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During my long career as an IH ventilation consultant, I’ve had my share of ethical dilemmas. In fact, it seems like I’ve grappled with an ethical issue in almost every consulting job I’ve ever had.
With ethical dilemmas, there is no equation to plug into. But the excellent ethical codes for our profession can provide guidance. Three organizations have produced ethical guidelines for industrial hygienists: the American Board of Industrial Hygiene, the Joint Industrial Hygiene Ethics Education Committee, and the International Commission on Occupational Health.
This article presents three examples of ethical dilemmas I’ve faced. My intent is not to identify or create precedents, or to show the “correct solutions” to ethical problems. Perhaps my choices, right or wrong, can help you think about how you might handle ethical issues. Names, dates, and other details of each case have been changed so that no one can be identified. WORKERS FIRST I was having an informal lunch-time chat with Steve, a 60-year-old worker at a recycled oil and solvent refining company where I was evaluating the exhaust ventilation system. He had recently been told in a personal medical exam that he had early-stage chronic kidney disease (CKD). Although Steve knew (from reports from his company) that his measured time-weighted average (TWA) exposure levels to solvent vapors were below both OSHA permissible exposure limit (PEL) and ACGIH threshold limit value (TLV) standards, he wondered whether he was at risk for faster CKD progression because of his continuing work with solvents. And he was also worried that if he told his employer about his kidney deficiency, he might be forced into early retirement.
I am neither a toxicologist nor an MD. I knew that poor kidney function was sometimes related to solvent exposures, but I was unsure at that time what exposure concentrations might be safe or harmful for Steve, in his situation, and I told him all that. (The Journal of the American Society of Nephrology published a thorough study on solvents and CKD in 2006.) Steve thanked me, but then asked me not to tell anyone about his problem. “I spoke to you in confidence,” he said. “I’ll just take my chances. Don’t worry about it.”

What would you do in these circumstances? What is the ethical thing to do?
The ICOH Code of Ethics states that “the purpose of occupational health is to serve the health and well-being of workers.” I didn’t know of that specific statement at the time, but that principle had been drummed into my head during my early days working at NIOSH. I think most IHs recognize and share that value. 
I went to see the person overseeing IH activities at the plant. I told her, “What if you found out that one of your solvent refining employees had a kidney deficiency? What would you do?”
She responded, “That’s happened before, a few years back. It’s our policy to move an employee like that to a job with little or no exposures to solvents. And we’d get him on a regular testing schedule to track his kidney function. We don’t generally advertise that policy, though, because we don’t want everyone trying to get out of the refining area.” 
“Well,” I told her, “one of your employees has early-stage CKD, and he swore me to secrecy. But you might let your policy be known to the group over in the solvents section, and he’ll likely come forward.” And that’s what happened. Steve works in the office now, handling shipping and receiving for the plant. And he is in a program to monitor his CKD.
Now, that story had a happy ending. But did I do the right thing? Did I handle the ethical problem in the best way? You can probably think of several different ways of handling it with potentially equal or better outcomes. STANDARDS OF PRACTICE I was once retained to assist with a paint booth ventilation survey in a plant that fabricates farm tools and parts. In the course of my work I noticed that welders in another part of the building were likely being overexposed to welding off-gassing products.
I had no exposure data or ventilation measurements, but I’ve seen many welding ventilation systems over the years. Welders at this plant, while doing very simple, repetitive work, were served by ventilation systems that obviously wouldn’t meet ANSI Z9.2 or ventilation standards from the American Welding Society or OSHA. I also noticed that the welders were young, probably in their late teens or early twenties.
At one of our meetings with the paint shop manager, Ron, I shared my observations and concerns. Ron responded that he had no responsibilities for the welding area of the plant but told me that management had adopted a policy of hiring young high-school graduates just out of their high school mechanics class, giving them a quick welding training course, and then transferring or laying them off after 4-6 months of welding.
This “early out” approach, Ron explained, was intended to provide adequate protection for the young welders because they “wouldn’t be exposed long enough to cause permanent damage to their health.” I asked about OSHA, but OSHA hadn’t visited the plant in several years, and since the plant had had no ventilation citations in the past, management either wasn’t concerned or they were naïve about IH and welding ventilation standards. I suggested he might look into the problem, but he shrugged and said, “They’ve heard it all before. And it’s not my shop. It wouldn’t do any good.” Our conversation turned back to my project, and I didn’t share with him that OSHA rarely gives citations for its mostly outdated exhaust ventilation standards unless the breathing zone exposure exceeds the PELs.
