Labor Secretary Tom Perez announced yesterday a new regulation designed to reduce coal miners’ risk of developing coal mine dust lung disease (CMDLD). I’ve written about these regulations many times, on both the need for them and the snail’s pace at which the White House’s Office of Information and Regulatory Affairs (OIRA) reviewed them. They are long overdue.
Depending on who you ask these new regulations have been in the works since 2009 (beginning of the Obama Administration), 1996 (following an advisory committee report and NIOSH recommendation) or as far back as 1991 (following a special MSHA spot inspection program.) They all had the same objective: to address a broken regulatory system that fails to protect coal miners from developing “black lung” disease.
- Reducing the permissible exposure limit (PEL) of 2.0 mg/m3 to 1.5 mg/m3 averaged over a full-shift, whether the miner works an 8-hour shift or one that is longer.
- Adopting a new continuous read-out air monitoring device that will give coal miners real-time information about their exposure to respirable coal dust. The device will also project what their total exposure will be at the end of their workshift (should their exposure remain the same.) This will allow miners to take (or demand) immediate action to control the dust if it is projected to exceed the PEL. Controlling respirable coal dust typically involves improving air flow and/or using water to eliminate dust at its source.
- Requiring mine operators to download data from these new sampling devices and transmit it to MSHA within 24 hours.
- Eliminating a requirement that dates back to 1972 that forces MSHA to use an average of five samples to determine whether a miner was over-exposed to respirable coal dust. If the average didn’t exceed the PEL, the mine operator could not be compelled (with a citation) to improve dust controls.
- Enhancing the components of the periodic health examinations offered to coal miners from just a chest xray, to one that includes spirometry, symptom assessment, and an occupational history. In addition, miners who work at surface coal mines will now also be offered the periodic health examinations by the mine operator .
The new rule, however, is not as protective as the one that MSHA proposed in October 2010. It
- Does not reduce the PEL to 1.0 mg/m3 which is the level recommended in 1995 by NIOSH. MSHA is adopting a 1.5 mg/m3 PEL despites its own data which shows the 1.0 mg/m3 is feasible. The decision is perplexing. For some key mining tasks, including dusty jobs like roof bolting, more than 50 percent of samples collected by MSHA are already at levels at or below 1.0 mg/m3.
- Does not offer the highest level of protection based on what is feasible. MSHA estimated that 20 coal miners out of 1,000 would develop progressive massive fibrosis (PMF) (the most severe form of coal workers’ pneumoconiosis) if it set the PEL at 1.0 mg/m3. The agency’s decision to set the PEL at 1.5 mg/m3 increases that estimate to 50 cases of PMF for every 1,000 coal miners. For emphysema, the risk estimate jumps from 61 cases per 1,000 (with 1.0 mg/m3 PEL) to 99 cases per 1,000 (at the 1.5 mg/m3 PEL.) Again, MSHA’s own data indicates the 1.0 mg/m3 standard is feasible.
- Does not eliminate the requirement that mine operators take their own respirable dust samples that will be used for enforcement. This provisions, which has been roundly criticized in all corners, is akin to driving over the speed limit and sending a notice to the police so they can send you a ticket.
Overall, the new rules are a step in the right direction to better protect miners’ health. Some will say a giant step, others might call it a regular step. Now that the new rules are on the books, they must be diligently followed and enforced. If they are, a couple of decades from now we’ll see the size of the difference they made.
By Sara Satinsky
Should pregnant women who use drugs be charged as criminals or given help? From a public health perspective the choice is clear: provide treatment to help women quit drugs before their use harms their child.
Less than a year ago, Tennessee adopted a progressive policy to provide such treatment, but now is on the brink of taking a big step back. It could become the first state to criminalize pregnant women whose drug use harms a fetus or newborn baby.
The state legislature has passed a bill that, if signed by Gov. Bill Haslam, would authorize the filing of criminal assault charges against a mother if it is determined that she has harmed her fetus or newborn by using illegal drugs.According to The Guardian, the bill says charges can be brought against a woman for “the illegal use of a narcotic drug while pregnant, if her child is born addicted to or harmed by the narcotic drug or for criminal homicide if her child dies as a result of her illegal use of a narcotic drug taken while pregnant.”
