This month, Kerry announced, the one millionth baby will be born HIV-free to an HIV-positive mother because of PEPFAR support. US Global AIDS Coordinator Eric Goosby spoke to AFP about this achievement. AFP’s Jo Biddle writes:

The program was working to “virtually eliminate pediatric HIV by 2015 and keep their mothers alive,” he said, with the aim of reducing the number of babies born with the infection to around 30,000 annually.

This involves not just identifying the mother, but getting her on a drugs program and keeping her in treatment through the pregnancy and any later ones — not always an easy task in rural Africa.

The chances of a mother infecting her baby once stood at around 30 percent, but now, with the launch of a cocktail of three anti-retroviral drugs, that has dropped to only about two percent, Goosby said.

In his remarks about the program’s 10th anniversary, Kerry also celebrated the fact that 13 countries have reached a “tipping point” at which the number of new adult HIV infections each year is below the annual increase in adults on ART — a point only seven countries were deemed to have reached last year. “This remarkable progress is thanks to the combined and coordinated efforts of all partners involved in the fight against global AIDS,” Kerry said.

It’s harder to feel celebratory about the HIV situation here at home, as some noted on World AIDS Day last December. As we mark the 10th anniversary of PEPFAR, though, it’s worth applauding the bold global approach to tackling a disease that was once a certain death sentence.

NPR Staff on All Things Considered: Water Wars: Who Controls the Flow?

Maryn McKenna at Superbug: The Risks You Don’t Think of: A Plea to Pack a ‘Go Bag’

Dwyer Gunn at Gothamist: Why Working Class Women Are Better Off Injured Than Pregnant

Jay Hancock at Kaiser Health News: Hospital CEO Bonuses Reward Volume and Growth

Brad Plumer at Wonkblog: Why does the government encourage people to build homes in wildfire zones?

An analysis by researchers with the National Institute for Occupational Safety and Health (NIOSH) suggest the answer is “yes.”  Their paper, “Effectiveness of Taxicab Security Equipment in Reducing Driver Homicide Rates,” was published this month in the American Journal of Preventative Medicine.  They analyzed 15 years of data (1996-2010) from 26 large U.S. cities.  Eight of the localities had ordinances or industry practices that led to at least 70 percent of  taxicabs being equipped with security cameras.  (Those cities were Austin TX, Dallas TX, Houston TX, Las Vegas NV, Orlando FL, Portland OR, San Francisco CA and Seattle WA.)  Another seven cities had at least 70 percent of taxicabs fitted with bullet-proof partitions which separate the driver from the passengers.  Eleven other large municipalities without camera- or partition-equipped cabs were used as the reference cities.

Among other things, the authors assessed changes over time in cab driver-specific homicide rates before and after bullet-resistant partitions and cameras were installed.  In the cities with taxicabs equipped with cameras, and after adjusting for each cities’ change in overall homicide rates, they reported the cab driver-specific homicide rate was 3.7 times lower in the post-installation period.  Some of the cities’ ordinances, the authors note, require a decal be displayed inside the cab to alert passengers they are under camera surveillance.   The installation of bullet-proof partitions, in contrast, was not associated with a change in driver homicide rates.  The authors write that this finding was “unexpected.”   Bullet-resistant partitions are:

“designed to give more power to the driver than to the passenger in regard to control of physical space.  Additionally, it separates the target (cash held by driver) from the perpetrator.”

As reported, however, in 2010 in the Chicago Tribune

“But many drivers say the partitions are useless. Most don’t keep the partitions closed because they’re cumbersome and restrict ventilation. And they say the partitions are awkward for passengers, who scrape their knees as they get in and out of the vehicles, and for drivers, who can’t move their seats back.  In the end, cabdrivers say, the partitions didn’t prevent crime.  ‘If someone wanted to rob me, they’ll get out, come to the passenger side and shoot me,’ said Folarin Odusanya, 48, who has driven a taxi in Chicago for 20 years.”

In response to the fatal assault last week on Mr. Orji, Fernando Mateo with a taxi driver’s union told the New York Times

“’Our drivers get robbed and assaulted every single day.’  He said that about 300 assaults and robberies of taxi drivers occurred in New York City every month, and that 10 percent of livery-cab fares are lost because passengers flee without paying.”

The reporter explained that Mr. Orjji moved to New York City from Nigeria about a decade ago.  He worked long hours as a cabdriver.   His sister-in-law told CBS New York :

“He was a very dedicated, loving father.  An innocent man who was just working hard to make sure his kids eat. Everything he wanted to do was take care of his children. It’s horrible.”

Under New York City laws, livery vehicles are supposed to be equipped with a bullet proof partition or an approved surveillance camera system.  One news report indicated that Mr. Orji’s vehicle—-likely his personal vehicle—had neither.    The peril of a parent trying to make ends meet.

