The Pitfalls of Home: Protecting the Health and Safety of Paid Domestics in the United States

1. The Pitfalls of Home: Protecting the Health and Safety of Paid Domestics in the United States Peggie Smith University of Iowa College of Law

2. Health & Safety Issues in Domestic Work • Home-based environmental risks such as exposure to second-hand smoke, cleaning chemicals, faulty electrical wiring in a client’s home, etc. •  Verbal, physical, and sexual abuse and harassment. • For live-in workers, unsafe and unhealthy conditions can also take the form of unsuitable living quarters and a lack of adequate food.

3. Health & Safety Issues in Domestic Work Domestics as home care workers: • Injuries caused by lifting and moving clients with limited mobility; • violence stemming from combative clients; • the risk of exposure to infectious material as a result of administering injections to clients and performing tasks such as assisting with bedpans and changing soiled linen.

4. Health & Safety Issues in Domestic Work • Magnitude of the problem: • Nearly two-thirds of domestic workers polled in a recent Californa study indicated that they considered their jobs hazardous. • Three-quarters stated that they did not receive basic protective gear to help prevent workplace injuries and illnesses. • A majority of workers reported that they had not received training in job safety or injury prevention.

5. Obstacles to improving the health and safety of domestic workers • Perception that the work does not pose a threat to health and safety • Invisibility of the work • Solitary aspect of the work • Disregard for the work as a form of legitimate work that requires regulation • Difficulty of enforcement • Competing interests between workers (health and safety) and clients (privacy and autonomy)

6. Contrasting workplace arrangements of domestics workers • Individual domestics who are hired directly by private households or clients (self-emoloyed or employed by the household) • Domestics with a defined employment relationship with a third-party agency, such as a home-care agency or a cleaning agency

7. Contrasting workplace arrangements of domestics workers: Legal distinction • In the US, worker health and safety is regulated by the federal Occupational Safety and Health Act. However, while the Act protects domestics employed by third-party agencies, it neither protects those domestics who are classified as self employed nor does it protect domestics employed on an individual basis by a client or household.

8. The problem of exposure to toxic cleaning • Industrial cleaners who work in public spaces • Domestic cleaners who work in private homes

9. The problem of exposure to toxic cleaning • Findings of a 2009 study: • Compared with industrial cleaners, domestics reported more frequent exposure to respiratory irritants from chemical cleaners, a significantly higher incidence of physical reactions to using cleaning products, and using more cleaning products that contained irritants.

10. The problem of exposure to toxic cleaning, cont. • Findings of a 2009 study: • Domestic cleaners reported less training than cleaners in industrial settings and commonly indicated that they received informal on-the-job training provided by a friend or a relative who also worked in domestic service.

11. The problem of exposure to toxic cleaning, cont. • Findings of a 2009 study: • One domestic commented: “‘I justuse whatever she has in her basket. If she has bleach I usebleach, if she has ammonia I use ammonia, if she has acid andso on, if she has nothing I’ll just use soap and water, butI can usually find something to use.’”

12. The problem of exposure to toxic cleaning, cont. • Findings of a 2009 study: • By contrast, industrial cleaners were more likely to have received formal training in the form of structured orientation sessions as well as supervisory instruction. • Industrial cleaners were also more likely to be aware of the harmful effects that could result if cleaning products were used incorrectly and they regularly engaged in protective measures to eliminate those risks.

13. Approaches to increase the health and safety of individual domestics • The use of model contracts that incorporate health and safety guidelines • “Domestic workers are particularly vulnerable to illness due to constant exposure to illness or toxic cleaning agents. The employer shall provide medical insurance for the employee. Alternatively, employer agrees to cover the cost of regular annual checkups and OBGYN exams, as well as the cost of emergency medical treatment when the employee is ill or injured.”

14. Approaches to increase the health and safety of individual domestics • The use of model contracts that incorporate health and safety guidelines • Additional useful provision: “Workers should be provided with adequate training that is relevant and specific to the hazards of the employment.”

15. Approaches to increase the health and safety of individual domestics Who has the obligation to provide training? • Hiring households/clients? • Impose an obligation on workers to require training via a licensing system? The status quo: • Various worker-oriented groups offer training sessions in safe cleaning techniques • Domestic Worker Cooperatives

16. The problem of health and safety for agency-employed domestics • Extremely high rate of musculoskeletal disorders among domestics who work as home-care workers • Home-care workers face a signicantly greater risk of injury from over exertion han their nursing-home counterparts.

17. The problem of health and safety for agency-employed domestics • Institutional settings typically provide patient-lifting devices that significantly lessen muscle strain for workers. • Health-care workers in institutional settings are often able to rely on co-workers to help lift clients and thus reduce the likelihood of injury. • A hospital or a nursing home also has the advantage of adjustable beds along with a generally clutter-free environment, making it easier for health-care personnel to assist clients.

18. The problem of health and safety for agency-employed domestics • Unlike health-care workers in institutional settings, home-care workers generally can’t rely on co-workers to help lift clients so as to reduce the likelihood of injury. • In addition, home-care workers commonly lack control over their working environments. Given that the elderly tend to live in some of the worst housing available, workers must frequently adapt to homes that are replete with hazards and which can impede their ability to care properly for clients.

19. The problem of health and safety for agency-employed domestics • “[The client] was lying in this damp room on a bed that was years old in a long narrow room. There was space there for one worker to help to wash and dress her but we needed a hoist and we needed two workers. You couldn’t bring the bed out to let the worker round to the other side. There was little to no access for the hoist. The client couldn’t walk. She couldn’t be washed in bed. The height of the bed was too low. It was a nightmare.”

20. Key obstacles to applying the OSH Act to address over-exertion among agency-employed domestics • Control concerns: Agency employers insist that they should not have to comply with health and safety standards b/c they lack control over the clients’ private space. • Cost-based considerations: Homes are not designed to accommodate the needs of the chronically ill and their care providers. • Privacy/autonomy concerns: Client resistance to devices such as lifting devices and hospital beds that may destabilize the meaning of home and mark it as a place of disability, disorder, and difference.

21. Value of domestic worker cooperatives • “It’s good to have training. Sometimes an employer says, ‘Don’t do it that way, that way won’t work,’ and then I can say, ‘Yes it will. I know because I have training.’ ‘Oh,’ they say . . . . Once I worked for this very rich woman and I told her I had had training, and so she started asking me all these questions and I answered them all, and then she was very impressed and left me alone.”

22. Contemporary Reality of Domestic Service • Domestic service remains outside the purview of the NLRA and most state collective bargaining statutes. • The SSA and the FLSA, while no longer categorically denying coverage to domestics, do not extend complete protection to them. • In the area of health and safety, most state workers’ compensation statutes and the federal Occupational Safety & Health Act exclude domestic service workers. • (*Re the OSH Act: Home care workers experience serious, debilitating workplace injuries at a rate higher than workers in coal mines and steel mills).