Thursday, October 16, 2003

See No Evil: OSHA Declares “Mission Accomplished” on Ergonomics in Nursing Homes

On the ergonomics front, OSHA is moving from Operation "Hear No Evil" on the recordkeeping form, to Operation "See No Evil" in its enforcement program.

Just over a year ago, Assistant Secretary for OSHA, John Henshaw announced with great fanfare a new Nursing Home Initiative that would attack the high rate of ergonomic injuries, as well as other hazards suffered by nursing home workers.

Henshaw originally justified the program by the fact that:
Nursing and personal care facilities are a growing industry where hazards are known and effective controls are available. The industry also ranks among the highest in terms of injuries and illnesses, with rates about 2 ½ times that of all other general industries. By focusing on specific hazards associated with nursing and personal care facilities, we can help bring those rates down.
On Tuesday Henshaw announced that he was ending the program: Mission Accomplished.

The "National Emphasis Program for Nursing and Personal Care Facilities" was an attempt by OSHA to show that it was serious about ergonomics. Nursing home workers, as Henshaw said, had 2 1/2 times as many injuries and illnesses as private sector workers. And over half of those injuries are from overexertion and other ergonomic problems. (And just to put all of this in perspective, OSHA estimated during the Clinton administration ergonomic hearings that only around one-half of all ergonomic injuries were even reported.)

Nursing homes had been part of OSHA's regular "Site Specific Targeting" program. In fact, 2500 nursing and personal care facilities, out of a total of 13,000 in the private sector, were notified by OSHA last year that their injury and illness rates were higher than average and that they therefore had a higher than average chance of being inspected. Approximately 800 nursing homes would have been inspected under the targetting program, but Henshaw announed that under the NEP, 1000 would be inspected.

Nursing homes were a good place to show that it was serious about enforcement in workplaces that had a high rate of ergonomic injuries. In addition to MSDs, OSHA also targetted bloodborne pathogens, tuberculosis and slips & falls.

So what's the deal? Henshaw had promised to inspect 1000 nursing homes they have inspected almost that many. And despite the fact that they are ending the program, "We will continue to inspect workplaces where there are numerous MSDs, and we will cite employers if they have ignored their responsibility to protect their workers from injury."

So what were the results of those 1000 inspections? According to Henshaw, OSHA has citing a whopping 7 facilities under the general duty clause for failing to protect workers from ergonomic hazards, and issued "alert letters" to 104 additional sites.

The average penalty? Just over $1600, with penalties ranging from $230 to $2975. So out of 2500 nursing homes with injury and illness statistics above average, out of almost 1000 that have been inspected, a total of 7 have received citations for ergonomic hazards -- in an industry where over half of the injuries are related to ergonomics. (For those of you who are mathmatically challenged, that's about 7 tenths of one percent of all of those inspected 3 tenths of one percent of all those on the list.)

That should be enough to strike terror into the hearts of nursing home workers from coast to coast.

But wait, says Henshaw
Of course, the bottom line is not the numbers of inspections or citations we issue. It is reducing workplace injuries and illnesses.
Hmm. Hard to argue with that. So have workplace injuries and illnesses been reduced?

Who the hell knows!

When Henshaw announced the program, the latest statistics available, from 2000, showed that Nursing Home workers were 2.3 times as likely to be injured on the job as the average private sector worker. The current figures (from 2001) show that nursing home workers are 2.4 times as likely to be injured on the job. 2002 numbers won't be available until December.

So, on one hand, Henshaw says that the proof of the pudding is not the number of inspections completed, but the reduction of injuries. On the other hand, we have no idea if injuries have been reduced as a result of the program, but the most important thing is that we've done the inspections. Time to close up shop:
We said we would conduct about 1,000 inspections, and we have done that. I want to let you know today that we have now completed that emphasis program, and we are not renewing it.
Nevertheless, nursing homes are doing so well that instead of inspecting 800 nursing homes next year that would have been expected as part of the targeting program, OSHA will only inspect 400, or half that number.

OK, the number of citations and level of penalties haven't exactly been overwhelming and there is no evidence that the number of injuries is coming down significantly. So what's going on here?

The only thing I can think of is the intense pressure that OSHA has been under by industry anti-ergo zealots that I've written about before.

Or, as SEIU's health and safety director Bill Borwegen says,
OSHA apparently does not see the need to treat a workforce of low paid women who are disproportionately compirsed of people of color - many working as single mothers, with the same degree of protection afforded workers in other high hazard sectors typically with different gender and/or race demographics. And this, after Chao, a former member of the board of directors of a large nursing home chain, promised the Congress and others that she would focus on the needs of nursing home workers soon after becoming the Secretary of Labor.
Henshaw's ergonomics program makes about as much sense Bush's economic program. But Henshaw was perfectly clear about one thing:
I want to be very clear about one thing when it comes to enforcement. We do not, have not and will not enforce voluntary ergonomics guidelines. We make this point on page six of the guidelines. And I have made it in letters to senators and representatives, in the frequently asked questions section on our ergonomics webpage, in news releases and in speeches I have given.
And just in case you missed that...
We've also made very clear to our inspectors that when they issue citations and provide examples of ways to fix problems, they should NOT use the guidelines for these recommendations. Rather they should turn to the literature -- there are plenty of examples available.
(And the guidelines are based on what, if not the literature? Oh, nevermind!)

OK, so we have an enforcement program that consists of no standard, wimpy, unenforceable guidelines, fewer inspections, a tiny handful of citations, puny penalties and a flawed recordkeeping system that will further encourage underreporting....