Low wages and insufficient benefits for Walmart workers don’t just affect workers and their families. Low-wage workers often need to rely on public benefits for healthcare, food, and other necessities for themselves and their families. A recent report by Congressional Democrats calculated that one Wisconsin Walmart supercenter likely costs taxpayers $900,000 a year when public assistance costs for the store’s employees and their families are added up.

When Elizabeth Grossman wrote last week about the Equitable Food Initiative, which combines respect for farm workers with food safety, one of our readers commented that EFI leading participant Costco has other initiatives to improve the food supply and pays employees well (including good benefits). A recent BloombergBusinessweek piece on Costco explores Costco’s treatment of employees, which is in stark contrast to Walmart’s. Brad Stone writes:

Despite the sagging economy and challenges to the industry, Costco pays its hourly workers an average of $20.89 an hour, not including overtime (vs. the minimum wage of $7.25 an hour). By comparison, Walmart said its average wage for full-time employees in the U.S. is $12.67 an hour, according to a letter it sent in April to activist Ralph Nader. Eighty-eight percent of Costco employees have company-sponsored health insurance; Walmart says that “more than half” of its do. Costco workers with coverage pay premiums that amount to less than 10 percent of the overall cost of their plans. It treats its employees well in the belief that a happier work environment will result in a more profitable company. “I just think people need to make a living wage with health benefits,” says [Costco CEO Craig] Jelinek. “It also puts more money back into the economy and creates a healthier country. It’s really that simple.”

In February, Jelinek set Costco’s convictions in ink, writing a public letter at the behest of Nader, urging Congress to increase the federal minimum wage for the first time since 2009. “We know it’s a lot more profitable in the long term to minimize employee turnover and maximize employee productivity, commitment and loyalty,” he wrote.

… Costco’s constitutional thrift makes its generous pay and health packages all the more remarkable. About 4 percent of its workers, including those who give away samples and sell mobile phones, are part-time and employed by contractors, though Costco says it seeks to ensure they have above-industry-average pay. And while Walmart, Amazon, and others actively avoid unionization, Costco, while not exactly embracing it, is comfortable that the International Brotherhood of Teamsters represents about 15 percent of its U.S. employees. “They are philosophically much better than anyone else I have worked with,” says Rome Aloise, a Teamsters vice president.

…Many conscientious companies such as Costco are performing well financially. Over the last few years, Nordstrom (JWN), the Container Store, Sephora, REI, and Whole Foods Market (WFM), all of which are known for treating employees well, have outpaced rivals. “This is the lesson Costco teaches,” says Doug Stephens, founder of the consulting firm Retail Prophet and author of the forthcoming The Retail Revival. “You don’t have to be Nordstrom selling $1,200 suits in order to pay people a living wage. That is what Walmart has lost sight of. A lot of people working at Walmart go home and live below the poverty line. You expect that person to come in and develop a rapport with customers who may be spending more than that person is making in a week? You expect them to be civil and happy about that?”

So far, Costco and other retailers that invest in employees seem to be performing well because customers are willing to seek out a high-value experience. For those of us who have lots of options for where to shop, it’s worth remembering that Costco and Walmart may both be big-box stores, but they treat employees differently.

One report from the BBC describes the factory:

Family members were quoted as saying the factory doors were always kept locked during working hours.

The plant is owned by Jilin Baoyuanfeng Poultry Co. It was only established in 2009 and is not an antiquated facility.

Located around 800km (500 miles) north-east of Beijing, it employs some 1,200 people and produces some 67,000 tonnes of chicken products every year.

Chickens are slaughtered at the plant and then cut up for retail – a process that takes place in cold conditions. Ammonia is used as part of the cooling system and in such plants flammable foam insulation is commonly used to keep temperatures low.
China map

Workplace safety standards are often poor in China, with fatal accidents regularly reported at large factories and mines, says the BBC’s John Sudworth in Shanghai.

Those lax standards are variously linked to corruption, the prioritisation of efficient production over worker safety in building design, and poor enforcement of safety rules.

As Dorry pointed out at the National COSH blog, the fire in Dehui has reminded many of us about past US workplace fires in which lost exits cost workers their lives, from the Triangle Factory Fire in New York to the Imperial Food Plant fire in Hamlet, North Carolina in 1991. The Hamlet fire killed 25 workers; News & Observer reporter Martha Quillin followed up two decades later with survivors and heard of respiratory ailments and other lingering impairments no longer covered by workers’ compensation.

In other news:

Huffington Post: A new NIOSH study conducted at a South Carolina poultry plant found that 40% of workers had carpal tunnel syndrome, and that finding raises fresh concerns about a proposed USDA rule that would let poultry plants increase their line speed.

US News & World Report: The US House of Representatives has passed the Ruth Moore Act, which makes it easier for survivors of military sexual assault to get disability benefits for related post-traumatic stress disorder, and the House Armed Services Committee has approved a National Defense Authorization Act provision that prevents military commanders from reversing servicemembers’ rape convictions. The Senate Armed Services Committee held a hearing on the epidemic of military sexual assaults, and a key issue of discussion was Senator Kirsten Gillibrand’s bill that would give military prosecutors (rather than commanders) discretion over which sexual assault cases should come to court.

