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Speeches (Archived)
Improving safety and health in the nursing home industry.

Speeches - Table of Contents Speeches - (Archived) Table of Contents
• Information Date: 04/07/1995
• Presented To: Service Employees International Union
• Speaker: Dear, Joseph A.
• Status: Archived

Archive Notice - OSHA Archive

NOTICE: This is an OSHA Archive Document, and no longer represents OSHA Policy. It is presented here as historical content, for research and review purposes only.

NOTE: THIS IS THE TEXT PREPARED AND SUBMITTED TO MR. DEAR AND IS NOT NECESSARILY THE SPEECH AS DELIVERED.

REMARKS BY JOSEPH A. DEAR
ASSISTANT SECRETARY OF LABOR
FOR OCCUPATIONAL SAFETY AND HEALTH
BEFORE SERVICE EMPLOYEES INTERNATIONAL UNION
DIGNITY CONFERENCE
2:10 p.m. APRIL 7, 1995, PITTSBURGH, PA

Good afternoon, and thank you, Secretary-Treasurer Cordtz, for that kind introduction. (Richard Cordtz, international secretary-treasurer, will introduce you.)

A few days ago, I met with a group of nursing home workers -- perhaps some of you were there -- and your President, John J. Sweeney, to receive a copy of your excellent report on hazards and injuries in nursing homes, "Caring Till It Hurts -- How Nursing Home Work is Becoming the Most Dangerous Job in America."

Some of the SEIU members at that meeting presented dramatic first-hand accounts of the disabling back injuries they suffered working in nursing homes. I told them that preventing such injuries is the mission of OSHA and that I will do everything in my power to make sure that the Agency carries out that mission effectively.

"Caring Till It Hurts" is truly an impressive document of the dangers that many of you face on the job. The facts it recites are APPALLING: that the occupational illness and injury rates for nursing home workers are higher than for workers in other high-hazard industries such as construction and mining; that those injury and illness rates increased by 55% in the last decade, with more than 200,000 injuries reported in the industry each year; and that now the nursing home industry is the MOST DANGEROUS FAST-GROWING INDUSTRY IN THE U.S.

The quotes from individual nursing home workers who suffered injuries are equally compelling. Carol Dean remarked that "I'm always in pain. You put up with it. You do what you've got to do. The residents depend on you. They need me. I love the job. It gives you a lot of gratification."

Yvonne Vanlandingham said she was out three months with a back injury incurred while helping another aide to get a patient out of bed. This was ten years ago and her back still bothers her. "After I hurt my back, I couldn't hold my grandchild," she said.

Pauline Koontz said she injured her neck, leg and wrist and, like Yvonne, can't hold her grandkids. She can't do other things she used to like, such as play softball or volleyball or dance.

Equally appalling as these statistics and stories about injuries in the industry is the attitude that many nursing home employers have adopted. According to the report, understaffing is a key cause of injuries. Yet many employers in the industry do not take worker safety concerns seriously. Rather than hiring additional staff to lessen workloads or redesigning work to eliminate hazards, these employers favor gimmicks such as "safety bingo," which encourages workers not to report injuries in exchange for the chance to win a television set.

Yet these employers should be concerned, both from a humanitarian aspect and an economic "bottom-line" aspect. The report estimates that the nursing home industry as a whole paid CLOSE TO A BILLION DOLLARS in workers' compensation costs in 1994. In some states the insurance rate for nursing homes is twice or three times the rate for the average private sector employer.

As you know, turnover in the industry is also very high -- more than 100% in some facilities. The injury rates, low pay and understaffing keep many of you from remaining in nursing home work very long. This makes it even more stressful for those who remain. It also forces employers to invest resources in recruitment and training of new workers.

So nursing home employers should be very concerned. All of them should read the report and take steps to improve the safety protection given to you.

You can rest assured that we in OSHA are studying the report closely and will use it in our activities in trying to provide better worksite safety and health in nursing homes.

OSHA has done extensive work in nursing homes. In the past two years, OSHA and its State Plan partners have conducted almost 1,100 inspections in nursing homes, found more than 2,000 violations of standards, and proposed about $2.2 million in penalties for those violations. More than 270 of the federal inspections found violations of the bloodborne pathogens standard, designed to protect health care and other workers from AIDs and hepatitis B viruses. Some of the federal inspections also found ergonomic violations, cited under Section (5)(a)(1) of the Occupational Safety and Health Act, which requires the employer to keep the workplace free from recognized hazards that could cause serious physical harm. SEIU has cooperated with us in some of our enforcement cases.