What to do? After weighing my options and potential actions, I called the area OSHA office. I told an official I knew there what I had seen and suggested they might want to schedule an inspection.
After a couple of months, I got a call from Ron saying that OSHA had come in and, after an inspection, had issued a General Duty Clause citation requiring the plant to bring their welding ventilation systems up to standards of practice. The plant was not going to challenge the citation and was taking steps to upgrade the ventilation. Would it be okay if they contacted me? 
I think he suspected I might have had something to do with OSHA’s visit, but we didn’t talk about it. He seemed a little sheepish to me on our final phone call. (The plant never called me.)
Again, was this the best way to handle a tricky situation? Should I, for example, have written a letter to plant management instead? (Paragraph 5 of the ICOH Code of Ethics suggests, in the case of management’s unwillingness to take steps to remedy a situation that presents evidence of danger to health or safety, the OH professional should make his or her concern clear, in writing, to management, stressing the need to take into account relevant standards.) Or should I have gone straight to the welders and told them I thought they might be in danger and to complain to management, or to call OSHA themselves? What other options come to your mind? LEGAL COMPLICATIONS I was asked by an international industrial firm’s attorney to assist in a case where a class-action suit had been brought against the firm for illnesses suffered by former employees who claimed they were overexposed to silica because of poor ventilation, among other things. The firm had denied responsibility for the illnesses and was fighting the case.
At a kick-off meeting in the attorney’s office, I was asked to review several plants’ mechanical records as far back as the 1960s and identify any mechanical ventilation plans, specifications, or testing reports that could conceivably be used to support their position that the ventilation was adequate and they were complying with recognized standards of practices of the time. I was also asked to explain any deficiencies I found so the lawyers could prepare for the hearings. That seemed okay, so far.
Then I was instructed to prepare a verbal report to be delivered during an “informal” meeting with the attorney in a restaurant. I was to put nothing in writing, and nothing was to be sent directly to the firm. I was told to bill the firm for my time and to identify my work as “routine IH activities.” I was not to be included in the official legal proceedings because the attorney didn’t want the other side to know what I had discovered or have access to me.
The whole thing made me nervous. It seemed extreme. And I was not really privy to the legal maneuvers used in such cases. Nothing I was asked to do seemed illegal, but the ethics, morality, and fairness of the process, especially for those sick workers, didn’t seem quite right.
I didn’t know what to do for several weeks. Then a good friend of mine, a noted IH experienced with legal proceedings and expert witness affairs, offered what I considered to be my best option. He suggested I simply not complete the job. “Tell them you’re not comfortable doing the work. You don’t need to give them any other reason.” And that’s what I did.
But did I do all that was ethically required of me? Did I overreact? Did I let the workers down? What do you think? THREE LESSONS In all three of these cases, several factors stand out. First, not letting people know they are out of compliance with current standards of good practice is unethical. Second, the main rule when it comes to ethics is to do that which is “right.” Third, don’t be lulled into a false sense of security by rationalizing yours or others’ unethical behaviors and actions.
The sidebar provides a three-step process you might consider when you are confronted by an ethics issue. You’ll probably think of several options and actions you could take. This three-step process can help you decide what to do. D. JEFF BURTON, MS, PE, is a past president of AIHA, chair of several ANSI Z9 ventilation committees, and a former CIH and CSP who is well known for his work and authorship in ventilation, IH training, and ethics.
Steps to Resolving an Ethical Dilemma The following steps are derived from ethical guidelines issued by Loyola Marymount University.
Step 1: Consider the consequences. For each option, make a list of those who will be helped if you acted, and make similar lists of those who will be hurt or negatively affected. Next, ask yourself the following questions:
  • What levels of benefit and harm are involved for each option? Some issues—worker health, for example—are more valuable than others, such as corporate quarterly profits.
  • What is likely to happen over both the long run and the short run? For example, is avoiding a short-term embarrassment for your boss as important as saving a worker from long-term health problems?
After considering each option, determine which one seems to offer the most benefit and the least harm.
Step 2: Analyze potential actions and behaviors. Instead of thinking about consequences, ask yourself:
  • How does each potential action fit with traditional moral principles?
  • Do any of the actions you’re considering “cross the line” in anything from decency to any of the ethical principles found in the three IH Codes of Ethics?
Again, choose an option whose actions are least problematic.
Step 3: Make a tentative decision. Ask yourself, “How will I feel if I actually go forward with this decision?” If you have doubts, repeat Steps 1 and 2 until you are comfortable.
Few Easy Answers
Case Studies in IH Ethics