OSHA (Work in Progress) blog: The Occupational Safety and Health Administration, along with partners NIOSH and CPWR, is kicking off a second year of the Campaign to Prevent Fatal Falls. The agency has made available free fall-prevention educational resources in many languages.

Boston Globe: Longtime labor union activist Charley Richardson, who died at age 60 of prostate cancer, is remembered as a dedicated activist and an “engaging, caring, wonderful human being.”

Cape Breton Post: Mario Sepulveda, one of the 33 Chilean miners who was trapped underground for 69 days following a mine explosion, spoke at the Mining Society of Nova Scotia’s annual meeting about the importance of respecting miners and following safety rules. Only four of the 33 miners have been deemed fit to return to working as miners, and many of the men — as well as their families — still struggle with psychological repercussions, Sepulveda explains.

The nominee’s written statement was short on details about his vision for OIRA, but in response to a question from Committee Chairman Tom Carper (D-DE), he mentioned three specific priorities:

“Should I be confirmed as OIRA administrator, my top priorities would really be three.  First, I would like to ensure that regulatory review at OIRA occurs in as timely a manner as possible.  That the quality of review remains high, and that timeliness and the notice to the regulated parties and to the public of what the regulatory regime will be will become finalized as effectively and efficiently as possible.”

“Secondly, I would view it as a very high priority to form good and respectful working relationships with the agency heads, with Members of Congress, with others in government, indeed with public stakeholders so that, should I be confirmed as administrator of OIRA, I will have the trust and positive working relationships that are essential to accomplish OIRA’s objectives.”

“Third, I think it’s extremely important to continue the good work that OIRA and the Administration have already been working on to further retrospective review and look back of regulation and our administrative system.  I think it is extremely important that even as we move forward as a country with new regulations, achieving new objectives or furthering old objectives, that we look back at regulations on the books to ensure that there are no longer burdens in place that are not achieving their objectives.”

Several Senators picked up on the timeliness theme.  Senator Carl Levin (D-MI) didn’t mince words in describing OIRA’s role in delaying agencies’ regulatory actions:

“We have now a situation where delays of agencies’ [rules] are chronic.  They [delays] fundamentally undermine the agencies’ ability to effectively execute the responsibilities that those agencies have.   Under the Executive Order which is in affect, EO 12866, OIRA has 90 days to review a draft of a proposed or final rule, there’s one 30 day extension that’s available.  As of May 14, 87 rules have been under review for more than 90 days, 51 have been under review for more than a year.” [00:51:20]

Senator Levin could have also quoted from “Down the Regulatory Rabbit Hole,” a new report by the Coalition for Sensible Safeguards.  It profiles eight regulatory proposals that are caught-up in OIRA’s review process and how the delays adversely impact public health, families and the environment.   I hope someone in the hearing room handed Mr. Shelanski a copy of the report.

Senator Levin asked the nominee:

“What’s your plan to change that situation?”

Mr. Shelanski responded:

“I absolutely share the concern you just raised about timeliness.  Not yet having been at OMB or OIRA , I can’t comment on what might have led to extended review of any particular rule, or what might have led to the number of rules that are under an extended review period, but I recognized that EO 12866 establishes the initial 90 day review process, and it would be one of my highest priorities, should I be confirmed as Administrator, to try to improve the timeliness, and the notice, and the certainty that lends to the regulatory environment.” [00:52:08]

Senator Rob Portman (R-OH) probed Shelanski about the Administration’s failure to publish its semi-annual regulatory agendas, as required by Executive Order 12866.

“For nearly three decades now, OIRA directors and OMBs of both parties have published their plans for new regulations.  They do so twice per year.  It’s an incredibly important opportunity for citizens to see what’s coming up and prepare for it.  That transparency measure is required under President Clinton’s Executive Order and also by the Regulatory Flexibility Act.  It calls for the publication of a regulatory agenda in the spring and one in the fall.  It lets people know what is in the pipeline, which I think is incredibly important, and what the potential compliance costs might be on small business.”

“…Last year, the Spring agenda was never released.    There was no Spring agenda.  It was the first time in decades, to my knowledge….  The regulatory agenda was not released, not in the Spring, not in the Fall, but in the winter, after the Election, on Friday, December 22.  …”

“In your briefing for this hearing, have you learned why OMB decided to skip the Spring regulatory agenda, and push back the Fall regulatory agenda?  Does this represent a policy change?  Are we seeing less transparency from an Administration that has claimed that it is the most transparent in history?” [01:25:13]

Nominee Shelanski responded:

“I share your concerns with transparency and the need to publish the regulatory agenda.  In my preparation for these hearings, being outside of OMB, I have not learned about why one agenda was not published and about the timing of other agendas.”

