I was born and raised in Panama. Owing to a combination of fortuitous events, my parents opted to move to the United States in the late 1980s, as I was starting my senior year of high school. For the next 20 years I studied and worked in the safety and industrial hygiene fields in the United States, although I “hung pumps” throughout Latin America while employed by a multinational company. The construction boom and growing economy that Panama experienced at the start of the century allowed me to return in 2008. As I immersed myself in the region from a professional standpoint, I quickly learned that great strides were taking place across Latin America in occupational health and safety, but equally large voids were forming in information and focus. Not long after my return to Panama, a local power company asked me to teach a course on illness prevention in welding operations to a group of its contractors. While I was describing metal fume fever caused by exposure to zinc fumes, one of the more experienced participants interrupted me. Addressing the rest of the class, a largely youthful crowd, he said, “When we built the La Fortuna hydroelectric plant [constructed in the ’80s in the western part of the country], we suffered constant fevers, and us welders always thought it was because of the dampness or depth of the tunnels we had to weld and work in. Nobody told us it could be due to exposure to welding fumes! Pay attention to what the instructor is saying. You still have time not to end up like me.”  It was clear to me that the man had suffered some ailments from his labor and was trying to pass down some wisdom. Today, more than 30 years have passed since his exposures. Over that time, I do not know how much headway has been made in work-related illness prevention in this part of the world, but several professionals, myself included, are vying to raise the profile of industrial hygiene and the impact it has on workers’ lives and companies’ bottom lines. 
In North America, one must often explain what an industrial hygienist does. In Latin America, the answer must be developed even further. Culturally in Central America, industrial hygiene still plays little brother in the great family that is the safety, health, and environmental professions. That the word “safety” translates closer to the term “security” in Spanish presents the first obstacle, as one must first clarify that safety is not about guarding installations. In Spain, safety professionals have skirted the issue by referring to themselves as “preventionists.” Calling industrial hygienists “occupational illness preventionists” seems to help the concept sink in.  In many organizations, responsibility for safety and health usually falls to a particular unit, either within human resources, medical, or, if the company is large or multinational, a safety branch. In many other cases, safety and health responsibilities are contracted out to a consultant. But mention “industrial hygiene,” and the buck starts rolling. Industrial hygienists in Central America face a bigger challenge in finding (top) management support than their colleagues in the U.S. because industrial hygiene may not have a place within their company’s organizational chart. For this reason, it is even more difficult to convince upper management of the value our profession adds to profitability through the betterment of workers’ health and to persuade them to include health-related objectives within performance goals or the organizational structure.
In Latin America, industrial hygiene (and safety) regulations are difficult to talk about in general because of the differences among countries in population size, economic development, and industries. Overall, local regulations vary widely in scope, ranging from the very general to the very prescriptive. The conversation turns even fuzzier if we talk about regulations specific to illness prevention or industrial hygiene versus accident avoidance or safety.  Latin American countries and territories with more robust regulations include Puerto Rico (where OSHA has jurisdiction), Mexico (whose norms are heavily influenced  by OSHA), Colombia, Peru, Brazil, Chile, and Argentina. These countries have exploited mineral deposits, oil fields, and their related industries; they also have large agricultural and textile activities and, therefore, more specific standards and regulations. The economies of smaller Central American countries are heavily based on services; therefore, safety and industrial hygiene regulations might not be as comprehensive. For example, the U.S. has a separate standard for confined space requirements, but in Panama these requirements amount to a handful of articles within a general standard.  In Central America, an OHS professional must be aware of jurisdictions that have few regulations but very strict requirements on specific hazards, such as radiation or asbestos. Some jurisdictions have regulations that are overly prescriptive or that lack definitions. For example, a reference standard for noise in Panama requires audiograms but does not specify trigger points. Colombia is struggling with a recent law that requires documented management systems for all employers regardless of size or operation, and another requirement that compensates workers with early retirement if they can prove exposure to heat stress.  In Panama, three technical standards related to industrial hygiene are worthy of note. These standards, all published between 2000 and 2001, regulate exposures to chemical substances, noise, and vibration. Among their merits, these standards require new workplaces to be designed so that exposures do not to exceed occupational limits; they also require hazard communication information in Spanish, medical surveillance, and adherence to the hierarchy of controls. Shortcomings include the high frequency of chemical substance monitoring—monthly or biweekly if exposures are up to three times or greater than three times the exposure limit; the establishment of the ACGIH Threshold Limit Value as a legal requirement, against ACGIH’s recommendation; and the lack of revision since the standards were introduced. Examples of the incorporation of hygiene aspects into regulations include a Panamanian regulation promulgated by the social security system for general industry and one from Panama’s ministry of labor for the construction industry, both of which require the establishment and implementation of “occupational health, safety, and hygiene” programs and committees. 
Culturally in Central America, industrial hygiene still plays little brother in the great family that is the safety, health, and environmental professions.
Although nowadays compliance should be the most basic driver for the implementation of health management systems, government inspection and oversight can be an important ally for organizations with mature health and safety cultures. But in Central America, lax enforcement of regulations can be an issue. Enforcement varies greatly from country to country. Local governments may not devote enough resources to ensure the regulations they promulgate are followed, and government health and safety inspectors often end up migrating to private industry, which can offer more appealing salaries and benefits.

