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PubMed1985

A union and consumer proposal for the regulation of enhanced natural radiation.

This paper discusses the problems related to enhanced exposure of workers to natural radiation and other pollutants in the working and living environment, with particular attention to radon. A method is proposed for regulating this high priority problem, which also considers the variable borderline between the controllable and uncontrollable exposure contributions. It is based on the principles of an integrated health policy regarding air quality. The complex multiple source exposure in private dwellings, at the workplace and through consumer goods should be taken into account as discussed in recent WHO and ILO reports. The important role of ventilation practices for future health is put forward. As far as regulation of exposure to ionizing radiation is concerned the present Euratom Basic Safety Standards are considered inadequate. Particular attention is given to a specification of justification and optimization and to a practical use of a hierarchy of limits as defined in the IAEA/ILO/WHO/NEA Basic Safety Standards.

Air Pollutants, Radioactive↗
PubMed1993

Litigating reproductive and developmental health in the aftermath of UAW versus Johnson Controls.

In a major decision handed down last term (International Union [UAW] versus Johnson Controls, Inc.), the Supreme Court ruled that employment practices excluding fertile or pregnant women from the workplace because of alleged concerns for fetal health constitute illegal sex discrimination. We analyze the three opinions in the case and explain why the decision was an essential first step to promoting reproductive and developmental health in the workplace. Continued progress toward eliminating or reducing reproductive occupational risks will require comprehensive legal strategies involving private lawsuits, governmental regulation and enforcement actions, and new legislation designed to preserve the existing rights of workers and to obtain new and additional protections. Finally, we caution that, in designing such strategies, it will be important to avoid solutions that either shift responsibility for reproductive health to workers, rather than to employers, or that undermine other important legal rights.

Embryonic and Fetal Development↗
PubMed2006

Eliminating child labour in Malawi: a British American Tobacco corporate responsibility project to sidestep tobacco labour exploitation.

OBJECTIVES: To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation. DESIGN: Analyses of internal tobacco industry documents and ethnographic data. RESULTS: British American Tobacco co-founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT's initial projects were budgeted at US2.3 million dollars over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US40 million dollars over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT's efforts to combat child labour in Malawi through ECLT was developed to support the company's "corporate social responsibility agenda" rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector. CONCLUSION: In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco.

Agriculture↗
PubMed1998

Proportionate mortality among union members employed at three Texas refineries.

The cause-specific mortality (1940-1993) of 2,985 male workers employed in three oil refineries was examined using a proportionate mortality study design. Separate analyses were undertaken by race, refinery, employment status (active and retired), and time since entry into the Oil, Chemical, and Atomic Workers (OCAW) union. Proportionate cancer mortality ratio (PCMR) analyses also were conducted. Proportionate mortality ratios (PMR) were significantly increased (P < 0.05) for cancers of the lip (PMR = 384), stomach (PMR = 142), unspecified sites of the liver (PMR = 238), pancreas (PMR = 151), connective tissues (PMR = 243), prostate (PMR = 135), eye (PMR = 407), brain (PMR = 181), benign and unspecified neoplasms (PMR = 289), and leukemia (PMR = 175) for the entire cohort. Significantly decreased mortality was observed for respiratory tuberculosis (PMR = 29), esophageal cancer (PMR = 45), rectal cancer (PMR = 49), and cancers of the bladder and other urinary organs (PMR = 40). Skin cancer was observed to be significantly increased (PMR = 242) for workers with less than 20 years since union initiation. Significantly increased PCMRs were seen for cancers of unspecified sites of the liver (PCMR = 205), brain (PCMR = 147), benign and unspecified neoplasms (PCMR = 243), and leukemia (PCMR = 146). Among nonwhites, an increased risk of bone cancer was observed in the PCMR analysis (PCMR = 704), although based on only two deaths. Analyses of mortality patterns for white males by refinery revealed similar patterns in each refinery as was seen in the overall cohort of refinery workers. Mortality patterns for whites and nonwhites also were similar. Additional analyses of deaths between 1960 and 1993 demonstrated increased mortality due to asbestosis (PMR = 683) and multiple myeloma (PMR = 124), although the multiple myeloma excess was not statistically significant. Ten deaths due to mesotheliomas were observed among these refinery workers.

Adult↗
PubMed2003

Development and evaluation of an advanced training technology course within a union-based industrial emergency response training program.

