduling of sessions planned for the afternoon of June 1, the first fully virtual AIHce EXP exceeded expectations. Counting PDC and single-day attendees, more than 3,100 people experienced some or all of the conference. The decision to prerecord most presentations allowed presenters to add unexpected value by engaging in real-time chat with attendees while their sessions were broadcast. And René Rodriguez bookended the conference with opening and closing session addresses that made full use of the virtual format and demonstrated the potential of online-only conferences.  THE COURAGE SCALE Rodriguez, an author and speaker, opened AIHce EXP 2020 June 1 with a discussion of the central role occupational health and safety professionals can play in leading their organizations’ response to the COVID-19 pandemic. In a series of prerecorded vignettes, Rodriguez addressed techniques leaders use to influence behavior, drawing lessons that have broad application but are particularly resonant as countries around the world continue to deal with the COVID-19 pandemic. In a pandemic, leaders are under a microscope: their every word and action will be judged, and they must set examples for others to follow. “Right now is an opportunity for you to really set the tone for what people around you are thinking,” Rodriguez said. One of the ways that leaders and others can achieve desired results is by affecting what drives behavior—primarily people’s beliefs. But rather than challenging others’ beliefs, Rodriguez encouraged the audience to approach change in a different way, by causing an “inner shift” that affects behavior. To help leaders gauge their effects on people, Rodriguez discussed the work of the psychiatrist David R. Hawkins, whose 2013 book Power vs. Force posits a hierarchy of consciousness that encompasses seventeen separate levels, from feelings of shame, guilt, and apathy at the bottom to peace, love, and enlightenment at the top. In Hawkins’ model, courage is midway between shame, the lowest level, and enlightenment, the highest.  Rodriguez encouraged attendees to think of Hawkins’ levels as a scale. Effective leaders, he suggested, are those who help people reach the higher levels on this “courage scale.” A leader’s goal should be to deliver information that motivates positive action, Rodriguez said. And a leader must take care to project calm in times of crisis. “We have to understand the difference between being prepared and being panicked,” he said. “If you just talk about how bad things are and don’t give me an actionable thing to do, you’re just causing fear.” HURDLES REMAIN FOR COVID-19 VACCINE NIOSH Director Dr. John Howard summarized the current state of knowledge regarding the COVID-19 pandemic on June 1, addressing disease transmission, testing, mitigation strategies, and vaccine development. Howard’s message regarding a vaccine was hopeful but cautionary.  “Things are happening faster than we’ve ever seen before,” Howard said of efforts around the world to develop a vaccine. But given that development encompasses several phases with the last involving thousands of volunteers, it is likely to take 12 to 18 months before a vaccine is ready. Howard also reminded listeners that resistance to vaccination has taken hold among people who question the safety of vaccines. “It’s important to remember even when we do get a vaccine” that convincing people to take it will be a challenge, he said. Howard emphasized the role of aerosols in transmitting COVID-19, explaining that infected individuals generate particles containing the virus when they cough, sneeze, or speak. While the larger droplets fall to the ground relatively quickly, smaller particles can stay airborne for long periods. Recently published research indicates that even speech from asymptomatic people can transmit disease, Howard said. The virus can also be transmitted through contact with surfaces that have infectious material, Howard said. The length of time the virus lasts on certain surfaces varies. Serology testing, which detects the presence of antibodies, looks for evidence of prior infection but does not identify whether people are protected from reinfection. Howard said that experiments have shown that antibodies protect monkeys from reinfection, but scientists do not yet know how long this protection lasts. Mitigation strategies developed by CDC have attempted to address the many ways that people congregate at home, at work, and during transport. While guidelines vary for different circumstances, the primary strategy, Howard said, is to keep infected people away from the non- infected. Studies show that stay-at-home orders have been very effective in reducing transmission.

