A 17-year-old bagger employed at his family's grocery store was asked for ground beef by a customer. None was available, so he decided to operate the grinder, despite the fact that workers under the age of 18 are prohibited by OSHA from operating meat grinders and slicers.
When the meat became stuck in the grinder bowl, he used his hand to push the meat down into the "worm," a rotating machine part shaped like a corkscrew. The worm caught his hand and fed it into the grinder's barrel, amputating his hand and part of his lower right arm.
If he had been older and better trained on the hazards of that equipment and the importance of lockout/tagout, he would not have reached into an energized machine. As a young worker, he was more vulnerable for a serious injury. Young workers, older workers, women and immigrants are all considered vulnerable workers.
"Vulnerable workers have one trait in common," says Joe Reina, deputy administrator for OSHA Region VI. "They are unprepared to deal with the hazards in the workplace. It might be because of a lack of education and information. It might be that the workplace equipment or personal protective equipment (PPE) wasn't designed to fit them. It might be because of physical limitations. It might be because of cultural reasons; they don't feel comfortable saying "no" to an employer."
The group that experts agree has the most difficulty saying "no" to employers or questioning the safety of job tasks is young workers those 18 years old and younger. "When you're 17 years old, your primary job is school. In school, you learn reading, writing and arithmetic. You don't learn about workplace hazards," says Dawn Castillo, supervisory epidemiologist and chief of the Surveillance and Field Investigations Branch at the National Institute for Occupational Safety and Health (NIOSH).
Emotionally, young workers think they are invulnerable, notes Barbara Lee, Ph.D., RN, director of the National Children's Center for Rural and Agricultural Health. Plus, she adds, "They are still at the age where they want to please adults, even if it means doing a job that they are forbidden by law to do. In agriculture, this is particularly challenging, because they are employed to do the same jobs as adults, with no special considerations: minimal breaks, hard work and little supervision."
Elise Handelman, RN, M.Ed., COHN, director of OSHA's Office of Occupational Health Nursing, says young workers "don't have a sense of empowerment and often, don't realize they are protected by workplace health and safety laws."
The news is improving, however. From 1992 to 2000, there were 70 deaths per year of young workers. By 2002, there were 41.
"It's a significant drop," said Corlis Sellers, the regional administrator for the Department of Labor's (DOL) Wage and Hour Division in the Northeast Region, "but to what extent it has to do with the employment rates of young people, we don't know."
Part of the drop in fatalities is due to stepped-up efforts from OSHA and DOL, notes Sellers, who is also the national child labor coordinator.
For example, Dan Corcoran, a compliance assistance specialist in OSHA's Region VII, is involved with a special program at the Center for Construction Excellence, part of the University of Missouri in Kansas City. Thousands of high school and vocational students from Missouri and Kansas compete to design and spec out a construction project. Now, as part of the competition, they are expected to incorporate safety, including costs and return on investment.
Emphasizing safety in the construction industry is particularly important, says Corcoran, because "When the boss says 'Jump down that hole,' young workers jump down a 20-foot-long, unshored trench without a second thought."
A Youth Rules rally held last spring in Philadelphia (and scheduled again for May) attracted 1,000 young people and their parents to a fun event aimed at educating them about workplace health and safety rules for young workers. Held at a major mall, the event included popular local disc jockeys, t-shirts, information booths and handouts. Schools, community organizations and libraries promoted the event. A similar event was sponsored in New Jersey, where the governor issued a proclamation declaring it "Youth Rules Day."
Such help came too late in Florida, where a 17-year-old immigrant worker, Fernando Paramo, was told by his supervisor to enter a sewer shaft. He was overcome by fumes and his older brother, Miguel, climbed down into the shaft to save him. Miguel managed to pass Fernando up to a third brother before he lost consciousness.
Fernando recovered, but Miguel died. The company was fined nearly $69,000 by OSHA. The Paramo family claimed Fernando was given no respirator or training in confined space entry and that no air monitoring was conducted, while Miguel's only "safety" equipment was a broken ladder. The brothers had several things working against them: the age and lack of training of Fernando Paramo, and the fact they were immigrants who were afraid to speak up to their employer about safety concerns they voiced to family members.
A representative from UNITE, a union that represents a large number of women and immigrant workers, comments, "Seasoned health and safety professionals know that workers... are a rich source of information and insights about workplace hazards and possible solutions to those hazards." However, the spokesperson adds, when workers are silenced by their lack of experience, training, language skills or education:
- Malfunctioning equipment and hazardous conditions often go unreported
- Injuries that can point to poorly designed workstations or tasks go untreated or treated outside of the system, and
- Dangerous procedures are performed without question.