“Should I be confirmed as Administrator, I think it is vitally important that Americans, businesses, those who would benefit from regulation and those who would bear its costs have notice of what is in the regulatory pipeline. It will be one of my highest priorities to ensure that the regulatory agenda is published, in so far as possible, twice a year and in a timely fashion.”

At this point in the hearing, I wondered to myself whether Mr. Shelanski knew that the Administration has yet to publish it 2013 spring regulatory agenda.

It will be interesting to see how an individual with an affinity for timeliness deals with a backlog of rules “under review” and an office plagued by missed deadlines.

It seems we barely go a week now without news of another violent gun incident. Last week’s shooting rampage in Santa Monica, Calif., has resulted in the deaths of five people. And since the Newtown school shooting last December — in the span of less than six months — thousands of Americans have been killed by guns.

Just a couple days before the Santa Monica shooting, the Institute of Medicine (IoM) and National Research Council released a new report proposing priority research areas for better understanding gun-related violence, its causes, health effects and possible prevention strategies. The report’s authors said a public health research agenda addressing gun violence should address five high-priority areas: the characteristics of gun violence, risk and protective factors, prevention and other interventions, gun safety technology, and the influence of video games and other media. The research agenda was designed to produce results within three to five years.

The report was developed in response to a presidential executive order made in the wake of the Newtown school shootings and which charged the Centers for Disease Control and Prevention with identifying priority firearm-related violence research needs. President Obama also called on lawmakers to provide $10 million in funding to CDC to support gun violence prevention research. Of course, whether that funding becomes a reality is up to appropriators in Congress.

Conducting the research won’t be easy, as there is currently no central repository for data on gun ownership, distribution, acquisition and storage. CDC does oversee the National Violent Death Reporting System; however, that system only collects data from 18 states and the data is limited. Still, CDC estimates that violent deaths cost the country $60 billion in medical costs and lost productivity every year.

In a National Academies news release, Alan Leshner, chair of the IoM Committee on Priorities for Research to Reduce the Threat of Firearm-Related Violence, called gun violence a topic of “considerable public health importance.”

“Therefore, when developing its agenda, the committee took a public health approach that focused on gun violence problems associated with significant levels of injuries and fatalities,” Leshner said. “Although this research agenda is an initial, not all-encompassing set of questions, it could help better define the causes and prevention of firearm violence in order to develop effective policies to reduce its occurrence and impact in the U.S. Similar approaches to public health problems have produced successes in lowering tobacco use, accidental poisoning and motor vehicle fatalities.”

On the prevention and intervention front, the IoM report stresses that any successful intervention must involve cross-sector collaboration. Authors also note that the effectiveness of firearm-related violence prevention is mixed and not well understood. For example, policies that set time limits on alcohol sales in bars and clubs have been linked to reduced violence, while firearm safety education in schools has been shown less effective. The authors write:

The evidence generated by implementing a public health research agenda can enable the development of sound policies that support both the rights and the responsibilities central to gun ownership in the United States. In the absence of this research, policy makers will be left to debate controversial policies without scientifically sound evidence about their potential effects.

The U.S. is home to the highest rate of firearm-related deaths in the industrialized world, with suicides significantly outnumbering homicides in all age groups. In 2010, more than 105,000 people were injured or killed with a gun.

To read the full IoM report, click here.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.

In January, federal OSHA issued 14 willful and 11 repeat violations to Panthera Painting for exposing its employees to lead.  The workers were using abrasive blasting equipment to remove lead paint from several bridge structures over the Pennsylvania Turnpike and along Interstate 81.  The OSHA inspector described how the Panthera crews didn’t have the proper equipment or training to do their jobs in ways to minimize exposure to lead dust.   Their exposure to lead exceeded OSHA’s permissible exposure limit (PEL) of 50 ug/m3.  One worker, called the “Blaster,” was exposed to a lead concentration that was five times OSHA’s PEL.  The crews also didn’t have appropriate respiratory protection.  The OSHA inspector noted that one worker simply had a shield taped to the front of his hard hat.  Another didn’t have new filter cartridges for his respirator, “so he wore the old ones and tied his shirt over his face,” the inspector wrote.

A New Hampshire firm, Franklin Non-Ferrous Foundry, received citations from OSHA last year for exposing workers to lead at concentrations as much as 1.7 times the permissible exposure limit.  The employer failed to maintain its equipment in the ways designed to control lead exposure.  On issuing the citations, OSHA’s area director commented:

“This employer is well aware of the necessary procedures to safeguard workers against lead exposure hazards, having been cited for 62 violations of OSHA’s lead standard since 1998, yet has chosen again to disregard them.”

And then there’s Welch Group Environmental, a firm that supposedly specializes in lead removal at shooting ranges.  Workers were exposed to 4 times, 8 times, and 9 times the maximum use concentrations of lead, and were not provided the proper respiratory protection.  Citations issued in 2012 by OSHA to the Welch indicate that one worker had a BLL of 61 ug/dL and another’s BLL was 96 ug/dL.  OSHA’s standard, which was adopted in 1978, requires employers to remove a worker from lead exposure when his or her BLL is 50 ug/dL or greater.  Public health experts consider BLLs at  or above 10 ug/dL as “elevated” and recommend interventions.