BACKGROUND: The Health and Safety Department of the United Automobile Workers recently introduced the use of Advanced Training Technologies (ATTs) into a previously successful Industrial Emergency Response (IER) program. The new curriculum attempted to incorporate web-based technology, while preserving the historical emphasis on the use of peer trainers and the Small Group Activity Method (SGAM) to promote team problem solving and worker empowerment. METHODS: The University of Michigan evaluated the program by administering a survey combining open- and closed-ended questions to trainees. RESULTS: Of the 46 respondents, most rated the program very highly, found that the use of internet technology allowed faster access to current information, reported peer trainers as one of program aspects they liked best, and did not find working in groups of three per computer difficult. CONCLUSIONS: It is possible to enhance a workplace health and safety training program through the introduction of ATT without compromising participant-centered, group learning program philosophies.

Curriculum↗
PubMed1995

Capital sectors and workers' health and safety in the United States.

The dual or segmented economy perspective suggests that the U.S. production system within a capitalist world-system can be divided into distinct sectors based on elements such as levels of industrial concentration, foreign involvement, and unionization. The differing organization of these sectors is argued to influence worker health and safety (WHS) outcomes. An economic segmentation model was applied to national occupational health data to examine the relationship between structural divisions in the economy and occupational hazard exposure, injury, and illness. Workers in more global industrial sectors had only average levels of hazardous exposure but a greater likelihood of occupational injury and illness than workers in other sectors of the economy. These differences are related to the structure of work in the various sectors. The findings suggest the need for (1) greater surveillance and reporting of WHS problems through the general health care system; (2) planning of economic and productive activity that takes WHS issues into account; and (3) greater worker organization and power within and between nations to improve WHS.

Adolescent↗
PubMed1993

The Ray Alexander Workers Clinic--a model for worker-based health services in South Africa?

During the period of current political transition, concern for the future of South Africa's health services have led to increased interest in different models for the provision and financing of health care. These debates have included an examination of the concept of Managed Care and the ideas of Health Maintainance Organization. Progressive trade unions, particularly, have been faced with the prospect of promoting private sector health care if they are directly to meet their members health needs, while at the same time seeking an equitable health care system for a future democratic South Africa. The Ray Alexander Workers Clinic is presented as a model of a worker-based health service which attempts to address this contradiction. Important lessons for a future National Health Service may be learnt. The role of worker control and cost containment are emphasized and implications for integration into State Services and relationships to social services for the broader community are explored. An argument is made that worker-based health services offer excellent possibilities for integration in a future National Health Service in South Africa that is centred on a Primary Health Care approach.

Ambulatory Care Facilities↗
PubMed2003

Falls in residential carpentry and drywall installation: findings from active injury surveillance with union carpenters.

Active injury surveillance was conducted with a large, unionized workforce of residential and drywall carpenters over a 3-year period. Injured carpenters were interviewed by trained carpenter investigators and sites were visited where falls occurred. Qualitative information was collected on exposures, risk perception, training, and mentoring. Falls accounted for 20% of injuries. Same-level falls were often related to weather, carrying objects-sometimes with an obstructed view-housekeeping, terrain of the lot, and speed of work. Falls from height occurred from a variety of work surfaces and involved ladders, scaffolding, roofs, work on other unsecured surfaces, unprotected openings, speed, and weather conditions. Recognized fall protection strategies, such as guardrails, toe boards, tying off to appropriate anchors, and guarding openings, would have prevented many of these falls; these practices were not the norm on many sites.

Accidental Falls↗
PubMed2005

Work-related pain and injury and barriers to workers' compensation among Las Vegas hotel room cleaners.

OBJECTIVES: We examined the prevalence of work-related pain and injury and explored barriers to and experiences of reporting among workers. METHODS: We surveyed 941 unionized hotel room cleaners about work-related pain, injury, disability, and reporting. RESULTS: During the past 12 months, 75% of workers in our study experienced work-related pain, and 31% reported it to management; 20% filed claims for workers' compensation as a result of work-related injury, and 35% of their claims were denied. Barriers to reporting injury included "It would be too much trouble" (43%), "I was afraid" (26%), and "I didn't know how" (18%). An estimated 69% of medical costs were shifted from employers to workers. CONCLUSIONS: The reasons for underreporting and the extent of claim denial warrant further investigation. Implications for worker health and the precise quantification of shifting costs to workers also should be addressed.

Accidents, Occupational↗
PubMed1984

Italian occupational health: concepts, conflicts, implications.

