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Preventing Illness and Injury in the Workplace

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Preventing Illness and Injury in the Workplace Preventing Illness and Injury in the Workplace April 1985 NTIS order #PB86-115334 Recommended Citation: Preventing Mness and Injury in the Workplace (Washington, DC: U.S. Congress, Office of Technology Assessment, OTA-H-256, April 1985). Library of Congress Catalog Card Number 84-601152 For sale by the Superintendent of Documents U.S. Government Printing Office, Washington, DC 20402 Foreword Congressional interest in work-related disease and injury led to the passage of the Occupational Safety and Health Act in 1970. The Occupational Safety and Health Admin- istration and the National Institute for Occupational Safety and Health were created to administer that Act, which stated an ambitious goal: “to assure so far as possible every working man and woman in the Nation safe and healthful working conditions. ” This report responds to a request from the Chairman of the House Committee on Energy and Commerce and a supporting letter from the Chairman of the Senate Com- mittee on Labor and Human Resources. In this report, OTA examines three main topics: identification of occupational hazards, including the available data on injuries and ill- nesses; development of control technologies for reducing or eliminating workplace haz- ards; and the incentives and imperatives that influence decisions to control hazards. Workers, employers, health and safety professionals, and government officials have all contributed to progress in this field. But improvements can still be made. More con- certed effort and better use of existing methods would enhance hazard identification. Further research could improve health and safety control technologies and contribute to their incorporation in U.S. workplaces. Employers’ decisions to control hazards might be fostered by changing the incentives and imperatives that affect those decisions. In preparing this report, OTA staff drew upon the expertise of members of the assess- ment advisory panel and contractors, as well as other experts in the field of occupa- tional health and safety. Contractors’ reports are available from the National Techni- cal Information Service. In some cases, contractors’ opinions and viewpoints differ from those in this report. Drafts of the final report were reviewed by the advisory panel, chaired by Dr. Morton Corn; executive branch agencies, congressional staff, and other knowledgeable individuals and groups. We are grateful for their assistance. Key OTA staff involved in this assessment were Michael Gough, Karl Kronebusch, Hellen Gel- band, Gwenn Sewell, and Beth Bergman. Denny Dobbin worked on this report while on detail from the National Institute for Occupational Safety and Health. Director Ill ADVISORY PANEL FOR PREVENTING ILLNESS AND INJURY IN THE WORKPLACE Morton Corn, Chair Department of Environmental Health Sciences The Johns Hopkins School of Hygiene and Public Health Baltimore, MD Duane L. Block Samuel Milham, Jr. Ford Motor Co. Washington State Department of Social Dearborne, Ml and Health Services Olympia, WA Richard F. Boggs Organization Resources Counselors, Inc. Kenneth B. Miller Washington, DC Workers Institute for Safety and Health Mark R. Cullen Washington, DC Yale Occupational Medicine Program Ted E. Potter Yale University School of Medicine Shepherd Chemical Co. New Haven, CT Cincinnati, OH Philip E. Enterline Graduate School of Public Health Milan Racic Pittsburgh, PA Allied Industrial Workers Union Milwaukee, WI Melvin W. First Department of Environmental Health Sciences Mark A. Rothstein Harvard School of Public Health West Virginia University College of Law Boston, MA Morgantown, WV Matthew Gillen Marilyn Schule Amalgamated Clothing and Centaur Associates Textile Workers Union Washington, DC New York, NY Melvin Glasser Michael O. Varner Committee for National Health Insurance ASARCO, Inc. Washington, DC Salt Lake City, UT William J. McCarville James L, Weeks Monsanto Co. United Mineworkers of America St. Louis, MO Washington, DC Wilbur L. Meier, Jr. Roger H. Wingate Dean, School of Engineering Liberty Mutual Insurance Co. (retired) Pennsylvania State University Mirror Lake Post Office, NH University Park, PA John Mendeloff, Special Consultant University of California—San Diego La Jolla, CA OTA PROJECT STAFF–PREVENTING ILLNESS AND INJURY IN THE WORKPLACE Roger C. Herdman1 and H. David Banta,2 Assistant Director, OTA Health and Life Sciences Division Clyde J. Behney, Health Program Manager Michael Gough, Project Director Karl Kronebusch, Analyst Denny Dobbin, Analyst3 Hellen Gelband, Analyst Gwenn Sewell, Research Assistant’ Beth Bergman, Research Assistant’ Virginia Cwalina, Administrative Assistant Rebecca Erickson, Secretary/Word Processing Specialist Carol