Curbing the use of illegal drugs by pregnant women is a worthy public health goal, as are efforts to reduce the numbers of children born with symptoms of withdrawal from drugs. But a groundswell of medical, health, substance abuse, and women’s rights professionals and advocates are in emphatic agreement that the bill would do more harm than good. Here’s why:
- If a pregnant woman fears getting busted for drug use, she may avoid medical care. Research published in the journal Drug and Alcohol Dependence found that when faced with a punitive law, some women will “go underground,” for fear of incarceration and losing custody of their child. By compelling a mother who is using drugs to avoid seeking care, the bill could cut pregnant women off from resources that would help them overcome their addictions — even though the bill ostensibly aims to reduce addiction.
- The bill could mean prison terms for women for whom treatment is a healthier option, at the expense not only of the mother’s future but that of her child. The bill carries a sentence of up to 15 years – a penalty that would also sentence children to growing up without their mothers. Long-term separation of parent and child can trigger a lifetime of mental and physical health problems for children. A 2012 Health Impact Assessment by Human Impact Partners found that sending non-violent offenders to treatment rather than prison would mean healthier lives, stronger families, and safer communities.
- The bill does not give equal opportunity to all women. It allows a woman to avoid a sentence if she commits to completing a drug treatment program. But programs are not available in all parts of the state, and less so to women in communities of color and rural areas, potentially creating a funnel to prison for these women who may lack access to treatment programs. “It’s poor women, black and brown women, rural women who will be criminalized,” said Cherisse Scott, chief executive of SisterReach, one of the groups calling for the governor to veto the bill.
- The bill would mark a serious retreat from state policy designed to encourage pregnant women who are using drugs to seek treatment. Less than a year ago Tennessee enacted the landmark Safe Harbor Act, put forward by the Tennessee Medical Association, to address an alarming increase in the state of children born with symptoms of withdrawal from illegal and legal drugs – a tenfold increase over a decade, according to the state Department of Health. The Safe Harbor Act amended the previous law that allowed prosecution of women whose babies were born with withdrawal symptoms, and instead put pregnant women “to the front of the line” to receive drug treatment if they admitted use. Only 11 months have passed – not enough time to see if the Safe Harbor Act is working.
Proponents of the bill say their motivation is to support mothers in getting help for drug use and protecting children. This bill will do the opposite. And that’s why experts are calling on Gov. Haslam to weigh the evidence and veto the bill.
Sara Satinsky, MPH, is a senior researcher at Human Impact Partners, an Oakland, Calif., nonprofit that studies the health and equity impacts of public policy.
to avoid the worst impacts of future climate change. It was the final interim report before the IPCC’s major Fifth Assessment Report due to be released in October. Yale Environment 360 asked Rajendra K. Pachauri, who has served as IPCC chairman since 2002, five questions about the latest report and about the prospects that the international community will finally take decisive action to address climate change at talks scheduled in Paris in 2015.
[Updated: 3 hours after I posted it. See below]
Black lung—-now referred to by experts as coal mine dust lung disease (CMDLD)— was back in the news last week courtesy of the Pulitzer Prize. The Center for Public Integrity’s Chris Hamby received the prestigious recognition for his reporting on the steep hurdles faced by coal miners who seek black lung disability compensation. Hamby’s piece focused on the back end of the problem. On the front end is preventing CMDLD in the first place. Coal miners wouldn’t have to maneuver the legal obstacle course for disability benefits if CMDLD became a thing of the past in the U.S.
The Labor Department’s Mine Safety and Health Administration (MSHA) proposed a new regulation in October 2010 designed to set the course for doing just that: eliminating CMDLD. The disease is 100 percent preventable if coal mine operators implement and maintain effective dust controls. MSHA took public comment on the proposal for seven months. Last August, MSHA submitted its final regulation to the White House’s Office of Information and Regulatory Affairs (OIRA) for review. There it sits.
Just a couple of months earlier, Howard Shelanski, JD, PhD was confirmed by the Senate to be the OIRA director. OIRA is responsible for reviewing proposed and final regulations, such as MSHA’s regulation to prevent CMDLD. The OIRA reviews, as prescribed in Executive Order 12866, are supposed to take no more than 90 days (with no more than a 45 day extension.) MSHA’s rule to address respirable coal dust has been stuck in OIRA, under Dr. Shelanski’s watch, for eight months (240 days.)
Habitual delay in regulatory reviews by OIRA is not a new problem. Shelanski was probed about it during his confirmation hearing. Senator Carl Levin (D-MI) noted:
“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 effect, 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.”
Nominee Shelanski responded by insisting that timeliness of the reviews was one of his top three priorities. Specifically, he said his goal was
“to ensure that regulatory review at OIRA occurs in as timely a manner as possible.”
