Whom Do you Protect, Now?

Whom Do IHs Protect Now?

Chris MarloweCamp Dresser &

McKee

Objective:To Examine

the “Market” for

Occupational Health

Services

Slide 3

Why Did You Become an Industrial Hygienist?

• To Become Rich?• For the Glory?• Attracted by the Glamour?• You Like a Steady Paycheck?

• Couldn’t Get into Med School?

• Wanted to Something Important?

Slide 4

How Many of You, This Year:

• Saved a Life? • Prevented a Systemic Illness?

• Eliminated a Local Toxic Effect?

• Saved Someone’s Hearing?• Avoided a Cumulative Trauma Disorder?

Slide 5

You Probably Did:• Explain Procedures to Co-Workers

• Conduct Training• Write Health and Safety:

– Memos– Programs

• Research Issues• Complete Records

Slide 6

You Probably Did:• Buy Equipment or Service • Deal with Doctors• Collect:

–Samples–Readings

• Inspect Workplaces• Comment on Capital Improvement

Why Did your Work Change?

Slide 8

Worker Injury & Illness Rates

1973

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

0

2

4

6

8

10

12Injury & Illness Rates

Injuries Total Case RateYear

Cases

/ 100

Employ

ees

Slide 9

Occupational Fatality Rates

1960

1965

1970

1975

1980

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

2000

4000

6000

8000

10000

12000

14000

16000

Occupational Fatalities 1960 - 2010

Total FatalitiesYear

Deat

hs

10

Why Leading Indicators?

• Accidents Are Unintended• Don’t Measure

–What You Don’t Intend• Measure What You Do Intend

–Presence or Absence of Safe Activities.

–Define Required Safety Activities

–Hold Managers Accountable for Them.

11

Typical Performance Metrics

• “Manager Commitment”– Safety Contact Rate– % of Workforce Safety-trained– Rate of Safety Plan Generation

• Results of H&S Audits • Number of Near-loss Investigations

• Perception Surveys

12

Why Outcome Indicators?

• Safety is the “Absence of Hazard”

• How Do You Know That a Leading Indicator Means Anything?– Inference.– Faith

How Can You Find Out? Patience.

Slide 13

Illnesses per Hygienist

Number (000's)

Category 1994 1996 1998 2006 2008 2010Total illness cases 514.7 439 391.9 228 187.4 157.2Skin disorders 65.7 58.1 53.1 41.4 35.8 24.9Dust/lung diseases 2.7 3.5 2.1 17.7 14.8 12.8Lungs / toxic agents 25.3 21.7 17.5Poisoning 7.2 4.8 4 3.4 2.6 2.4Physical agents 21.7 16.8 16.6 24.4 22.1 18.8Repeated Trauma 332.1 281.1 253.3All other illnesses 60 53 45.4 141.1 112 98.3AIHA Membership 11.15 12.51 12.22 11.06 10.46 10.08

Slide 14

Illnesses (PI) / Hygienist

1994 1995 1996 1997 1998 2006 2007 2008 2009 20100

5

10

15

20

25

30

35

40

45

50Illness Cases per AIHA Member

Total Cases / MemberSystemic Cases/Mem

Year

Case

s /

Memb

er

Slide 15

Work Place Illness Types

1994 1995 1996 1997 1998 2006 2007 2008 2009 20100

10

20

30

40

50

60

70Illness Rates 1994 - 1998 & 2006 - 2010

Total illness casesSkin disordersLungs / toxic agentsPoisoningPhysical agentsRepeated Trauma

Type of Illness

Case

s / 10

,000 w

orker

- year

s

Slide 16

Systemic Illnesses (PI) / IH

1994 1995 1996 1997 1998 2006 2007 2008 2009 20100.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5Systemic Illness Cases per AIHA Member

Systemic Cases/Mem

Year

Case

s /

Memb

er

What Happened?

We WonSlide 17

Slide 18

Risk Assessments • Occupational Injury and Illness in the United States Arch Intern Med 1997; 157:1557-1568 Leigh, Markowitz, et. al.

• 6,500 deaths from job-related injury

• 60,300 deaths from job-related disease –From an Arbitrary % of all Illness

–That’s 1.2% of the Work Force!

Slide 19

What’s Your Experience?

• Does your Company kill one worker in 2,000 every year?

• Is your Company in the Safest 1%?–Why?–Should you Move?

• Either: –The Assumption is Wrong, or–We are Screwing Up.

Slide 20

More Recent Risk Assessments

Economic Burden of Occupational Injury and Illness, Milbank Quarterly 89:4 12/2011 J. Paul Leigh • 5,600 deaths from job-related injury

• 53,445 deaths from job-related disease –Used Steenland’s Factors

Slide 21

More Recent Risk Assessments

Dying from Work, K. Steenland, et. al. Am Journal Industrial Med 43:461–482 (2003)• 6,200 deaths from job-related injury

• 49,000 deaths from job-related disease

Slide 22

Occupational Illness Fatalities

Lung Disease Work Deaths

Pneumoconiosis 1,087Coalworkers’ pneumoconiosis 486

Asbestosis 405COPD 13,100Total 15,078

Slide 23

Until the 1970’s, no Practical Control

for:• Silica Asbestos• -Naphthylamine Lead• Mercury Beryllium• Cotton Dust

• Thousands Died

Slide 24

Occupational Illness Fatalities

Cancer Work Deaths

Chemical exposures 11,900

Enviro Tobacco 870Indoor radon at

work 2,000

Mesothelioma 2,200Total 16,970

Slide 25

Occupational Illness Fatalities

Heart Disease Work Deaths

Noise 356Job control 7,750Shift work 1,619ETS at work 2,400

Total 12,125

Slide 26

Occupational Illness Fatalities

Classification Work Deaths

Total non-trad 14,639Total Historic 29,178Reported Total 49000

Remainder 5,183

Slide 27

Why Did your Work Change?

• The Field became “Mature”–Business Term that Means–We met the Pre-Existing Demand

• Don’t Relax Now!• High Exposures May Exist in the Shadow Economy.–It’s Hard to Affect those Places

What Kinds of Owner?

Slide 28

What Kinds of Owner?

Slide 29

Slide 30

What Should Employees in a

Mature Field Do?• Take Care of Business• Prevent Mistakes• Optimize the Process• Look for Opportunities

Slide 31

How Do You Affect Your Employer’s

Finances?• Maintain Program

• Loss Control–Real Losses–Regulatory

• Maintain Good Will–Employees–Customers

• Remove Obstacles

What Kills US Employees?

Slide 32

What Hurts Our Employees?

Slide 33

Slide 34

Litigious Society

• Plaintiff’s Attorneys are Everywhere

• All Managers are D. J. s

• You’re Their Shield

Slide 35

The Burden of Proof• Future Plaintiffs May Want To Prove Wrong-Doing

• Expert Witnesses need “Ammunition”

• The Best Defense Cases are Built before the Accident

Slide 36

Safety and Purchasing

• Sometimes, You’re Buying–Asking the Right Questions–Informing the Vendor–Checking on the Vendor

• Sometimes You’re Selling–Answering Questionnaire–Making the Promises True

Slide 37

Where Are the Opportunities?

• Indoor Environment

• Environmental Issues–Chemophobia

• Proactive Protection–Risk Communication

–Environmental Management Systems

–Responsible Care

Whom Do IHs Protect Now?

Any Questions?