Comparison of U.S. Occupational Safety and Health Administration standards and German Berufsgenossenschaften Guidelines for Preventive Occupational Health Examinations

Thirty-three U.S. Occupational Safety and Health Administration (OSHA) standards contain mandated medical service provisions. The German Berufsgenossenschaften Guidelines for Preventive Occupational Health Examinations currently comprise 38 guidelines, which contain mandated medical service provisions. Based on a previously published method for scoring several medical program elements, the Berufsgenossenchaften guidelines were compared with the OSHA standards. Specific program elements were combined to generate and compare quality control scores, screening scores and surveillance scores. The asbestos standard/guidelines were compared in more detail (e.g., physical examination, laboratory tests, examination schedule, eligibility). The German medical requirements consistently ranked higher than their U.S. counterparts for overall scores and the scoring indices for quality control, screening, and surveillance. However, this comparison also reveals that few surveillance features have been incorporated into the medical requirements of either country, suggesting that neither country is making full use of workplace medical services for primary prevention.

The origin and development of the asbestos Threshold Limit Value: scientific indifference and corporate influence

Several recent articles have critiqued the process employed by the American Conference of Governmental Industrial Hygienists in determining Threshold Limit Values. Criticisms have included inadequate data collection, inadequate research, excessive corporate influence, and slow response to informational changes. In this article, the authors address the historical development of the American Conference of Governmental Industrial Hygienists' asbestos exposure guideline. They demonstrate that the proposed guideline was known to be inadequate when it was first proposed, was severely criticized between 1946 and 1968, but nonetheless was promulgated annually and remained unchanged 1971.

OSHA inspections. Workplace inspections

The Occupational Safety and Health Act of 1970 requires that every worker be provided with a safe and healthful workplace and authorizes the Occupational Safety and Health Administration (OSHA) to conduct workplace inspections. OSHA conducts workplace inspections in hospitals and checks for compliance with the Bloodborne Pathogens Standard, the Enforcement Policy and Procedures for Occupational Exposure to Tuberculosis, and the Hazardous Chemicals Standards, among others. The hospital epidemiologist bears considerable responsibility for developing and implementing plans to protect employees from occupational exposures to infectious hazards such as bloodborne pathogens and tuberculosis. To prepare for an inspection, the hospital epidemiologist must understand the basis on which OSHA operates and must proceed in a thoughtful, coordinated manner.

Ergonomics in the electronic library

New technologies are changing the face of information services and how those services are delivered. Libraries spend a great deal of time planning the hardware and software implementations of electronic information services, but the human factors are often overlooked. Computers and electronic tools have changed the nature of many librarians' daily work, creating new problems, including stress, fatigue, and cumulative trauma disorders. Ergonomic issues need to be considered when designing or redesigning facilities for electronic resources and services. Libraries can prevent some of the common problems that appear in the digital workplace by paying attention to basic ergonomic issues when designing workstations and work areas. Proper monitor placement, lighting, workstation setup, and seating prevent many of the common occupational problems associated with computers. Staff training will further reduce the likelihood of ergonomic problems in the electronic workplace.

Development of an ISO 9000 compatible occupational health standard: defining the issues

Corporate ISO 9000 registration is gaining international acceptance as the hallmark of quality system achievement. The International Organization for Standardization (ISO) is currently drafting environmental standards that will complement ISO 9000. Should the international community also consider development of an ISO 9000-compatible occupational safety and health management standard (OSHMS)? To determine the advantages and disadvantages of this issue, the investigators conducted interviews with government and private sector experts, reviewed publicly accessible ISO documents, and evaluated published literature germane to the subject. Major advantages of an ISO OSHMS were the harmonization of national standards, maximizing Occupational Safety and Health Administration (OSHA) efficiency through third-party registration audits, and increased emphasis on employee-driven health and safety programs. Major disadvantages were the single vote of the American National Standards Institute at international proceedings, direct and indirect program development costs, potential unethical or incompetent conduct of registrars, and the logistics of developing an acceptable standard to all stakeholders. Some unresolved issues were the inevitability of an ISO OSHMS, auditor indemnification, and the scope of OSHA participation. Industrial health and safety professionals should initiate formal discussion on this issue to elaborate on findings presented here and to establish a consensus on future activities.

Safety and health in the construction industry

Workers in the building, renovation, and demolition of roads and commercial structures in the U.S. suffer a disproportionate share of occupational fatalities and lost-time injuries. Nearly all of the injuries and deaths are preventable. The fatality rate from work-related ailments, such as cancers and silicosis, is believed to be excessive, but is not generally computed. The safety and health problems are tied largely to the construction industry's organization and how the work is performed. Many hazardous exposures result from inadequacies in access to information, measurement technology, and personal protective equipment. Potential solutions are in labor-management site safety and health planning and management, education and training of workers and supervisors, new technologies, federal regulation, workers' compensation law, medical monitoring, and occupational health delivery. Public health opportunities involve health care delivery systems, improved preventive medicine, disability determination and rehabilitation programs, and research, beginning with the standardization of data to monitor these problems.

The OSHA bloodborne pathogens standard. Implications for optometric practice

The Occupational Safety and Health Act empowers the Occupational Safety and Health Administration (OSHA) to establish a standard when it determines that a significant risk to employees exists. Leading to the OSHA bloodborne pathogen Standard were the following events: recognition of Hepatitis B virus as an occupational hazard where blood and body fluids are handled. Similarly, the human immunodeficiency virus (HIV) had been shown to infect those exposed to blood and body fluids, and OSHA was petitioned by two unions to require employers to require Hepatitis B vaccine free of charge and to mandate general infection control practices as recommended by the Centers for Disease Control (CDC) as early as 1983. OSHA determined that the risk of contracting Hepatitis B virus and HIV was significant and that the final bloodborne pathogens Standard would substantially reduce that risk.

Gowns: selection on a procedure-driven basis

The Occupational Safety and Health Administration requires that the types and characteristics of personal protective equipment used "depend upon the task and degree of exposure anticipated." The level of protection required, therefore, is logically contingent upon the operative site, estimated blood loss, and duration of the procedure. However, more recent studies provide data that specifically identify the personnel and areas of the body that are most likely to become contaminated. This adds a new dimension to the procedure-oriented selection process that is worthy of consideration.

Regulatory considerations of occupational tuberculosis control

The authors argue that the classic hierarchy of industrial hygiene controls may be successfully used to control TB. Various elements of hygiene control programs reviewed here include TB exposure control programs, identification and isolation of patients, respiratory isolation, local source capture ventilation, laboratory procedures, employee surveillance programs, reporting of occupational illnesses, labeling requirements, and respiratory protection.

Universal precautions: an update

Universal precautions, the set of work practice recommendations designed to help minimize occupational exposure to bloodborne pathogens, have been shown to be effective. However, lack of compliance with these recommendations has been well documented, both before and after the enactment of the OSHA Bloodborne Pathogens Standard. Current issues, including occupationally acquired human immunodeficiency virus, percutaneous exposures and lack of compliance are discussed in this article.