An industrial hygienist from a consulting firm that participated in the sampling of ethylene oxide (EtO) in the Willowbrook, Illinois, community discussed his  experiences on June 1 as part of a prerecorded virtual session. The presenter, Benjamin Chandler of GHD Services in North Little Rock, Arkansas, shed light on the sampling challenges associated with a case that drew national attention and resulted in the shuttering of a Willowbrook facility. In August 2018, EPA released information indicating that residents of Willowbrook and surrounding areas were at increased risk of cancer from exposures to EtO. The gas was being emitted by Sterigenics, whose Willowbrook facility used EtO to sterilize medical devices. The community was alarmed by EPA’s findings, and the Village of Willowbrook formed a task force to investigate the issue. The task force hired GHD to conduct sampling. One challenge was identifying laboratory methods. Several options exist for collecting air samples in workplaces, Chandler said, but criteria for community exposures were much lower.  “We were unable to initially find a method with a laboratory that gave us a low enough detection limit,” Chandler explained. Eventually, a few labs modified their methods and achieved a detection limit of around 0.02 parts per billion, a level that allowed comparison to some existing limits corresponding to a 1-in-10,000 risk of cancer but not low enough for EPA’s estimated 1-in-10,000 cancer risk level for EtO of 0.01 ppb. Sample collection began in November 2018 following EPA TO-15, Determination of Volatile Organic Compounds (VOCs) in Air Collected in Specially-Prepared Canisters and Analyzed by Gas Chromatography/Mass Spectrometry. By then, Chandler said, the project had drawn the attention of organizations such as the American Chemistry Council and advocacy groups. Willowbrook residents took a keen interest, filling meeting rooms for town hall discussions.  By the time sampling concluded in August 2019, Chandler said his team had taken more than 200 ambient air samples of indoor and outdoor environments, from areas upwind and downwind of the Sterigenics facility. The team consistently found background levels of EtO above the EPA risk criteria up to three miles from the facility. Detectable levels of EtO were found inside residences and businesses.  “Some of the data we collected ultimately was used to issue a seal order to Sterigenics,” Chandler said. Not long after the sampling project ended, Sterigenics announced it would permanently close its Willowbrook plant. REFOCUSING OPERATIONS DURING COVID-19 In June, General Motors was among the businesses already well into their response to COVID-19. Eltaneice Bolden, GM’s global manager for industrial hygiene, shared her company’s efforts to refocus operations during the pandemic with AIHce EXP attendees in a prerecorded session broadcast on June 3.  As a global operation, GM had a preview of what was coming when its facilities in Asia were shut down by government order in the pandemic’s early days. Before GM’s sites in North and South America shut down as well, the company instituted visitor questionnaires that were eventually expanded for use by all employees. At the same time, GM fielded concerns about incoming materials from suppliers around the world. The company began sanitizing shipments prior to arrival. Notices were placed on the containers to indicate they had been sanitized so that employees at GM’s assembly plants would be willing to open them. The company eventually began recommending that anyone who could work from home should do so. In mid-March, Bolden said, came the official shutdown of all nonessential operations. Essential employees continued to work, mostly from home, while several of the company’s U.S. sites remained open to fill critical needs. GM formed a “COVID Team,” comprising representatives from several departments.  Medical staff developed guiding principles, interpreted guidelines, and responded to cases of illness, while safety and industrial hygiene personnel revised the respiratory protection program and developed policies for face shields and for sanitizing shared fall hazard equipment. Members of GM’s facilities team established stepped-up cleaning schedules, and engineering staff helped set up new production lines for some of GM’s COVID-19 response work, particularly for mask production. The company also needed strategies and guidance for managing HVAC, cooling fans, team rooms, and rarely used spaces. Operations personnel managed return-to-work requirements, facility entry points, and social distancing. Chemical risk mitigation, purchasing, and corporate communications were also critical to GM’s response team, Bolden said.  GM also created a comprehensive “playbook” that covered items like the company’s risk mitigation strategy, communication and awareness efforts, sanitization schedules, and approaches to social distancing and ventilation. “When the hourly workforce comes back, they’re going to have nothing but questions and concerns, and we know that,” Bolden said. “So it’s up to us . . .  