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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? 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
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 • 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 • 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 • 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
Association Membership Trends(When Did OSHA, Asbestos, Lead Come Along?)
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? • 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? • 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 • 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 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 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 Do? • Demand that our societies collaborate(federate? merge?!?) • Work together to generate OUTRAGE • Costs to society are high; • Pain and suffering are high