Guntow, Clerical Assistant Brenda Miller, Word Processor/P.C. Specialist Contractors Linda Starke (Editor), Washington, DC Robert Arndt and Larry Chapman, University of Wisconsin Margit L. Bleecker, The Johns Hopkins Medical Institutes Jacqueline C. Corn, The Johns Hopkins University School of Hygiene and Public Health Robert Goble, Dale Hattis, Mary Ballew, and Deborah Thurston, Clark University and Massachusetts Institute of Technology Philip J. Harter, Washington, DC John L. S. Hickey, Carol H. Rice, and Brian A. Boehlecke, University of North Carolina INFORM, New York, NY Marthe Beckett Kent, Kensington, MD Judith R. Lave and Lester B. Lave, Pittsburgh, PA Douglas MacLean and Mark Sagoff, University of Maryland W. Curtiss Priest, Massachusetts Institute of Technology Jerry L. Purswell and Roger Stephens, University of Oklahoma Springborn Management Services, Inc., Enfield, CT Ruth Ruttenberg, Washington, DC .— ‘From December 1983. 2Untll August 1983 ‘Detallee from National Inst]tute for Occupational Safety and Health ‘June 1983 -Ju]y 1984 ‘January-June 1983 Contents Chapter Page l. Summary and Options.....,,.....,.. 3 2. Data on Occupational Injuries and Illnesses . 29 3. Health Hazard Identification . 41 4. Safety Hazard Identification . 67 5. Technologies for Controlling Work-Related Illness . 77 6. Technologies for Controlling Work-Related Injury . 103 7. Ergonomics and Human Factors. 123 8. Personal Protective Equipment. 143 9. Hierarchy of Controls ., . 175 10. Training and Education for Preventing Work-Related Injury and illness. 189 11. A Short History of Private and Public Activities. 205 12. Governmental Activities Concerning Worker Health and Safety . 219 13. Assessment of OSHA and NIOSH Activities . ,.. 257 14, Decisionmaking for Occupational Safety and Health: The Uses and Limits of Analysis . 275 15. Incentives, Imperatives, and the Decision to Control . 297 16. Economic Incentives, Reindustrialization, and Federal Assistance for Occupational Safety and Health . 327 17. Preventing Work-Related Injury and Illness in the Future . 345 Appendix A.–Supplemental Information on OSHA and NOSH. 359 Appendix B.—Working Papers. 381 Appendix C.—Acknowledgments and Health Program Advisory Committee . 382 Appendix D.—Glossary of Acronyms and Terms. 386 References . 393 Index . 423 vii . Summary and Options . Contents . 4 Associated Deaths, Injuries, and Illnesses . 4 Identification of Occupat ional Hazards . 6 Technologies to Control Hazards . 7 Training and Education . 10 Dissemination of Health and Safety Information . 11 Incentives and Imperatives That Influence the Decision to Control Hazards . 11 Reindustrialization and Workplace Health and Safety. 15 options for Controlling Workplace Hazards. 16 Data and Hazard Identification . 16 Improved Control Technologies . 18 Education,Training, and Information Dissemination . 19 Incentives and Imperatives . 21 The Role of OSHA. .22 Creation of an Occupational Safety and Health Fund.. 24 The Needs of Small Businesses . .: . 25 Assessing Health and Safety Programs.. 26 — 1 ■ Summary and Options Occupational hazards are not spread evenly: Because the relationship between these hazards Some workplaces, such as banks and offices, have and injuries is usually immediate and direct, rec- few hazards; manufacturing is more dangerous; ognition of the hazards is relatively straightfor- and mining and construction are comparatively ward. The connection between occupational haz- the most hazardous, Certain hazards—some chem- ards and illness is more difficult to pin down. icals and forms of radiation—are concentrated in Although a number of skin and respiratory dis- particular places of work; others—powerful ma- eases and some kinds of poisoning caused by chines and fast-moving machinery—are found metals are definitely associated with work, predominantly in manufacturing and construc- deciding whether other illnesses stem from tion. Each uncontrolled hazard is an opportunity workplace exposures is difficult. for preventing illness or injury. This century has seen some examination of the The exact numbers of workplace-related deaths role of the workplace in injury, illness, and death. and injuries are disputed, but OTA estimates that Motor vehicles used in work are involved in thou- there are about 6,000 deaths annually—about 25 sands of accidents, resulting in many injuries and per working day—due to injuries. Depending on deaths. Construction remains a relatively danger- how injuries are counted, between 2.5 million and ous trade: Powerful earth-moving and erection 11.3 million nonfatal occupational injuries occur machines, high scaffolding, and falling objects are each year. Each working day there are about hazards continually faced by construction work- 10,000 injuries that result in lost work time and ers. Painful and sometimes incapacitating re- about
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