These examples from OSHA inspection cases are not anomalies.  A new report from the California Department of Public Health (CDPH) provides the latest evidence that thousands of workers in the U.S. get lead poisoning.  It describes the results of blood lead tests conducted in California for the years 2008 through 2011.  (Laboratories conducting the analyses are required by State law to report the results.)    Each year, the CDPH receives about 20,000 results for which the source of lead exposure is known.   About 90% of the cases involve work-related exposures, and between 8-10 percent of the cases show elevated BLLs.  In 2011, for example, the results revealed 1,475 workers tested with elevated BLLs, including 285 with BLLs between 20-29 ug/dL of blood, and another 93 with BLLs at 30 ug/dL or higher.  Elevated BLLs in adults is associated with hypertension, decrements in renal function and cognitive dysfunction.

The CDPH’s report, prepared by the Occupational Lead Poisoning Prevention Program, notes that 96-97 percent of the cases involve male workers.  A large share of the workers with elevated BLLs were employed in storage battery manufacture and battery recycling.  In addition, workers with Hispanic surnames were disproportionately represented among those with elevated BLLs.  The report authors write:

“California’s workforce is 36 percent Hispanic, whereas the proportion of Hispanic surnames among individuals with elevated BLLs reported to the Registry was 64-70 percent.”

A study from 10 years ago found Hispanic workers were overrepresented in Massachusetts’ blood lead registry.

The report also explains why the 1,500 or so California workers identified each year with elevated BLLs is likely an undercount.  Current regulations by federal OSHA and for the states like California that run their own OSHA program (Cal/OSHA):

“…tie BLL testing requirements to air monitoring.  Employer must do initial air monitoring and, if air lead concentrations are above 30 ug/m3 more than 30 days per year, employers are required to provide employees with BLL testing.  Since many employers never conduct the required air monitoring, the BLL testing requirement is not triggered.”

The staff has made recommendations to Cal/OSHA to revise its lead standard.  Specifically, they want a requirement for BLL testing for all workers who “use, alter or disturb lead or lead-containing materials in a way that releases lead dust, mist, fume or other particles,” adding:

“If this recommendation were adopted we expect that the number of workers receiving a BLL test would increase significantly, allowing OLPPP to provide a more complete picture of workplace lead exposure in California in the future.”

The most recent national assessment of lead poisoning prevalence among U.S. workers was published in July 2011 in MMWR.  The numbers total 6,081 cases of elevated BLL in 2008, and 4,998 in 2009.  A substantial number of the workers with elevated BLLs were employed in battery manufacturing, secondary smelting/refining non-ferrous metals, and painting.   The data, based on reports from 40 States for the years 2008 and 2009, only included BLLs at or above 25 ug/dL of blood.   There were hundreds of workers in the dataset with BLLs over 40 ug/dL—918 in 2008 and 668 in 2009.   A panel of scientific experts recommends that workers with BLLs of 30 ug/dL or greater be temporarily removed from the exposure.

The authors of the July 2011 MMWR report write:

“using a threshold of 25 ug/dL likely underestimates harmful occupational lead exposure because lead-related toxicity can occur at levels as low as 5 ug/dL and the Healthy People 2020 target is set at 10 ug/dL.”

The data likely undercounts the number of lead poisoned workers in the U.S. for other reasons.  For one, it does not include data from 10 States (e.g., Arkansas, Mississippi, Nevada, West Virginia.)  More importantly, there’s no way to know how many workers with elevated BLL have not been tested.  As the OLPPP staff note, if employers shirk their duty to do air monitoring for lead, the blood-lead testing requirement isn’t triggered.

That’s why they’ve made recommendations to Cal/OSHA to revise its lead standard to better protect California’s workers.  Specifically, they want a requirement for BLL testing for all workers who “use, alter or disturb lead or lead-containing materials in a way that releases lead dust, mist, fume or other particles.”

Every Tuesday night, the Austin-based Workers Defense Project welcomes standing room-only crowds to its Workers in Action meetings. During the weekly gatherings, low-wage, primarily Hispanic workers learn about their wage and safety rights, file and work on wage theft complaints, and organize for workplace justice.

Once a month, a representative from the local OSHA office would join the Tuesday meeting, giving some of Texas’ most vulnerable workers the chance to meet face-to-face with the agency charged with protecting their health and safety on the job. Unfortunately, due to the federal sequester, OSHA has had to indefinitely suspend its attendance at the meetings, said Jason Cato, workforce development coordinator at Workers Defense Project. It’s a significant loss.

OSHA’s meeting participation often led to critical interactions, Cato told me. Even though Hispanic workers bear a disproportionate burden of workplace injuries and fatalities (recent federal statistics found fatal work injuries increased among Hispanic workers in 2011), a number of barriers may prevent workers from speaking up or filing complaints. But when vulnerable workers meet OSHA reps within the walls of an organization they know and trust, such as Workers Defense Project, it makes a real difference.

