Saturday, January 20, 2007

CalOSHA Standards Board Chickens Out of Issuing Emergency Temporary Standard for Popcorn Lung

As long as I've been in this business, there are some things I just don't understand. Like this: Earlier this week, the CalOSHA standards board decided not to issue an emergency temporary standard to protect workers from "popcorn lung." Instead, they decided to send the issue to an advisory committee.

The chemical at question here is diacetyl, the chemical butter flavoring that wreaks havoc on workers lungs. It's a chemical that causes bronchiolitis obliterans a disease that obliterates the lungs bronchioles (the lung's tiniest airways), resulting in "astonishingly grotesque" effects on the lungs, "the worst" that this nation's leading experts have ever seen. Its effects have been "likened to inhaling acid."

California, where health officials have detected a number of cases of bronchiolitis obliterans, established a "Special Emphasis Program" in the roughly 30 manufacturing facilities that use diacetyl. The agency is monitoring workers for signs of the disease and educating employers about how to prevent overexposure.

But cases continued to turn up. Just last week, the Sacramento Bee reported that
An ongoing health investigation of California's flavor manufacturing industry has found another six workers who have lost nearly all use of their lungs.

The six are in addition to two cases that sparked the investigation nine months ago, according to the state's occupational health chief, Barbara Materna.

"Most of these workers are severely impaired, cannot work and suffer extreme shortness of breath on exertion," Materna wrote in a Jan. 11 report updating investigation results. "At least one is reported to be on a list for lung transplantation."
And last week George Washington University Professor David Michaels, on behalf of the Project on Scientific Knowledge and Public Policy (SKAPP), sent the Board additional evidence from an unpublished Dutch study reporting three cases of the rare lung disease among workers at a diacetyl factory.

Last August, the United Food and Commercial Workers and the California State AFL-CIO petitioned CalOSHA for an Emergency Temporary Standard to protect workers against the damaging lung disease caused by diacetyl. (In July, UFCW and the Teamsters petitioned federal OSHA for an emergency temporary standard.)

What's an Emergency Temporary Standard (ETS) and why is it so important to use it. Normal OSHA standards can take ten years or more from the time that OSHA decides to start working on them until they are actually issued. Most OSHA chemical standards date from the 1960's and, under the Bush administration, only one new chemical standard has been issued -- and that was done under court order.

But the Occupational Safety and Health Act states that if the Assistant Secretary determines that "employees are exposed to grave danger from exposure to substances or agents determined to be toxic or physically harmful or from new hazards." OSHA also has to show that the ETS is "necessary to protect employees from such danger." The ETS serves as a proposed standard until the final standard is issued, which must be done within six months.

Sounds like diacetyl would be a prime candidate.

OSHA has rarely used this provision of the act, even in the rare case that the agency has issued an ETS, the courts have often overturned it. No successful ETS has been issued in over 25 years. Nevertheless, as UFCW Health and Safety Director Jackie Nowell told the CalOSHA Board, "If this doesn't rise to the need for an emergency standard, I don't know what does."

More insulting to workers afflicted with bronchiolitis obliterans are the excuses the Board members used to chicken out, according to the Cal-OSHA Reporter.

Board occupational health representative Jonathan Frisch, Ph.D, said "doing the speedy thing isn't necessarily the right thing." He and the other board members backed the decision to send the petition to advisory committee, which DOSH Acting Chief Len Welsh said would meet the first or second week of February. Frisch commented that it takes courage to "step back, even when people are hurt," if it's the right thing to do. "Let's take a hard look at the exposures that are going on."

Board Chair John MacLeod agreed. "We're in a groundbreaking situation," and it's important to develop good information, he said.

No, Doctor Frisch, it actually takes courage to do the right thing -- take immediate action to protect workers. Developing good information is important. But in this case it's possible to protect workers at the same time you develop good information. Isn't it better to err on the side of overprotection if the alternative is more dead workers?

As Dr. Michaels explains in the Pump Handle,

Regulators cannot wait for complete information before issuing rules to limit exposure to potentially toxic substances. Diacetyl poses the classic (but easily addressable) regulatory dilemma. The evidence for the toxicity of diacetyl is limited by an obvious problem: we do not have (and cannot have) controlled studies of humans exposed to diacetyl but to no other potential toxins. There are multiple chemical exposures at factories where diacetyl is used. Regulators must rely on these studies of the patterns of disease in workplaces, in addition to evidence gathered in experiments with laboratory animals.

It is hard to imagine what additional evidence could still be gathered on diacetyl. We will never find a workplace in which only diacetyl is present. The Dutch study comes close, since it deals with a diacetyl production plant rather than a plant producing multiple flavorings, but reluctant regulators could still argue for the presence of other confounding factors. The animal evidence is very strong. It is time to assume that diacetyl causes obstructive lung disease at extremely low levels and prevent all exposure – probably by banning it.

Meanwhile, OSHA has still not bothered to respond to the unions' petition -- almost 8 years after learning of the first cases of bronchiolitis obliterans.

Like I said, after all these years, there are still some things I just don't get.

More information on popcorn lung here in Confined Space and here from SKAPP.