AIHce: Public Health at Core of IH Mission

In an outspoken address at the American Industrial Hygiene Conference and Expo in Philadelphia, Linda Rae Murray, M.D., MPH, urged industrial hygienists to remember that the mission of the profession is rooted not only in safeguarding workers but also in protecting the communities in which they practice.

“It was never envisioned that what we do on a day-to-day basis stopped at the factory door or the office elevator,” Murray said, underscoring her point by reading the American Industrial Hygiene Association's (AIHA) definition of industrial hygiene. “We may be forced to limit our work activities that way – because of our bosses, or politics, or budget constraints – but we must never forget that the real core, the soul of our field, commands us to think beyond the factory gates to embrace broad environmental and public health issues.”

Murray – whose illustrious career in occupational and environmental health includes her current position as the interim chief medical officer for the Cook County (Illinois) Department of Public Health and chief medical officer of primary and community health for the Ambulatory and Community Health Network of Cook County – added that industrial hygienists should know better than anyone “that what goes on in our workplace impacts the community.”

“It's not an accident then that the first organized formation of industrial hygienists occurred in 1914 in the industrial hygiene section of the American Public Health Association [APHA],” said Murray, who is a member of the APHA Executive Board. Murray urged industrial hygienists who currently are not involved in APHA to “come home.”

Public Health Infrastructure Under “Attack”

Because industrial hygiene is “part and parcel of the national public health infrastructure,” Murray asserted that industrial hygienists should be concerned about challenges facing that infrastructure – such as the lack of health insurance coverage for many Americans.

“We as a field must not only think about the four walls of the factory or the office, but we have to look beyond that and understand that when we come together to address the critical issues of our society, we in fact are solving problems of occupational health and safety,” Murray said.

Murray asserted that the public health infrastructure is under attack.

“This attack on the infrastructure takes from us basic tools that we need to do our jobs,” Murray said.

As an example, she pointed to recent lawsuits seeking to stop the American Conference of Governmental Industrial Hygienists (ACGIH) from promulgating its threshold limit values for exposure to hazardous substances. While Murray acknowledged that the attack on TLVs is “nothing new,” she admitted that she was stunned to learn that the recent spate of lawsuits has cost ACGIH more than $1 million.

“Whether or not they win the lawsuits, their existence is threatened, which means not only the United states but the world will lose an independent scientific voice for sifting through the evidence and trying to draw that line ... between what is dangerous and what might be safe,” Murray said. “We cannot stand by as health and safety professionals and allow that to happen.”

Murray lamented that recent analyses of Bureau of Labor Statistics (BLS) data estimate that BLS undercounts workplace fatalities, injuries and illnesses by 30 to 65 percent and that BLS statistics exclude the self-employed, small farms and government workers. Consequently, Murray contended that BLS statistics do not “fully elucidate the problems we face in the workplace,” making the work that industrial hygienists perform “seem less valuable.”

That's all the more reason, Murray said, for industrial hygienists to fight recent proposals to cut the budget of the Centers for Disease Control and Prevention's National Center for Health Statistics.

“When you are in a field that has trouble counting workers dropping dead, I would suggest to you that we would increase the funding for the National Center for Health Statistics,” Murray said.

Later in her address, Murray drew enthusiastic applause when she told the audience: “The fact that we live in a nation, the only industrialized nation, where health care is not a human right should disgust all of us as health professionals.”

Such comments were meant to underscore her larger point: that the mission of the industrial hygiene profession cannot be accomplished if its practitioners operate in a vacuum.

“[W]e cannot make a worker safe in Philadelphia if we fail to understand the nature of a globalized economy and what's going on with workers in china,” Murray said. “We cannot continue to saves lives in the workplace if we don't come to grips in an open way with the society in which we live, with the context in which work takes place.”

Old and New Challenges

Murray was brutally honest in her assessment of the state of the industrial hygiene profession and of the way it is perceived by the rest of the world.

“In spite of all our advances, in spite of all the lives that we've saved, in spite of the advancement of our science, we remain a field that's isolated, narrowly defined, mired in litigation of all types,” she said. “Go to your local medical school or engineering college, find your local environmental sciences department or nursing school, and ask them if they've ever heard of an industrial hygienist or occupational medicine or workplace injury, and you'll get the same answer I did: 'No, what's that?'”

Pointing to the graying of the industrial hygiene work force, Murray asserted that “we can't afford to have a profession that's not renewing itself.”

“We need every young person that we can drag into the profession,” Murray said, adding that the demographics of the profession – as indicated by a glance around the lecture hall – are “too white, too male.”

Murray asserted that other challenges in industrial hygiene and public health – such as asbestosis, silicosis and lead poisoning – should have been eliminated a long time ago.

“We know how to do it. We have the tools to do it. We just have to have the political will to make it happen,” she said, provoking more applause.

Murray concluded by saying that industrial hygienists can overcome the challenges of the 21st century – from old ones such as asbestosis to new ones such as pandemic flu planning and popcorn lung disease – by embracing its tradition as a cross-disciplinary field and thinking outside the factory or office walls.

“And when we come together as health and safety professionals, when we're not afraid to understand out traditions and to speak to the challenges that face us, the new technologies, the globalization, the immigrant labor, the young work force, when we're able to speak to those issues honestly and with courage, we in the next 100 years can make progress that far exceeds what we've seen in our lifetimes.”

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