Levin prodded, by asking Shelanski his plan to meet those deadlines. The nominee responded:
“I absolutely share the concern you just raised about timeliness. …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.”
Looking back, when Dr. Shelanski told Senator Levin he would “try to improve the timeliness,” I wish the Senator would have channeled Yoda and said:
“Do or do not…there is no try.”
How much longer will the Obama Administration take to issue a regulation to prevent miners from developing CMDLD?
[Update 4/22/14 (3 hours after I posted the above): Labor Secretary Tom Perez, MSHA chief Joe Main, and NIOSH director John Howard will be announcing the release of new regulations designed to protect miners from developing coal mine dust lung disease. I'm eager to read the final rule, and will report on The Pump Handle what the new requirements will be for coal mine operators.]
April 2010 saw two major workplace disasters: The April 5th explosion at the Upper Big Branch Mine in West Virginia, where 29 workers lost their lives, and the April 20th explosion at the BP Deepwater Horizon oil rig that killed 11 workers. Four years later, Ken Ward Jr. of the Charleston Gazette reminded us that “for those who lost loved ones, April 5 is now forever the day that they became a widow or an orphan, the day they lost their son or their best friend.” He posted the names of the 29 miners and a slideshow memorial about them at his Coal Tattoo blog.
The BP Deepwater Horizon explosion also resulted in a massive oil spill in the Gulf of Mexico, where its effects are still being felt today (see the New Orleans Times-Picayune’s site for articles). Among those suffering four years later are many of the thousands of cleanup workers who labored to remove oil from water, beaches, and other affected areas. Scientists with the National Institute of Environmental Health Sciences are studying the health of nearly 33,000 cleanup workers, and The Times-Picayune’s Jennifer Larino reports on their latest update:
Dale Sandler, a principal investigator with the National Institute of Environmental Health Sciences epidemiology group and leader of the research effort, said early data show symptoms of depression are prevalent among cleanup workers. The study group reported symptoms at a rate 30 percent higher than other people in areas affected by the oil spill.
Sandler said the findings are “not a surprise” given the stressful and dirty work most cleanup workers were involved in. Most were residents of communities impacted by the spill, which prior research show are prone to higher rates of depression and anxiety, she said.
Still she said there is no definitive link between the spill and mental and physical health problems.
Sandler said her team is still gathering key data, including how much oil and dispersants each participant was exposed to.
“It will be many years before we can know if the oil spill had an impact on the risk of developing chronic disease such as lung disease or cancer,” Sandler said.
In other news:
Washington Post: After OUR Walmart and A Better Balance pressured the retail giant over its lack of a policy assuring accommodations (like switching to lighter-duty jobs) for pregnant workers who need them, Walmart issued a new policy saying a woman employee with “a temporary disability caused by pregnancy” may be eligible for “reasonable accommodation.” Advocates say the policy doesn’t go far enough and the emphasis on the word “disability” is problematic. And, Salon spoke to Tiffany Beroid, a Walmart worker who was refused lighter-duty work while pregnant and became a poster child for the OUR Walmart campaign, who says she faced retaliation at work the day the Washington Post piece was published.
San Gabriel Valley Tribune (California): On the same day, two nurses at separate UCLA hospitals were stabbed; one of them has been hospitalized in critical condition, and the two alleged attackers are in custody. In February, SEIU Local 121RN and SEIU Nurse Alliance of California petitioned the state’s Occupational Safety & Health Standards board for a workplace violence prevention standard for healthcare workers.
Slate’s The XX Factor: In the past, judges have dismissed assault and harassment suits filed against employers by interns, because unpaid workers don’t meet the definition of employees. A new law in New York City extends existing human-rights protections to include unpaid workers, which gives them the right to sue their employers for harassment and discrimination. Oregon and Washington, DC already have similar laws, and a bill is in committee in California. (For more on the distinction between employees and interns, see ProPublica and the Department of Labor.)
NIOSH Science Blog: Researchers from the Washington State Department of Labor and Industries and the National Institute for Occupational Safety and Health analyzed Washington state obesity rates by occupation, and found that while 24.6% of all Washington state workers are obese, obesity prevalence in specific occupations ranges from 11.6% to 38.6%. Truck driving was the occupation with the highest percentage of obese workers.
CIDRAP: Healthcare workers are among those diagnosed with the Middle East respiratory syndrome coronavirus (MERS-CoV), for which the World Health Organization reports 212 lab-confirmed cases, 88 of them fatal. The United Arab Emirates has announced that six paramedics have been found to have MERS, and one of them has died from it.