Nursing homes also are involved in OSHA's continuing attempt to protect workers against tuberculosis which, as you know, has had a resurgence in recent years. TB will be the subject of a national emphasis enforcement program later this year.

Health care workers, including those in nursing homes, also have been victims of workplace violence. One study found that more than 100 cases of workplace homicides occurred among health workers in the decade from 1980 to 1990. Non-fatal assaults are found on a daily basis in some areas of health care, notably psychiatric care.

In any event, because of the problems of violence affecting health care workers, our Office of General Industry Compliance Assistance is currently developing guidelines to assist health care managers and administrators in the development of programs to protect their employees against such violence.

Those are a few of the activities we are currently undertaking that affect you as workers in nursing homes.

But I must warn you, as we view the current Washington scene, some of the actions being taken by Congress may delay or prevent necessary improvements in occupational safety and health.

Right now, our principal challenge in OSHA is to convince our many audiences--including Congress--that OSHA serves a vital purpose.

I have been spending a lot of time on Capitol Hill. In addition to testifying before Congressional committees, I have been meeting with members of Congress almost every day. I feel that if I just have the opportunity I can convince every member of Congress that OSHA is not the agency that they perceive and that negative stories about OSHA are just plain false.

The members have been hearing that OSHA is filled with inspectors who fine businesses thousands of dollars for nitpicky violations that have little to do with worker safety. They hear about everything from the tooth fairy to guardrails to chewing gum to dishwashing detergents.

I try to correct the record, because virtually all of these stories are FALSE. OSHA has NOT banned the tooth fairy, dentists CAN give children their extracted teeth. OSHA does NOT require all guardrails to be precisely 42 inches high, and has not enforced such a requirement in nearly two decades. OSHA does NOT prohibit workers from chewing gum, although we do restrict asbestos removal workers from ingesting food where a high level of asbestos is present, since ingestion of asbestos causes cancer and lung damage. OSHA does NOT require Material Safety Data Sheets for the normal use of consumer products like Joy; workers must be informed of risks ONLY when they are regularly exposed to high levels of substances that actually pose health risks.

OSHA's record is a good one.

Simply put, OSHA SAVES LIVES. Through its protective standards and enforcement programs, OSHA has helped reduce the workplace fatality rate by over 50 percent since 1970. Eliminating the Agency or gutting these programs would be a terrible tragedy for working men and women and their employers -- most of whom sincerely want to provide safe and healthful workplaces.

OSHA standards make a real difference -- often the difference between life and death -- to millions of working Americans. Since OSHA strengthened trenching protection in 1990, trenching fatalities have declined by 35 percent. OSHA's lead standard saved thousands of smelting and battery plant workers from anemia, nerve disorders, seizures, brain damage and even death resulting from prolonged exposure to lead. The grain handling standard protects workers from grain dust explosions and has helped reduce fatalities by 58 percent and injuries by 41 percent.

Millions of working Americans also have benefitted directly from OSHA's enforcement program. In the three years following an OSHA inspection and fine, injuries at the inspected worksite decline by as much as 22 percent.

We can cite many specific workplace success stories. For example, Meridian Healthcare, Inc., a long-term care chain with headquarters in Towson, Maryland, saved $800,000 in workers' compensation insurance in one year by developing a comprehensive safety and health program that includes principles of ergonomics. Adams House, a facility of the Hillhaven Corp. in Torrington, Connecticut, reported decreased workers' compensation costs, improved employee morale and lower employee turnover following implementation of an ergonomic program that included a labormanagement ergonomic task force. Kennebec Long Term Care in Augusta, Maine, a nursing home firm, sharply reduced lost work day cases due to back injuries after developing a program that utilized mechanical lifting devices in patient transfers.

BUT OUR WORK IS FAR FROM DONE. Every year, work-related accidents and illnesses cost an estimated 56,000 American lives -- more than the total American lives lost in battle during the entire 9-year Vietnam war. On an average day, 17 working Americans are killed in safety accidents, an estimated 137 more die from occupational disease, and another 16,000 are injured.

Safety accidents alone cost our economy over $100 billion a year, and occupational illnesses cost many times more. We all bear these costs, as employers, as workers and as taxpayers.

So we should be doing even more, not less. There is a tremendous gap between our mission, which encompasses safety and health for over 93 million workers employed at over 6 million workplaces and our resources, $312 million and 2,300 people. So we have to change the way we do business in order to narrow that gap. We have to reinvent ourselves.

