Since the results are to be made available to
the employer, allowing the employer to select the
physician has the advantages of both convenience
and efficiency. Some employers already maintain
an industrial medical staff skilled in dealing with
asbestos-related medical problems, and the require-
ments of the standards as promulgated appear likely
to encourage the development of additional staffs
of this sort. The employee would then benefit from
the expertise associated with specialization, and
the state of medical knowledge concerning these
diseases should likewise be improved. All of these
factors, identified in the record, operate to make
the Secretary's decision on this point a nonarbitrary"
one. (footnotes omitted). (8)

One such company with a reputedly "skilled" medical staff is the Dupont Corp. However, the trust granted by OSHA and the Court was cavalierly violated by even Dupont. As a result of a long, detailed investigation, OSHA cited Dupont in 1979 for failing to provide accurate medical examinations to pipefitters exposed to asbestos at its Gibbstown, N.J. plant. (see Appendix I) OSHA also cited the company for willfully violating the Act, as follows:

. . the employer did not adequately correlate and
evaluate the medical tests results of employees in
accordance with standard medical practice, nor was
appropriate action taken by the employer regarding
notification of the involved employees concerning
these results. Specifically:

a) Employer failed to correlate the available medical
data of the X-rays and pulmonary function tests. This
data, concerning pulmonary and radiological changes,
gives evidence of seven cases of pleural thickening
and two cases of asbestosis. The nine insulators in-
volved were not notified by employer of their medical
conditions.

b) The administration and organization, within em-
ployer's management hierarchy, did not insure that
medical data was competently evaluated and reviewed,
and in addition, did not ensure that effective treat-
ment or preventative action was taken when warranted.

The lesson of this tragedy is that employers, even the socalled "best" employers, are not to be trusted to adequately evaluate available information indicating the presence of occupational diseases among their workers. The incentives to do otherwise are simply too strong.

However, there is another lesson from the asbestos tragedy. The 1972 standard contains no requirement that asbestos-related illnesses be reported to anyone outside the company. This defect is present as well in every other OSHA health standard. Furthermore, OSHA has yet to seek that information from employers, using its right of access. Accordingly, no cases of illnesses are reported to OSHA or NIOSH, and the responsible officials continue their tasks in blissful ignorance.

-

Such a reporting system is not only a nice idea it already exists. Under the Mine Safety Acts, the coal miners examinations are actually performed by independent physicians and reviewed by NIOSH. Why could not the same be done for workers exposed to asbestos, lead, cotton dust or benzene. Our detailed knowledge of the current prevalence of black lung disease stands in stark contrast to our pitiable ignorance concerning the rest of the occupational diseases. The situation is easily remedied, if we would but do so.

OSHA, however, appears to be moving in exactly the opposite direction. We believed, when the noise standard was amended, that OSHA would finally require an accurate accounting of cases of occupational hearing loss. The amendment to the standard, even

after undergoing considerable weakening at the hands of the Reagan Administration, still contained a reasonable definition of "significant threshold shift (STS)." The need for a uniform definition was widely cited during the rulemaking by employers and professional audiologists as well as the trade union movement. However, OSHA deleted the requirement to enter STS cases

on the log when it revised the standard. Moreover, OSHA has persisted in that effort. For instance, OSHA Policy Director Anthony Goldin recently requested the National Advisory Committee on Occupational Safety & Health to review a proposal to issue additional disclaimers from both OSHA and the BLS to further protect employers from any admission that recorded cases of occupational hearing loss are in fact work-related. Mr. Goldin took this action after his staff had recommended in an earlier proposal that "work relationship is presumed when the employee [with STS] has been exposed to noise levels exceeding 85 dBA."

These efforts by OSHA will only further reduce the number of recordable occupational illnesses, and prolong the day when the true facts of the epidemic in the workplace are allowed to surface. We urge the Subcommittee to investigate OSHA's proposal and, if possible, ensure that such cover-ups be ceased. No serious effort will be ever made to identify the true incidence of occupational illnesses as long as this sort of behavior on the part of OSHA persists.

References

1.

2.

3.

4.

5.

6.

7.

8.

National Institute for Occupational Safety & Health, Pilot
Study for Development of An Occupational Disease Surveillance
Method, Discher, D.P., Kleiman, G.D., and Foster, F.J., (HEW
Publication No. (NIOSH) 75-182), p. 45, Rockville, MD, 1975.

Fine, L.J., et al, "An Alternative Way of Detecting Cumulative Trauma Disorders of the Upper Extremities in the Workplace," Proceedings of the 1984 International Conference on Occupational Ergonomics, 425-9, 1984.

System Sciences, Inc., "Comparison of Employer-Originated Fatal Accident Reports to N.C. OSHA With Medical Examiner's Reports for North Carolina, 1978-79," Chapel Hill, N.C., 1980.

Kronebusch, K., "Occupational Injury Data: Are We Collecting What We Need For Identification, Prevention, and Evaluation," in Proceeding of the 19th National Meeting of the Public Health Conference on Records and Statistics, Washington, D.C., 1983. Bureau of Labor Statistics, Occupational Injuries and Illness in the United States by Industry, 1982, Washington, D.C., 1984, p. 3..

Hilaski, H.J., and Wang, C. L., "How valid are estimates of occupational illness?", Monthly Labor Review, U.S. Bureau of Labor Statistics, 105:8, p. 27, 1982.

Id., p. 27-8.

IUD v. Hodgson, 499 F. 2d 467 (D.C. Circ. 1974).

Excerpt from: Fine, L.J., et al, "An Alternative Way of Detecting Cumulative Trauma Disorders of the Upper Extremities in the Workplace," Proceedings of 1984 International Conference on Occupational Ergonomics, 425-9, 1984