This paper examines Italy's worker-based model for occupational health, especially its key concepts and its relation to social conflict. It briefly reviews the history of three approaches to occupational health in Italy: university-based, industry-based, and government-based. It then analyzes the worker-based approach, which emerged in the late 1960s and early 1970s as worker groups and trade unions mobilized around new concepts of occupational health. Five key concepts are discussed: the workers' homogeneous group; workers' subjectivity; the use of contract language; the development of local occupational health institutions; and the use of occupational hazard risk maps. The analysis illustrates how the social processes of mobilization and institutionalization affected the ideas and structures of Italian occupational health. Worker mobilization in Italy produced ideological changes in the nation's occupational health system, institutional changes in universities and governments, and legislative changes at national and local levels. The institutionalization of reforms, however, created new conflicts and problems and tended to restrict worker participation and promote expert intervention. The paper concludes with a brief outline of the history of occupational health approaches in the United States and then discusses the implications of the five Italian concepts for US occupational health policy.

Attitude↗
PubMedDate not supplied

A preliminary report of mortality patterns among foundry workers.

A proportional mortality study was conducted utilizing the death records maintained from 1971 to 1975 by the International Molders and Allied Workers Union as part of a death benefits program. Death certificates were obtained on 3,013 members of the study group and classified according to the 8th Revision of the ICA by a trained nosologist. The ate- and race-specific cause distribution of all deaths among males in the United States for 1973 were used as a standard from which expected deaths were calculated. The statistical significance of differences between observed and expected numbers of deaths was determined by a chi-square test. The most statistically significant finding in this study was an excess lung cancer mortality (208 observed vs. 142 expected) and an excess mortality due to pneumoconiosis (29 observed vs. 5 expected). A discussion is included of the potential agents found in the foundry environment that may be responsible for the increased lung cancer risk.

Adult↗
PubMed1991

Ghana social mobilization analysis.

In order to increase communication channels for child survival and development, the government and UNICEF Ghana undertook a "social mobilization analysis." This analysis included three studies that aimed to identify individuals and existing organizations with the potential to serve as health communicators and to determine the type of assistance that they needed to maximize their effectiveness in this role. The first study surveyed governmental institutions, trade unions, revolutionary organizations, traditional leaders, and others and found a largely untapped reservoir of capacities to promote child health, with varying levels of current involvement. The primary need identified was for information and training materials. The second study focused on the mass media and revealed a low coverage of maternal and child health topics and the need for better cooperation between journalists and health professionals. The third study assessed sources of health information for parents and found several sources, such as religious organizations, women's groups, and school teachers that could be mobilized to promote child health. Recommendations are made for the use of the findings.

Attitude to Health↗
PubMed1991

Medical ethics committees in Hungary.

Hungarian medical ethics committees were established at the end of the 1950s. They came into being on the Communist Party's initiative. They could hardly be called "interdisciplinary" since their membership was made up of high-ranking physicians and a few head nurses. Their main task was to counter the practice of "tipping." Medical ethics and "tipping" were practically synonymous. These committees did not confront or try to resolve ethical problems concerning such issues as patient rights, informed consent, refusal of treatment, human experimentation, abortion, etc. These committees - whether it is believable or not - belonged to the Physicians Health Workers Trade Union. They were under the guidance and supervision of this social organization. The public was excluded from their meetings, and the committees' duty was to follow the health laws which were supposed to have given excellent ethical guidance. Even in a textbook on medical ethics used at one of the medical universities, written by a psychiatrist, the health laws were presented and explained back and forth. Of the 88 pages only 23 dealt with morals in general and the Hippocratic tradition. The Hungarian National Health Service as well as its medical ethics committees are similar in many respects to the Soviet and Eastern European countries' health care system and ethics committees. Since radical changes have taken place in these so-called "former" communist countries, it can only be hoped that these committees will eventually develop into groups who will deal directly with the moral questions or medicine and health care.

Communism↗
PubMed1995

Best practice and enterprise bargaining.

The Australian Council of Trade Unions (ACTU) and its affiliated health unions have strongly supported and actively participated in the Federal Government Best Practice in Health initiative over the past two years. We believe the initiative has been an important vehicle in fostering the development of the Best Practice approach in this vital sector of the economy. Healthcare expenditure in this country runs to some $34.3 billion (1992/93 figures) annually, financed by a mix of Commonwealth, State and private sources and constituting approximately 9% of GDP. Hospital expenditure alone absorbs just over a third of the total at $11.8 billion (1990/91). At the same time, we have developed one of the most accessible and equitable healthcare systems in the world and an increasing source of valuable export dollars. The Australian trade union movement, like others in the community, recognizes that real cost constraints exist on governments in healthcare as elsewhere. Those constraints can lead to a variety of responses, such as to withdraw money from the system, combined with total reorganization of financing through the introduction of casemix and hospital reorganization, to see whether the system survives. The alternative is one epitomized by a Best Practice type approach. It is these types of approaches and their relationships with enterprise bargaining on which I intend to focus. However, I hasten to add that the issue of context is all important. Whilst it may be possible to create a microcosm of Best Practice change in a particular healthcare setting, it is unlikely to be maintained. The interface with the socio-ecomonic and political context cannot be avoided and it is this context which will determine the continuing success of Best Practice initiatives--whether in health or elsewhere.