Joe Reina serves on OSHA's Hispanic Task Force, which was launched in response to reports that the fatality rate for Hispanic workers was 14 percent, yet they made up 11 percent of the work force. He says that until recently, OSHA never asked about the ethnicity of the worker on the 300 Log. "Now, on Supplemental Form 170, we ask, 'Was language a barrier?' We are finding out that the language barrier was a factor in many fatalities of immigrant workers," Reina reveals.
OSHA has launched a number of efforts to reach immigrant workers, says Reina, including creating a Web site dedicated to Spanish-speaking workers www.osha.gov/as/opa/spanish/index.html and publishing "Todo Sobre La OSHA," the Spanish-language version of "All About OSHA." The agency has also started reaching out to community centers and churches to get the safety message across. "Many Hispanic workers are Catholic. We reached out to priests to teach them what OSHA is and how we can help. We also needed to reassure them that we are not immigration," says Reina.
Vulnerable workers are primarily low-wage, non-union workers of color and immigrant workers, says Beverly Tillery, coordinator of the New York Committee for Occupational Safety and Health (NYCOSH). "They work extremely long hours at dangerous jobs, which puts them at high risk for injuries, illnesses and fatalities. Many of them work in the 'informal' work sector doing day labor or domestic work or other jobs where they are getting paid cash or are 'off the books,'" she adds.
At particular risk, says Tillery, are women workers who fit that profile. "A range of low-wage jobs held by women such as cleaners, laundry and dry cleaner workers, garment factory workers and home health aides involve hazardous chemical exposures and back-breaking repetitive motion jobs."
Jeanne Stellman, Ph.D., is the founder and executive director of the Women's Occupational Health Resource Center at Columbia University. "What makes women vulnerable is not their biology. Women's multiple roles [mother, family caregiver, worker] and relative lack of power in the workplace make them vulnerable," says Stellman.
According to NIOSH, women currently comprise 46 percent of the 137 million workers in the United States, with their share of the labor force projected to reach 48 percent by 2008. Of employed women in 1999, 40 percent held technical, sales and administrative support positions; 32 percent worked in managerial and professional specialties; and 17 percent worked in service occupations.
"[Our society] perceives heavy construction and factory work as hazardous and women's work as being much safer," says Stellman. "The nature of women's work is that it is much more repetitive work and that it often requires standing or sitting for long periods of time. In Europe, cashiers sit while customers unload and bag the groceries. As a nation, we've chosen to ignore repetitive strain injuries."
Adds Karen Johnson, executive vice president for the National Organization of Women (NOW), "The fact of the matter is, carpal tunnel syndrome from this 'light' work is a debilitating, work-related injury as debilitating as an injury suffered doing 'heavy' work."
Both women are quick to point out that the situation is slowly improving for some women workers. Up until a few years ago, many employers issued their female employees PPE that was designed to fit small men. When NIOSH researchers conducted interviews with 475 tradeswomen across the country several years ago and asked about personal protective equipment (PPE), one respondent said, "They gave me gloves so humongous, I couldn't even pick anything up."
"Women aren't mini men," observes Stellman. "They have different body frames, different body structures." She notes that while "there has been a huge improvement in the availability of PPE that is designed to fit women, that doesn't mean we've solved" all workplace problems facing women. Issues such as indoor air quality, chemical exposures and musculoskeletal disorders remain challenges for women workers.
A new challenge for safety professionals is the rising age of the work force. Tomorrow's work force will be older, heavier and unable to retire, says Mark Marsters, senior vice president, CIGNA Disability Management Solutions. He says health care will continue to drive costs for businesses, a problem that will become even more urgent with the aging work force. And, he says, "The aging work force will drive greater incidences of disability. The economy may force companies to push their employees even further to boost productivity, which may in turn result in greater stress-related disability."
In 2006, baby boomers will begin to turn 60. By 2008, 40 percent of the labor force will be 45 or older, with older workers up to five times more likely to submit claims for short- or long-term disability, and on average absent longer following an injury than younger employees.
"We need to ask ourselves if we have enough in the way of disease management, medical specialists and vocational rehabilitation experts to meet this population's needs," says Marsters.
Dr. Don Wright, director of OSHA's Office of Occupational Medicine, says older workers often suffer from a loss of visual acuity, hearing loss, decreased coordination and balance, and medical conditions that put them at greater risk of suffering workplace injuries.
Employers should not count on workers to notify them when they are having problems reading instructions because of failing eyesight or cannot do as much bending and lifting because of conditions such as arthritis, says Wright. Instead, he suggests employers offer periodic physicals for all employees and examine their OSHA 300 logs to determine if there are clusters of injuries occurring to older workers. "It might be necessary to periodically adjust work to accommodate physical changes," he advises.