Noncompliance with health and safety regulations usually results in minimal monetary penalties. Fines in Panama, for example, range from US$50 to US$1,000. Government entities are increasingly taking aggressive action for egregious violations, such as shutting down work sites and pursuing legal action against corporate officers, but those violations almost always involve the extreme case of fatalities from accidents, not occupational diseases. OHS professionals in Central America should avoid using the threat of fines to justify investment in industrial hygiene because, due to low monetary penalties, such an argument may not have the same impact with line managers or clients as it does stateside.

Except for large regional or multinational companies with internal requirements or social and environmental responsibility programs, lawsuits may not present a deterrent either. According to local contractors, estimated settlement costs for a fatal accident may add up to US$15,000 to US$20,000—a low figure when compared with U.S. compensation rates.

The old joke goes that OSHA is not a small town in Wisconsin. Well, it is not a city in Mexico either. Several popular reference documents and standards from OSHA and NIOSH have been translated into Spanish, but OSHA’s literature in particular is not always appropriate for the Latin American audience because the agency’s focus is, appropriately, on the Spanish-speaking work force in the U.S.

More useful Spanish-language references—owing to their general, non-country-specific regulatory nature— include those from the World Health Organization, the International Organization for Standardization, the European Agency for Safety and Health at Work, and the International Labor Organization. ILO’s recent “World Day for Safety and Health at Work” campaigns, commemorated every April 28, have emphasized occupational illness-related topics including prevention of occupational diseases, chemicals at work, and workplace stress. Spain’s National Institute for Occupational Safety and Health also has useful technical bulletins, some based on research from U.S. NIOSH. ACGIH is widely known and respected throughout Central America. Industrial hygiene associations from Mexico and Colombia have gone to great length and expense to have the TLV booklet translated into Spanish every two years.

In-country assistance can always be found through local professional associations. Mexico and several countries in South America have thriving associations dedicated to industrial hygiene promotion, education, and networking. By contrast, in Central American countries—including Guatemala, Costa Rica, and Panama—these organizations more broadly group occupational safety and health professionals. Also, some entities at the regional level, be it Central America and the Caribbean or Latin America as a whole, incentivize common goals and objectives by organizing conferences and training programs.

Another major obstacle to overcome for the industrial hygiene profession in Latin America is the lack of data on occupational illnesses. In the U.S. and England, the Bureau of Labor Statistics and the Health and Safety Executive, respectively, deliver annual reports on incidents, injury and illness rates, and estimated costs, breaking down accidents and, more important for hygienists, work-related diseases. Additional studies yield, for example, specific numbers of deaths according to the type of carcinogens involved (fibers, chemicals, radiation, particles, fumes, and so on). These types of databases, statistics, and research projects are rare in Central America, but the information they provide is necessary to establish the benefits of identifying and controlling hazards, measuring progress over time, or setting policies.

Another challenge is informal employment, which accounts for a significant percentage of Central America’s total employment. It is common for people in the region to perform odd jobs on an infrequent or temporary basis or move from one craft to another depending on remuneration or other factors. These workers may experience temporary or permanent illnesses, but no system or entity is overseeing their work conditions or physical state. Even workers who stay within an industry are likely to jump from one company to the next, or from one type of project to another. This type of turnover complicates companies’ choices when deciding whether to invest in control measures for health effects that may not appear until months or years after exposure.

For the most part, industrial hygienists in Central America are an empirical group—they gain their knowledge by studying overseas, by working for a multinational company, or through self-directed study. Only recently have undergraduate and graduate educational programs surfaced at local colleges, and most classes are taught not by full-time professors but by practitioners who moonlight as course instructors. This is the natural progression of a growing field within the realm of occupational and public health. But because of language barriers to other sources of technical information and current studies published in English, a gap in knowledge and information remains. This gap must be filled.

Mesoamerican nephropathy, also known as chronic kidney disease of unknown etiology, is the region’s most important health issue. This epidemic has killed thousands of workers over the past two decades, mainly young males in rural agricultural communities such as sugarcane plantations. This disease is also seen in other regions of the world, such as Sri Lanka, Egypt, and India. The international community has united to tackle this epidemic. Local industrial hygienists and public health experts have complemented the research performed in this area to identify probable causes, which include excessive heat, exposure to agrochemicals and heavy metals in soils, dehydration, or a combination of these factors.

Industrial hygienists in Central America often find themselves riding on the coattails of more established professions, such as environmental health and safety. For example, fence-line noise monitoring for environmental permits is commonplace at construction sites; from there, a shrewd hygienist might introduce noise dosimetry. During accident investigations, an industrial hygienist can expand on issues such as the effects of illumination or human factors on performance. Safety and health audits also provide an opportunity to emphasize compliance with hygiene-specific standards and best practices, even if they are documented as recommendations.

As these countries’ economies grow, occupational diseases will continue to outpace accidents. The small group of industrial hygienists based in Central America will keep shining a spotlight on our cause and improving our numbers and our expertise for the benefit of the health of our workers and their employers.

EDUARDO SHAW, CIH, CSP, is an occupational safety and industrial hygiene professional in Panama. He can be reached via

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Industrial Hygiene in Central America and Panama

“Preventionists” On The Rise
Aerial view of Panama City, Panama