“We’ve had years of experience building up trust and organizing in the community,” Cato said. “OSHA has structural barriers to doing that effectively…and so when OSHA comes to us, it allows (the agency) to educate and reach more and more people and follow up on complaints.”

Since February, when OSHA personnel had to stop attending the meetings, Cato said there’s been a decrease in complaints filed between workers at Workers Defense Project and the Austin-area OSHA office as well as a decease in communication between the two organizations — and it’s not because there are fewer violations to complain about. He noted that OSHA’s presence at the meetings allowed workers to interface directly with OSHA and file complaints, which meant Workers Defense Project could direct more of its limited resources toward issues that OSHA doesn’t regulate, such as wage theft. Cato said OSHA’s absence has affected the project’s capacity to deal with workplace hazards.

In addition to the Tuesday meetings, OSHA reps also used to travel to and attend worker safety trainings that the project conducts around Texas. Cato said OSHA’s participation brought with it valuable feedback and assistance. However, sequestration has put a stop to those activities as well, he reported.

“(Sequestration has) had a really big impact on our work and it’s something we experience as a big loss in our service capacity for workers,” he said. “We’ll always be here to help workers carry out complaints and to offer trainings…but it’s the bigger context of how effective OSHA can be nationally and in Texas that’s the real question.”

Sequestration and OSHA: Is the worst yet to come?

Because members of Congress failed to come to an agreement on federal budget cuts, sequestration officially kicked in this past March, enacting billions of dollars in automatic cuts across federal agencies. Neither need nor effectiveness factor in when it comes to sequestration — everyone not specifically exempted in legislation (e.g., Medicaid and veterans’ benefits) got hit. As of today, the sequester represents a 10-year plan to cut $1 trillion in federal spending.  At OSHA, sequestration meant a cut of more than $28 million in its fiscal year 2013 budget.

The run-up to sequestration came with dire warnings from advocates and community-based organizations and, indeed, many important programs, such Meals on Wheels and Head Start, are feeling immediate pain from Congress’ inaction. (More examples of sequestration effects are chronicled in this ProPublica piece.) At OSHA, it seems the impact of sequestration has so far been somewhat minimal; however, some advocates say that — maybe — it’s just that the worst has yet come.

According to reports from a meeting of the American Industrial Hygiene Conference & Exposition in late May, U.S. Assistant Secretary of Labor for Occupational Safety and Health, David Michaels, said this about sequestration: “It’s a huge loss for us. We made the decision when the sequester came down to do everything we could not to furlough our staff. The consequence is that we have to cut everything else.” Michaels said OSHA had to cut back on travel and compliance assistance, such as within the Voluntary Protection Programs, but not on enforcement activities.

Aaron Trippler, director of government affairs at the American Industrial Hygiene Association (AIHA), has noticed the travel cuts. At last year’s AIHA annual conference, upwards of 75 OSHA personnel were able to attend; at this year’s conference, only about nine were in attendance, he said. (He also noted that the conference usually attracts about 100 or so officers from the U.S. Public Health Service Commissioned Corp, but this year he didn’t spot an officer in attendance.) The drop doesn’t seem like a big deal on its face, but it does take a toll on professional workforce development and on the ongoing dialogue between OSHA staff and workplace health and safety professionals in the field, Trippler said.

In terms of the Voluntary Protection Programs, in which employers are recognized for comprehensive safety and health systems, Trippler said compliance assistance cutbacks at OSHA could result in fewer workplaces participating.

“But as far as occupational health and safety and OSHA, I don’t think we’ve seen the full impact of what might take place down the road,” Trippler told me. “What I’m really concerned about is future sequestration because unless something is done, that’s about another $100 billion in cuts (across federal agencies in the fiscal year 2014 budget).”

Trippler said that so far, he isn’t hearing many complaints from the field that can be directly linked to sequestration — mainly it seems that the sequester is simply exacerbating existing issues in the field, such as a cumbersome and drawn-out rulemaking process. On a positive note, he said the less-than-rosy budget outlook is an opportunity for health and safety professionals to get creative — “surely there’s someone out in this profession who can say ‘here’s what we can do to fill the void.’”

“Still, Congress has to step up to the plate, they can’t allow another sequestration to go through across the board,” Trippler said. “I don’t think we can cut back on occupational health and safety anymore than we already have.”

Other groups and advocates involved in OSHA activities are reporting similar perspectives to Trippler’s — that right now, the impacts of sequester aren’t catastrophic, but they’re bracing for the other shoe to drop.

Reports from the field

Laurie Montanus, director of communications at Independent Electrical Contractors (IEC), told me that members aren’t reporting any problems as of yet. However, they will likely feel it in the long-term when OSHA inspectors begin retiring and budget cuts prevent the agency from filling vacant positions. Many IEC members take part in OSHA’s Voluntary Protection Programs, she said, but they need inspectors to certify their participation.