Employing Vulnerable Workers
Despite special considerations some vulnerable workers might require, such as limiting work hours and tasks (young workers), modification of job tasks (older workers), providing special emphasis on training (young workers, immigrant workers) or ensuring proper ergonomics (older workers, women), all the experts agreed that the outcome is well-worth the investment.
"The experienced worker has a great deal to offer the workplace, but employers need to know their limitations and be aware of how physiological changes may affect their ability to do assigned job tasks," notes Wright of older workers.
Barbara Lee points out that a company that invests in training young workers could end up with loyal employees for years. "Especially in agriculture, where the work force is so transient, an employer who really takes the time to mentor a young worker could end up with an excellent employee who wants to continue in agriculture, rather than move on to another occupation," she says.
Providing a safe and healthy workplace for vulnerable workers is really no different than providing one for a work population that is not considered vulnerable, says NYCOSH's Tillery. "Employers who take seriously their legal responsibility to provide workers with a safe and healthful workplace should assess the hazards workers may be exposed to and take steps to eliminate those hazards from the workplace. They should also train workers about how to protect themselves and make it clear they should have no fear of reprisal for exercising their rights," she advises.
Sidebar: Resources for Vulnerable Workers
NIOSH has issued a special report, "Preventing Deaths, Injuries and Illnesses of Young Workers" (DHHS (NIOSH) Publication No. 2003-128) which can be found at www.cdc.gov/niosh/docs/2003-128/2003128.htm. The report urges employers to:
- Recognize the hazards by assessing and eliminating hazards in the workplace. Make sure equipment used by young workers is safe and legal. Visit www.dol.gov/dol/topic/youthlabor/hazardousjobs.htm or call 1-866-4-USADOL.
- Supervise young workers and make sure that supervisors and adult coworkers are aware of tasks young workers may perform. Label equipment that young workers cannot use, or color-code uniforms of young workers so that others will know they cannot perform certain jobs.
- Provide training in hazard recognition and safe work practices. Have young workers demonstrate that they can perform assigned tasks safely and correctly. Ask young workers for feedback about the training.
- Know and comply with child labor laws and occupational safety and health regulations that apply to their business. State laws may be more restrictive than federal laws, and they vary considerably from state to state. These regulations should be posted for workers to read. For information about federal child labor laws, visit www.dol.gov/dol/topic/youthlabor/index.htm or call 1-866-4-USADOL. Links to state labor offices are available at www.ilsa.net or www.youthrules.dol.gov/states.htm.
- Develop an injury and illness prevention program and a process for identifying and solving safety and health problems. OSHA consultation programs are available in every state to help employers identify hazards and improve their safety and health management programs. Visit www.osha.gov/oshprogs/consult.html.
The Department of Labor offers information to young workers, employers, parents and educators at the Youth Rules Web site, www.youthrules.dol.gov.
OSHA offers a Spanish-language Web site for workers at www.osha.gov/as/opa/spanish/index.html.
States under federal OSHA offer consultation and compliance assistance and can help with training and education of immigrant workers. Visit www.osha.gov/dcsp/smallbusiness/consult.html for more information about federal OSHA programs or, if you're in a state-plan state, visit www.osha.gov/fso/osp/index.html to find a consultation office in your area.
OSHA has signed agreements with employer groups and associations pertaining to alliances and partnerships to improve safety for immigrant or Hispanic workers. For more information, visit www.osha.gov/fso/vpp/partnership/index.html (partnerships) or www.osha.gov/dcsp/alliances/index.html (alliances).
The Canadian Centre for Occupational Health and Safety offers a Web page devoted to issues related to aging workers at www.ccohs.ca/oshanswers/psychosocial/aging_workers.html. It includes information about accommodations, specific health and safety concerns for older workers and the changes that occur in cognitive functions with age.
For a variety of information about occupational safety and health for women workers, visit the NIOSH topic page for Women's Safety and Health Issues at Work at www.cdc.gov/niosh/topics/women. This page contains links to related NIOSH topic pages, as well as additional resources related to women's health, research on occupational safety and health for women and women at work.
Vulnerable Workers in General
There are Committees for Occupational Safety and Health (COSH) groups in 25 cities. You can find NYCOSH at www.nycosh.org or by calling (212) 627-3900. The NYCOSH Web site includes links to labor organizations and government resources.
Many unions provide training on workplace safety, workers' rights, and communication skills. Union representatives are available to speak on behalf of their co-workers who may not be able to speak out on their own. Union contracts often provide structures for labor/management co-operation on health and safety issues. UNITE (Union of Needletrades, Industrial and Textile Employees) says that with a union contract, vulnerable workers can become full partners in the safety process in their plants. For more information, visit www.uniteunion.org.