to know the rules and understand them.” SINCLAIR LECTURE: RECYCLING IN CALIFORNIA Reporter Susie Neilson, a 2019 graduate of the University of California-Berkeley’s School of Journalism, delivered the 2020 Upton Sinclair Memorial Lecture on June 4. Neilson described a project she and her classmates worked on during their second year. “Unseen: Living in the Shadows of the Golden State” focused on workers who are at risk for injury, and who are often denied healthcare, safety training, and legal protection, while working in jobs not often under public scrutiny.  Neilson’s contribution to “Unseen,” titled “On the Line,” was an investigation of the state’s waste and recycling workers. Her research revealed that recycling facilities are tied for the fourth highest occupational injury rate among all American industries. Neilson interviewed workers who spoke of having handled grenades on the line, in addition to dealing with broken glass, dust, and toxic chemicals. Victoria Leon was one of the many people Neilson interviewed over the course of her project. In 2016, Leon was injured on the job. That day, a doctor treated her with pain relievers and minor physical therapy, but over time, Leon found herself increasingly incapable of performing her work. According to Neilson, Leon asked multiple times to see a doctor again, but her supervisor refused. Eventually she was permitted to see a doctor, who dismissed her injury without examining her and asserted that the injury was not work-related. A qualified medical evaluator for the state of California later found that Leon’s injuries were work-related and had left her partially disabled with 40 percent loss in upper body strength. The lawyers who Neilson spoke with for the project stated that while most employers genuinely want their workers to be well, they are often concerned with controlling their company’s healthcare costs. California’s progressive safety laws should protect workers at recycling facilities but are grossly underenforced, Neilson said. She explained that most recycling facilities in the state were not inspected during a four-year period from 2014 to 2018, while between 2015 and 2017 the rate of injuries for recycling workers increased. Neilson said that during the COVID-19 pandemic, recycling plant workers have continued working in close quarters and handling increased amounts of residential waste, some of it contaminated, while lacking appropriate PPE. Neilson’s project, and those of her classmates, can be viewed online. NEUROLOGY FOR LEADERS Leadership—particularly leading people under stress—is a skill that takes years of trial and error to develop. In the Closing Session, broadcast on June 3, René Rodriguez addressed a virtual audience on techniques based in neurology that leaders can use to exert influence. Drawing on the work of Dr. Paul MacLean, Rodriguez illustrated the three systems within the brain: the “reptilian” brain, or basal ganglia; the “mammalian” brain, or limbic system; and the “human” brain, or cerebral neocortex.  The reptilian brain oversees all autonomic functions, such as breathing and heart rate—in other words, survival. In times of extreme stress, this part of the brain takes control, to decide quickly between fight, flight, or freeze responses. During this time, the systems in the higher parts of the brain, including the limbic system, which governs memory and logic, and the neocortex, which is responsible for planning and predicting outcomes, go dormant. People under extreme stress make quick decisions to ensure their survival, not well-thought-out plans. Unfortunately, during the uncertainty of the COVID-19 pandemic, many people’s brains are currently operating in this state, Rodriguez said. A leader’s job, Rodriguez said, is to inspire a sense of safety and allow people to engage the functions of their limbic system and neocortex. Once a leader has assured people that their basic physical and social needs have been met, they are in a position to make logical, long-lasting decisions, he explained. To inspire change, according to Rodriguez, leaders need to appeal to others’ values and their desire for community through effective communication. Rodriguez described a communication technique called “framing,” a way of answering questions or communicating information that encourages the listener to make a personal connection with the speaker.  “A powerful frame can cause an internal shift in us emotionally,” Rodriguez said. “If you could relate to that frame, if that triggers a value set inside you, [then] you’ve connected.” WHAT HAPPENS NEXT YEAR? As this issue of The Synergist went to press, AIHA was preparing to hold AIHce EXP 2021 in Dallas, May 24–26. The health and safety of attendees is of paramount concern, and plans may change as the conference draws closer. For the latest information, visit the conference website.   KAY BECHTOLD is managing editor of The Synergist.

ED RUTKOWSKI is editor-in-chief of The Synergist. Send feedback to The Synergist.