“If there’s fewer number of inspectors to do the same amount of work, it will make it easier for the bad apples to slip through the cracks,” Montanus told me.

Charlie Ayers, president and CEO of the Coordinating Committee for Automotive Repair, a nonprofit that provides safety, pollution prevention and hazmat training for the motor vehicle industry, said he’s “cautiously optimistic.” His organization is a member of the OSHA Alliance Program and he reports that the collaborative relationship they’ve built with OSHA hasn’t yet been affected due to sequestration.

“I can’t really say that we’ve had any difficulties or issues so far,” Ayers told me, “But (our partnership with OSHA) is so very, very important. Keeping our industry safe, clean and green is what we’re all about and having OSHA backing is crucial to our vision, our mission and our goals.”

On the labor side, Peg Seminario, safety and health director at AFL-CIO, noted that many worker centers and Council for Occupational Safety and Health (COSH) groups receive funding via OSHA’s Susan Harwood Training Grant Program, which bring critical education and training to under-served and low-literacy workers in high-risk industries. And Seminario said the next round of Susan Harwood grants could be significantly impacted by sequestration.

She also noted that current cutbacks in OSHA’s travel budget are impacting “basic outreach on health and safety…it can be very problematic because what’s so important is having people come together to share strategies, to come to agreements on problems…you really do lose the feel and the dynamic of when people can come together in person to do that.”

Catherine Singley, senior policy analyst at the National Council of La Raza, the largest Hispanic civil rights and advocacy group in the country, told me that one the organization’s “top priorities is to draw attention to the high Latino (workplace) fatality rate and the factors that drive death on the job for Latinos.” National Council of La Raza participates in the OSHA Alliance Program and works to connect its local affiliates with OSHA personnel and regional offices. Singley said she hasn’t heard from affiliates about any “palpable changes” due to sequestration.

“But we are very concerned about the enforcement and compliance front,” Singley said. “Cuts in OSHA personnel means fewer eyes in the field, fewer inspections in the workplace and frankly, fewer people manning the hotline when there are dangerous conditions for workers to report. …The more urgent and immediate consequences (of sequestration) is the exit of OSHA inspectors from the workplace.”

The question of sequestration’s impact is a topic that National COSH is also trying to answer, said Tom O’Connor, the group’s executive director. So far, there’s little definitive data, he said, but “we’re hearing rumblings.”

“I’ve been sort of surprised not to hear about more problems,” O’Connor told me. “My impression, so far, is that it’s not had a big impact.”

However, he noted that sequestration has had a clear effect on OSHA staff travel, which “impacts OSHA’s ability to have good, strong relations with the community.” Right now, O’Connor said sequestration seems to be exacerbating a long-standing underfunding of OSHA.

“It started out bad and now it’s going in the wrong direction,” he said. “As the economy is expanding and more people are going back to work and a lot of those people are working particularly hazardous jobs, that’s when there’s a need for OSHA to be out there policing work sites. So the timing is unfortunate.”

In Maine, Peter Crockett, director of the Maine Labor Group on Health, reports that the sequestration-related hiring freeze means the state is down from 11 to eight compliance officers. So far, he told me, compliance inspections are running at a normal pace; however, Maine’s construction season is just ramping up and so OSHA’s ability to keep up remains to be seen. Right now, Crockett and his colleagues are sitting tight.

“It’s almost like we can still see the storm clouds,” Crockett said. “But it hasn’t started hailing on us yet.”

(Repeated requests into the Department of Labor’s media relations office to comment for this article went unanswered.)

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.

“If we could get growers to comply with the law, that would revolutionize agriculture in this country,” said United Farm Workers (UFW) national vice president Erik Nicholson  explaining the circumstances that led to the creation of the Equitable Food Initiative. As Nicholson describes it, despite Americans’ intense interest in food and concern for their families’ health, most don’t think much – if at all – about the people who grow, pick and bring this food to market. And while most people not closely involved with agriculture assume that food is grown here under fair and safe conditions and that we have regulations to ensure that this happens, reality doesn’t always match this assumption.

Agriculture has the worst safety record of all US industries, with fatality rates about seven times that of the county’s all-industry average and reported injury rates 3 to 4 times the all-industry figures. “Where are the alarm bells?” asks Nicholson, pointing out that US farm workers continue to die each year from heat, deaths that can been prevented with solutions as simple as shade and water. Average non-supervisory farm work wages are just above federal minimum wage, which means a great many farm workers are being paid the minimum of $7.25 an hour. (Under the Fair Labor Standards Act agricultural work is exempt from overtime, and some small farms don’t have to pay the minimum wage.) Between 2007 and 2009, an estimated 43% of US farm workers surveyed were receiving some form of public assistance. A scan of UFW recent “victories” highlights some of the issues farm workers are grappling with: lack of overtime pay or paid holidays, hazardous pesticide use, health insurance costs, rotation of workers on heavy-labor tasks, and the right to organize.