Women aren’t the only ones at risk for depression and in need of screening services when a new baby comes into their lives. Young fathers face significant mental health challenges as well, according to a new study.
Published in the May issue of Pediatrics, researchers found that fathers who live in the same households as their children experience a decrease in depressive symptoms in the period immediately before their children are born. However, depressive symptoms among young fathers, who were around 25 years old when they became fathers, increased an average of 68 percent throughout their children’s first five years of life.
The study notes that depressed fathers are more likely to experience parenting-related stress, more likely to use corporal punishment and neglect their children, and less likely to interact with their sons and daughters. As a result, their children may be at higher risk of social problems throughout life, psychiatric problems later in life, and of experiencing delays in language and reading development. According to lead author Craig Garfield, of Northwestern University Feinberg School of Medicine, the study is the first to pinpoint when young fathers face an increased risk of depression, which could help inform more precise and targeted interventions.
“It’s not just new moms who need to be screened for depression, dads are at risk, too,” Garfield said in a news release. “Parental depression has a detrimental effect on kids, especially during those first key years of parent-infant attachment. We need to do a better job of helping young dads transition through that time period.”
To conduct the study, Garfield and his colleagues examined data from more than 10,600 young men who participated in the National Longitudinal Study of Adolescent Health. The Pediatrics study found that young fathers who do not live with their children experienced high levels of depressive symptoms before their children are born, with such symptoms decreasing during the years of early fatherhood. That’s in contrast to fathers who live with their children — described as resident fathers in the study — who experience fewer symptoms before their children arrived and higher levels in the years after birth. Black and Hispanic young fathers experienced more depressive symptoms than white fathers — a finding that study authors warned may result in a “clinically significant rise” and may merit special attention.
Identifying and helping fathers struggling with depression could have a positive domino effect, improving health for the entire family, writes Garfield and co-authors Greg Duncan, Joshua Rutsohn, Thomas McDade, Emma Adam, Rebekah Levine Coley and P. Lindsay Chase-Lansdale. However, reaching such fathers and getting them into appropriate treatment is a challenge, as the study notes that men ages 18 to 44 years old are less likely than women to interact with the health care system, have a primary care doctor or have health insurance. Though, the Affordable Care Act could start improving those numbers. Plus, the study noted that fathers often accompany their children to pediatric visits, which could make such clinical settings an ideal place for reaching young fathers at risk.
“This is a wakeup call for anyone who knows a young man who has recently become a new father,” Garfield said. “Be aware of how he is doing during his transition into fatherhood. If he is feeling extreme anxiety or blues or not able to enjoy things in life as he previously did, encourage him to get help.”
To read the full study, visit Pediatrics.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.
Going to a job and getting paid appropriately for your time is how it is supposed to work. Doing your job and getting ripped off by not getting paid is wrong and illegal. The economic consequences of wage theft for the victims and their families are profound: the threat and reality of losing utilities, food and housing. One of the single biggest risk factors for ill health is poverty. That makes wage theft a public health problem.
But catching and punishing employer-thieves is difficult. The federal and state enforcement agencies are under resourced and the laws weak. It’s also one thing to have a law on the books. It’s another to have that law enforced. A group of Houston workers fought several years for the former and succeeded last year in getting it. They took steps this week for the latter. The workers delivered their complaint to the City of Houston’s Inspector General (IG). That’s the first step to trigger a possible enforcement action under the City’s new anti-wage theft ordinance. The law took effect in January.
Thirteen workers allege that Hyland Construction, Bradley Demolition and BSP Construction hired them for jobs, which the workers completed, but the firms failed to pay them the wages owed. The workers say they are waiting for more than $200,000 in back pay.
The new ordinance provides workers with a formal process to lodge wage theft complaints and puts in place penalties for employers convicted of stealing workers’ wages. Businesses convicted of wage theft — either civilly or criminally — will be listed in a publicly accessible city database. They will also be ineligible for city contracts or subcontracts, and certain permits and licenses. That’s especially meaningful in this week’s complaint because the firms were engaged in projects contracted by the City of Houston.
One of the groups that was instrumental in getting the anti-wage theft ordinance passed was the Fe y Justicia Worker Center. Laura Boston, executive director of the worker-led organization, reported that the City’s IG, Robin Curtis, and her staff met personally with the workers to receive their complaint. “She seemed grateful,” said Boston, “and thanked the workers for coming forward.” The workers themselves, Boston added, “were proud that what they fought for [the ordinance] can work. It was not just a paper victory.”