Our goals are simple. First, we must reinvent the agency, stripping away unnecessary regulations and processes, and refocusing on real improvements in worker safety and health. Second, we must increase and strengthen our efforts to provide compliance assistance to the majority of employers who want to protect their workers. And third, we must target our limited enforcement efforts at the worst hazards and worksites, so that we can save the most lives for the least dollars.

Here is how we are meeting our goals.

We are improving the way that OSHA responds to workers' complaints about hazardous conditions. Some employees think that OSHA takes too long to respond to complaints. Some employers think many complaints are not worthy of a formal inspection yet current policy dictates that every formal complaint must be answered with an inspection. We want to prioritize our responses based on the nature of the hazards, and to allow compliance officers to work with employers and employees in ways that don't mandate a formal inspection. Field offices in Peoria, Ill, and Cleveland already have sharply reduced the time from receipt of a non-formal complaint to abatement of the hazard, and we are developing a test program for handling formal complaints.

We are working closely in partnership with key labor and employer groups to develop a proposed rule for safety and health programs. This proposed rule will indicate how systematic safety and health programs can be used to find and fix hazards by emphasizing management leadership and worker involvement. OSHA is writing this rule in plain, easy to follow language, which will give users flexibility to respond to their own specific conditions. We look forward to SEIU's input on this standard.

We also are working to weed out outdated, duplicative or conflicting standards. We want to get rid of provisions that clutter up the standards books and do nothing to protect life or limb. Along that line, we published a request in the Federal Register last October, well before the election, asking workers, employers and others in the safety and health community to identify those regulations that should be repealed.

In Maine, we are running a pilot program designed to encourage employers to eliminate hazards in the workplace. One of the participants in this Maine program is Androscoggin Home Health Services, one of the largest providers of Medicare home health services in New England. As a result of this pilot program, Androscoggin developed a comprehensive safety and health program that included management commitment, employee involvement, and an action plan to reduce employee injuries and illnesses.

Part of the plan was employee training in how to properly lift patients.

The firm has enjoyed sharply reduced workers' compensation costs as a result of participation in the Maine program. We have set up a similar pilot program in Wisconsin, and we are looking to expand it further.

We are expanding recognition programs for workplaces with strong demonstrations of worker participation and management commitment to comprehensive hazard recognition and control. In 1994, we added over 80 new sites to our Voluntary Protection Programs, expanding our safety and health excellence recognition program by over 75 percent.

The benefits are considerable -- lower injuries and illnesses, lower workers' compensation payments, higher productivity and enhanced community standing, and an exemption from programmed inspections.

We also want to increase our assistance to small businesses. In FY 1995, state consultants funded by OSHA are projected to conduct 23,000 visits, mostly to help small businesses who need help in complying with our standards. We have requested additional funds to increase that number to 25,000 in FY 1996.

In sum, OSHA is working hard to improve its focus on real improvements in safety and health, to simplify its protective regulations, to assist employers who want to comply with them, and to target our limited resources at the most dangerous hazards and worksites.

But Congress is moving so fast to "deregulate" industry that many of these valuable OSHA programs may be destroyed.

President Clinton supports OSHA. He has requested an additional $34 million in funds for the Agency for FY 1996.

But what is Congress doing right now? Cutting OSHA's budget for the current fiscal year, in fact impeding our ability to protect workers while giving wealthy Americans big tax breaks. That "Contract with America Tax Relief Act" passed by the House this week gives the wealthiest 1% in America -- those families making more than $350,000 a year -- more tax breaks than the bottom 60% -- over 65 million families. The "Contract with America Tax Relief Act" would give the wealthiest 1% a tax cut of more than $20,000, which is 75 times bigger than the average break for the 65 million families in the bottom 60%.

Most of us fall in that bottom 60% and not in the top 1%. Beyond that, while the President fights for better safety on the job and other goals such as better education in America, Republicans are fighting to allow 24 billionaires to escape $1.4 billion in taxes by renouncing their citizenship.

SEIU has been a good partner for OSHA over the years. We have worked well together in trying to improve job safety and health in the nursing home industry. And we hope that we can continue to work together with you in the future, no matter what comes out of the 104th Congress.


Archive Notice - OSHA Archive

NOTICE: This is an OSHA Archive Document, and no longer represents OSHA Policy. It is presented here as historical content, for research and review purposes only.


Speeches - Table of Contents Speeches - (Archived) Table of Contents



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