Nicholson notes the recent increase in food-borne illness and increasing concern about effects of pesticide use, along with the trend toward consolidation in food retailing and ongoing pressure to keep food prices down. “At the end of the day,” he says, “Farm workers are subsidizing this.”

The Equitable Food Initiative (EFI), of which UFW is a founding member, was started to address these issues in ways they typically haven’t been before. By connecting labor and management collaboratively throughout the fresh food supply chain, EFI’s goal, explains project director Peter O’Driscoll, is to ensure not only the safety of food itself but also the health, safety and respect of farm workers and their families. “It’s about changing the culture of compliance,” said O’Driscoll – moving it beyond a “check-list mentality” that focuses on tidying things up for auditors to one that it “ongoing and collaborative.”

When it comes to food safety programs, farm workers have typically not been engaged in any ongoing or substantive way, explained Nicholson. Rather, he said, farm workers have often been discouraged or prevented from sharing information that could jeopardize the outcome of a safety audit. “Our members, many of whom come from generations of farm workers, felt their knowledge and experience was being overlooked,” said Nicholson. (A 2011 survey found that US farm workers had an average of 13 years’ experience.) Many farm workers are still paid not by the hour, but by the piece or volume picked, which discourages anything that would interfere with those numbers. EFI aims to change this whole status quo.

EFI is now in a pilot phase, with one major California-based grower, Andrew and Williamson (A&W), and one major retailer, Costco, fully involved. Food service company Bon Appetit is also involved, as are Farmworker Justice, the Farm Labor Organizing Committee, Oxfam America and Pesticide Action Network North America, among other organizations. Nicholson describes these groups as unlikely “bedfellows” and says that bringing them together through EFI is an “unprecedented opportunity.”  O’Driscoll explained that EFI is currently in discussion with at least eight other companies and that he expects commitments will be forthcoming from companies beyond A&W as well as with other farm worker unions.

Based in Watsonville, California, A&W’s crops include strawberries, tomatoes, and  cucumbers grown both in California and Mexico. They’re a major supplier to Costco. A&W manager Ernie Farley credits both UFW and Costco as instrumental in getting them involved in the program. A&W has experienced food safety issues and wants to, as Farley said, turn that experience “to good.”

Key to the program are worker-management teams that create what Farmworker Justice communications director Jessica Felix Romero calls “a safe environment” for workers and management to discuss concerns that can range from wages, to occupational and food safety issues. Program participants agree to uphold EFI standards that mean increasing existing benefits for workers, but there is no quid pro quo for doing so, explains O’Driscoll. The idea is that both workers and managers will monitor for ongoing compliance with standards set for labor conditions, pesticide use and food safety issues. This kind of dialogue is not typical at a farm level, she explains. Nor is the idea that farm workers would be engaged in ongoing monitoring of growing conditions that could affect food quality and safety. “Let’s be more diligent on a daily basis” and be willing to say when something is “less than 100%” so we can fix it, says Farley. O’Driscoll and A&W manager Ernie Farley call this a cultural change – change that Farley says isn’t easy.

Food safety isn’t the whole focus of EFI’s program, but it’s helped engage both A&W and Costco. “We don’t want to participate in a product that has gotten to us by the wrong practices,” says Jeffrey Lyons, Costco senior vice president for fresh food. “What’s good for the farm workers benefits the entire supply chain,” he says. Better conditions in the field, including higher pay and fully engaging farm workers in delivering a safer and better product, reduces waste and damage and adds value for everyone involved, he explains. “That everyone in the field understands food safety and safe pesticide use, benefits them and their families. These people deserve our respect and deserve to make a fair living. They’re a valuable asset to us,” he says. This may cost Costco a bit more but it pencils out in value, Lyons explains. “We benefit from the quality.” This, he says, more than pays for itself – taking shortcuts, doesn’t.

“We needed to flip the whole narrative,” says Nicholson. Instead of practices that drive prices down at the expense of workers and product safety and quality, we have to figure out “how to have upward price pressure” by increasing value.

EFI, explains O’Driscoll, is now in the process of finalizing a set of standards on labor rights, occupational health and safety (including pesticide management), and food safety that will be used to inform its work. The challenges are substantial, he acknowledges. As we talk, I wonder out loud if such a model of involving workers directly and substantively with their management and the retailers who buy and sell their products, might also help improve conditions in other industries. “Yes,” says O’Driscoll emphatically.

Elizabeth Grossman is the author of Chasing Molecules: Poisonous Products, Human Health, and the Promise of Green Chemistry, High Tech Trash: Digital Devices, Hidden Toxics, and Human Health, and other books. Her work has appeared in a variety of publications including Scientific American, Salon, The Washington Post, The Nation, Mother Jones, Grist, and the Huffington Post. Chasing Molecules was chosen by Booklist as one of the Top 10 Science & Technology Books of 2009 and won a 2010 Gold Nautilus Award for investigative journalism.