Frances Perkins is Rolling in Her Grave

Earlier this week, the Bush Administration released its semi-annual regulatory plan (71 Federal Register 72725, Dec 11, 2006).  The 473-page document describes the Presidentâs regulatory priorities, with the âaim of implementing an effective and results-oriented regulatory system.â  The document, prepared by the Office of Management and Budgetâs (OMB) Office of Information and Regulatory Affairs (OIRA), provides plenty of fodder for the blogosphere, but Iâll focus here on just one absurd statement in the Department of Laborâs section (beginning on page 72828) describing its 19 high-priority items.  Here's what the document says about crystalline silica:

âThis substance [silica] is one of the most widely found in workplaces, and data indicate that silica exposure may cause silicosis, a debilitating respiratory disease, and perhaps cancer as well.â

Three statements from this 30-word sentence irritate me.  First, the âperhaps cancer as wellâ phrase makes light of the known risk of lung cancer for workers exposed to respirable silica dust.  It disregards the 1997 conclusions of the International Agency for Research on Cancer (IARC) that silica âis carcinogenic to humansâ and the 2000 finding of the National Toxicology Program (NTP) that silica is âknown to be a human carcinogen.â  It also ignores at least a dozen studies published after the NTP 2000 designation, including Steenland, Mannetje (Cancer Causes and Control, 2001) ; Zeka, Mannetje, et al (Epidemiology, 2006); Pelucchi, Pira, et al (Ann Oncol, 2006); Wernli, Fitzgibbons, et al (Am J Epidemiol 2006); Marinaccio, Scarselli, et al (Occup Environ Med, 2006); and Cassidy, Mannetje, et al  (Epidemiology, 2006).

Is the âperhaps cancerâ phrase just a case of sloppy report drafting by officials in OIRA or Secretary Chaoâs office?  I doubt it.  I suspect something more troublesome: senior Administration officials are trying to soothe their friends in the construction and mining industries who insist that more scientific research is necessary before silica is called a carcinogen.  These same industry officials have insisted for decades that a new workplace health standard for silica is not necessary, claiming that new cases of silicosis are simply due to non-compliance with the existing workplace exposure limit.  Now, the Administrationâs âperhaps cancerâ phrase is an open invitation to the regulatory opponents to claim scientific uncertainty about the association between silica exposure and cancer.  Granted, anti-public health forces will make those uncertainty claims regardless, but the Administration was wrong to evoke scientific doubt when it does not exist.

The second irritating statement is âdata indicate that silica exposure may cause silicosis.â  Huh?  Are they suggesting that we donât know the cause of silicosis?  Almost 90 years ago, in 1917, the US Public Health Service issued a report on the dangers of silica dust for miners, granite cutters, foundrymen, glassworkers and others.  The scientists observed   

ââ¦if we can imagine a man with his chest bound with transparent adhesive plaster, we can form a mental picture of how useless were the efforts at deep inhalation made by these patients.â (Markowitz and Rosner, 1990, p.531)  

When Frances Perkins--a social reformer who recognized the intrinsic link between public health and workersâ rights--came on the scene as President Franklin Rooseveltâs Secretary of Labor, she approached silicosis prevention and fair compensation with vigor.  Her Department maintained this opinion about silica:

âthere is nothing ânormalâ about dust in the workplace or silicosis among workers.â (Markowitz and Rosner, 1990, p.544)

And, what Secretary Perkins knew in 1933 still holds true today: microscopic particles of SiO2 (silicon dioxide, or quartz), when inhaled, can penetrate deep into the lungâs alveoli.  The bodyâs natural defense mechanisms attack the tiny silica particle, which creates scar tissue.  Too much exposure leads to too much scar tissue and silicosis develops. 

When I read the Bush Administrationâs statement âdata indicate that silica exposure may cause silicosis,â I wondered if the Presidentâs nominee to head OIRA, Susan Dudley, had a hand in this section of the report.  As Iâve written here and here, Ms. Dudley published a 2006 law review article asserting that a workplace regulation to prevent silicosis would be premature.  An economist by training, she claims that

âwe do not know whether particular forms of silica are harmfulâ and the scientific evidence âcomes from extremely limited sources.â 

Yet, in 1997 when the American Thoracic Society published its official statement on the health effects of exposure to respirable crystalline silica they cited more than 140 scientific papers.  In the subsequent 10 years, dozens and dozens of studies have been published about silica and human health effects, which extend beyond respiratory damage to renal and autoimmune diseases.

The third phrase, âthis substance [silica] is one of the most widely found in workplaces,â is annoying because it is factually incorrect, at least with respect to the respirable form of silica and the subject of a potential OSHA rule.  Itâs true that crystalline silica makes up 60 percent of the earthâs crust, and many, many workers are exposed to respirable silica in a variety of industries and occupations.  But of the 115 million workers in the U.S., NIOSH estimates that about 2 million workers are exposed to respirable silica dust.  For an Administration that introduced this 2006 regulatory plan with their pledge of âhigh-quality data,â use of the âhighest quality data,â and strict adherence to âInformation Quality Actâ guidelines, Iâd like to see the data used to substantiate their phrase âsilica is one of the most widely found [substances] in workplaces.â  Itâs not an egregious error, but makes me think that if an OSHA scientist had been given an opportunity to peer review OIRAâs final document, this phrase and the other absurd statements may have been corrected.

P.S.  Markowitz and Rosner's 1990 article "'The Streets of Walking Death': Silicosis, Health, and Labor in the Tri-State Region, 1900-1950" is a true gem!  It is refreshing to read about Secretary Perkins and her colleagues Verne Zimmer and Clara Beyer, who were officials in the Department's Division of Labor Standards.  According to Beyer, the Division "should be a service agency for labor [workers], just as the Department of Commerce is a service agency for business." Wow, what a concept.

If Frances Perkins is rolling in her grave over the Administration's statements about silica, Clara Beyer is equally disturbed with the Department of Labor's over-emphasis on partnerships, alliances and cooperative agreements with trade associations and businesses.  As Markowitz and Rosner note, the New Deal Labor Department believed collaboration with the industry "usually reinforced the status quo."