Sunday, March 28, 2004

ACOEM Jumps On Bandwagon, Misses Boat

Occupational Physicians Group Makes Obesity the Focus of Annual 2004 Labor Day Checklist.

Every year the American College of Occupational and Environmental Medicine (ACOEM) identifies a topic for its "Labor Day Checklist" which is designed to provide "quick tips on a timely topic to improve the health and safety of workers, the workplace, and the environment." In past years, ACOEM has chosen hearing loss, occupational asthma, eye safety, communicable diseases, back injuries and ergonomics. Not a bad list.

So what to choose this year? It's probably not an easy decision. Look around. We have an epidemic of immigrant worker death, injury and illness. Asbestos-related illness remains a serious nationwide problem, and millions of workers face harmful exposure to toxic chemicals about which we know very little. Year after year, OSHA "enforces" the same forty year old chemical standards for a tiny fraction of the chemicals used in this country. Meanwhile, OSHA, the only government agency charged with enforcing safe workplace conditions is rapidly turning into a poorly funded business consulting association while thousands of workers die every year from perfectly preventable "accidents."

So what should ACOEM choose for its 2004 Labor Day list? So much to choose from. So few opportunities to make a splash. Definitely not an easy decision.

Or maybe it can be an easy decision. Why not just peruse the news and see what's popular these days? How about OBESITY? Yeah, that's the ticket. Everyone's jumping aboard the obesity train. The Bush Administration has declared war on obesity. Obesity among children is at epidemic proportions. Walks to raise money to fight obesity have joined walks to fund AIDS and Breast Cancer research.

Of course, people can take this all too far. Happily, we have the U.S. Congress (joined by a number of state legislatures) who have manned the trenches in defense of the embattled double bacon cheeseburger by passing legislation to ban lawsuits against the fat food pushers. (Thank heavens for the U.S. House of Representatives, which in the span of a couple of weeks has saved the Republic from both hamburger haters and breast exhibitionists.)

Happily, there are a few thinkers going against the flow. Responding to a 102-1 vote by the Florida legislature to ban lawsuits against restaurants and fast food vendors, the Palm Beach Post had the nerve to note that the Emperor is slightly underdressed:
Courageous lawmakers might have considered actually doing something about public health. At the least, public-service messages could instruct families on healthy eating habits. If the state gave public schools an adequate budget, they could afford physical education programs and wouldn't have to sell sodas and junk food in vending machines in an attempt to make ends meet. The governor's task force on obesity recently criticized the machines but offered no ideas as to how schools might afford to get rid of them. Without help from the state, they can't. If the legislators really wanted to take on a public-health problem, they might try doing something about the one in six Floridians who have no health insurance. How about some protection for those families?
But I digress. Back to trashing ACOEM.

What are they thinking? Enquiring minds want to know. A study in the January issue of ACOEM's Journal of Occupational and Environmental Medicine found that
Workers' physical activity and physical fitness had a significant impact on their work performance. More physically active workers reported higher work quality and better overall job performance. As physical fitness increased, so did the quantity of work performed. In addition, more fit workers needed to expend less extra effort to do their work.

Obesity had a significant but negative impact on work. Twenty-two percent of workers in the study were classified as obese, and 4.5 percent as severely obese. Obese employees reported more difficulty getting along with coworkers, while severely obese workers missed significantly more days of work.
Now I don't doubt that these findings are true. Nor do I think it's necessarily a bad idea to use the workplace to educate people about healthy eating habits. But that shouldn't be the central focus of an association that is first and formost "devoted to prevention and management of occupational and environmental injury, illness and disability."

Again, I'm not saying that fighting obesity is a bad thing, nor is it necessarily inconsistent with the rest of ACOEM's mission, to promote the "health and productivity of workers, their families, and communities."

But come on people, everyone and their uncle is promoting the war against obesity these days, whereas almost no one (with the exception of labor unions and a handful of health and safety activists and enterprising reporters) is making any serious attempt to focus the public's attention on the continuing carnage in America's workplaces.

Instead of spending their time and resources telling people they eat too much, occupational physicians, organized by ACOEM, could use this opportunity to call attention to sick, injured and dead workers that almost no one else in this country seems to know or care about. For ACOEM to just melt into the throngs and choose obesity as the main focus of this Labor Day is, as one occupational physician told me, "an embarrassment to occupational medicine."

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