Sunday, February 19, 2006

At least I don't work for Howard Hughes

As someone who works in and near the health care industry, the most important occupational hazard that I think about is infectious disease. Hospitals are dangerous to patients, because they are full of debilitated people with holes in them, and tubes going into the holes, where all sorts of nasty bugs go in and out, which live in the continual presence of antibiotics and so develop drug resistance. These can also be dangerous to health care workers, obviously, and there are elaborate precautions taken in the health care industry to try to protect workers as well as patients.

Other specific occupational risks of infection are recognized, such as risk for people who work with animals (dead or alive), sewer workers, obviously, and HVAC workers who may be exposed to Legionnaire's disease. For some reason, I found better summaries of these issues in British and Australian sources than in the U.S., so if you're interested, here's an Australian site.

However, infectious disease as an occupational hazard is not just about specific, often fairly exotic hazards associated with particular occupations. Workplaces are one of the main places where people come into close and sustained contact with each other, and therefore play an important role in the transmission of ordinary, easily transmissible ailments such as colds and flu. We think about this as a responsibility of employers to the extent that they provide basic sanitation, such as having the bathrooms cleaned regularly and providing soap, but the SARS scare caused the International Labor Organization to review the issues systematically and in depth. (PDF file)

SARS is not thought to be transmissible in its asymptomatic stage, but nevertheless the ILO does consider the possibility and urges appropriate precautions. These are a good idea all the time, of course, and become even more salient during winter flu season and yet more in the event of a serious situation such as an influenza pandemic. It may be that some of these are indeed covered by OSHA regulations (not my department, as I have already confessed), but if so, there is no chance whatsoever of any enforcement action in workplaces such as offices where OSHA is but a distant rumor.

These include:

1. The provision of clean toilets, liquid soap and hand washing facilities. 2. The provision of individual towels or hand dryers for hand drying. 3. The provision of covered rubbish bins for used towels, handkerchiefs or litter. 4. Encouraging workers to wash their hands after they use the toilet and before eating. 5. The provision of individual, clean utensils for eating and drinking. 6. Encouraging workers to use tissues to contain respiratory secretions, to dispose of the tissues immediately after use in a covered bin, and then to wash their hands. 7. Not allowing spitting in the workplace. 8. Ensuring daily cleaning of workplace areas and toilets, using normal household disinfectants or diluted household bleach.

There's even an international standard, it turns out:

The ILO Hygiene (Commerce and Offices) Convention, 1964 (No. 120) Article 7 All premises used by workers, and the equipment of such premises, shall be properly maintained and kept clean. Article 8 All premises used by workers shall have sufficient and suitable ventilation, natural or artificial or both, supplying fresh or purified air. Article 12 A sufficient supply of wholesome drinking water or of some other wholesome drink shall be made available to workers. Article 13 Sufficient and suitable washing facilities and sanitary conveniences shall be provided and properly maintained. The Occupational Safety and Health Recommendation, 1981 (No. 164) II. Technical Fields of Action (o) sanitary installations, washing facilities, facilities for changing and storing clothes, supply of drinking water, and any other welfare facilities connected with occupational safety and health.

In my checkered career, I now realize, I have had many jobs that were in violation of international law.

But the most important issue of all is that people who are sick not come to work. Part-time and casual workers often do not have any sick leave -- if they take the day off, they lose a day's pay. And even when workers are entitled to sick leave, they may be discouraged from taking it. Their supervisors may view it as a demerit when it comes time for merit raises or promotion.

Management where I work, I'm sorry to say, once decided that people were taking suspiciously large amounts of sick leave on Mondays, and the days after holidays. They established a policy that you would be charged a vacation day if you tried to take a sick day on such occasions and didn't produce a note from your physician saying that you were indeed sick. As we all know full well, you're lucky to be able to see your doctor in two weeks, let alone today. And even if we could get in, we'd have to make a copayment. I assume such policies are legal, but they are hazardous to your health.

By Cervantes Stayin' Alive