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Health & Safety Professions: What Can We Do To Shape Our Futures ? . Manuel R. Gomez, DrPH, MS, CIH Northern CA Local Section, 11/12/03 . My Goals Tonight. Review some trends: What has been happening? How have we responded? How have our societies responded? Conclusions: Where we need to go.

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health safety professions what can we do to shape our futures

Health & Safety Professions:What Can We Do To Shape Our Futures?

Manuel R. Gomez, DrPH, MS, CIH

Northern CA Local Section, 11/12/03

my goals tonight
My Goals Tonight
  • Review some trends: What has been happening?
  • How have we responded?
  • How have our societies responded?
  • Conclusions: Where we need to go
fact costs of injury and illness
Fact: Costs of Injury and Illness
  • 1992: 6K deaths; 60K illnesses;
  • Cost: $155B ($52B direct, $104B indirect)
  • Injuries 85%, illnesses 15%
  • Workers’ comp only pays 27%: workers, you and I pay the rest.
  • Costs are 3% of GNP = 5X aids, 3X Alzheimer’s, > arthritis, same as cancer, 82% of circulatory (heart & stroke).
  • Costs of Occupational Injuries and Illnesses, U. Michigan Press, 2001 (J.P.Leigh, S. Markowitz, M. Fahs, P. Landrigan).
cost facts continued
Cost Facts, Continued
  • Reality Check: Liberty Mutual Study, 2000 (Direct Costs only, only >6 days off) = $46B
  • My point: Order of magnitude, not details
  • Do we get as much attention as cardiovascular? Where is the outrage?
brief history of outrage
Brief History of Outrage
  • Gauley Tunnel-Silicosis
  • MSHAct: Farmington mine disaster, 78 deaths.
  • OSHAct: Steeply rising injury/illness rates (1961-70 = 29%)
  • EPA: Cuyahooga River on fire
  • Asbestos: Incurable disease, clear links, Johns Manville scandals
  • Lead (children, not workers)
  • Mold?
trends continued
Trends, Continued
  • Environmental issue grew, got more attention;
  • IH lines blurred & merged with environmental;
  • Downsizing era: cutback & outsourcing/globalization
  • Conservative political climate: less regulation & public service, more greed
how have we responded
How Have We Responded?
  • Weakening of public health core and focus
  • Unrealistic hopes for “safety pays”
    • Safety often doesn’t, illness prevention rarely
  • “Compliance reliance” but wrong response: OSHA & NIOSH bashing;
  • Unjustified Complacency (big problems solved?!)
  • Largely missed major developments:
    • Ergo, IAQ, risk and exposure assessment, chemical toxicity issues (e.g., HPV, REACH), global standard activities
how have societies responded
How Have Societies Responded?
  • Abandonment of public health mission:guild vs public service models. Do they protect workers or “serve the professions”?
  • Insufficient attention to mega-trends & big developments; looked at trees, forgot forest;
  • Tried to be businesses vs operating in a business-like manner to pursue core mission (chased the quick buck?)
  • Tunnel vision: destructive competition, splintering.
what should we do
What Should We Do?
  • Return to core business: public health & worker protection
  • Anticipate & take on strategic issues:
    • Toxic chemicals (HPV, REACH) & OELs
    • Management systems
    • Process controls vs. hazard by hazard
    • Stress & psychosocial issues
    • Corporate social responsibility
    • Corporate performance disclosure
    • Tri-partite approaches
    • Global standardization, especially European
international standards a sidebar
International Standards—A Sidebar
  • Jeffrey Immelt, GE Chief Executive, Wall St. Journal, April 23, 2002: “Almost 99% of regulation will come from the EU over time.”
  • We can’t ignore this major trend, must become part of it
  • It’s money & trade; money talks
what should we do1
What Should We Do?
  • Support strong regulatory & research agencies. They are necessary but not sufficient. Our membership numbers don’t lie.
  • Support standards (regulatory and strong voluntary consensus): Send costs where they belong
  • Break “welfare”dependency on OSHA (go beyond compliance, continual improvement).
  • Abandon “small business can’t do it” mantra—it’s a copout. That’s where challenge lies.
what should we do2
What Should We Do?
  • Don’t put all our bets on “safety pays”
  • Promote more consensus
    • We don’t know it all, or know best;
    • Not just the “experts,” but all parties, not just those we like (labor, business, government, political leaders, other disciplines)
    • Emphasize tripartite approaches.
what should we do3
What Should We Do?
  • Demand that our societies collaborate(federate? merge?!?)
  • Work together to generate OUTRAGE
    • Costs to society are high;
    • Pain and suffering are high