Australia↗
PubMed1979

Ideology, class and the National Health Service.

Since the start of the British National Health Service, disputes between the government and the medical profession have become formalized battles with well-recognized rules. But between 1974 and 1976 the consensus underlying the conflict was challenged by the Labour Government's policy on private practice and pay beds. This paper examines the course of the conflict and analyzes the factors underlying the eruption of this issue. It draws attention to the role of the trade-unions in activating the Labour Party's latent ideological commitment on private practice. Although the issue appears to conform to a class-conflict model, this simple symmetry becomes blurred on closer analysis. In conclusion the paper argues that while socio-structural factors extrinsic to the health service explain the appearance of private practice on the political agenda, it is factors endogenous to the NHS which explain the outcome of the dispute. In turn, however, these endogenous factors have little to do with the fact that the NHS is delivering a commodity called "health." Instead, what is important is that the NHS is a complex organization and, as such, depends on the co-operation of a variety of groups--ranging from the medical profession to laundry workers. The analysis, therefore, concludes that the power of the medical profession derives not from its elite status but from its position as an organized group in a complex industry.

Beds↗
PubMed1994

The determinants of hypertension awareness, treatment, and control in an insured population.

OBJECTIVES: The purpose of the study was to identify the determinants of awareness, treatment, and control of hypertension in a population with full access to medical care. METHODS: Unionized New York City health care workers (n = 1394) with comprehensive medical insurance were screened for hypertension. Union records documenting all physician visits and prescription medications for the year before screening provided the opportunity to relate patterns of treatment to blood pressure outcomes. RESULTS: Of the 409 employees found to have hypertension, 289 (71%) were aware of their condition and 201 (49%) had been treated, but only 51 (12%) had their blood pressure controlled at the recommended level (< 140/90 mm Hg). In a logistic regression model, the only variable of treatment associated with control was days of antihypertensive medication. The total number of physician visits was not associated with control. CONCLUSIONS: These findings demonstrate that in conventional community settings, even in the absence of financial barriers, treatment for hypertension continues to be characterized by poor outcomes. Improving access to primary care, without changes in the nature of that care, may not substantially improve blood pressure control.

Aged↗
PubMed2004

Impacts of health and safety education: comparison of worker activities before and after training.

BACKGROUND: The International Chemical Workers Union Council (ICWUC) Center for Worker Health and Safety Education in Cincinnati, Ohio, trains workers to protect themselves from hazards due to chemical spills and other chemical exposures. We evaluated whether the ICWUC Hazardous Waste Worker Training Program affects the attitudes and post-training activities, of trained union workers. METHODS: Detailed survey questionnaires were administered to 55 workers prior to and 14-18 months following training. Surveys queried trainees' interest and involvement in safety and health, use of information resources, training activities at their worksite, and their attempts and successes at making worksite improvements. RESULTS: Post-training, the study population showed an increase in training of other workers, use of resources, attempts at improvements, success rates for those attempting change, and overall success at making improvements. Self-reported interest decreased, and self reported involvement in health and safety did not significantly change. CONCLUSION: The study demonstrates that workers are more willing to attempt to change worksite conditions following training, and that their efficacy at making changes is substantially greater than before they were trained. The study confirms earlier work and strengthens these conclusions by using statistically tested comparisons of impact measures pre- and post-training.

Adult↗
PubMedDate not supplied

Case study. Does this company need a union?

No doubt about it, the top managers in this fictitious case study agree, Wellington Associates is a great place to work. Analysts at the high-tech consulting firm enjoy some of the best pay in the industry. And their benefits are extensive: flextime, liberal educational opportunities, comprehensive medical and dental coverage, generous vacation leave, and even on-site day care. So it came as something of a shock to CEO Jane Wellington and her top executives when HR chief Elvin Cusack started out the weekly senior-management meeting by declaring that the United Office Workers Union had begun organizing the support staff. Turns out, Cusack explained, that the company looks very different from the support staff's point of view. Although their starting salaries are indeed competitive, raises average a mere 2% to 3%, and promotions to professional ranks are rare. Medical and dental coverage take a greater chunk out of clerical pay than out of the larger professional salaries, and the cost of the day care center is pretty much out of reach for the support staff. Flextime is impractical for workers who need to be in the office to answer phones and to file papers. Worse, the support staff is expected to accommodate the analysts' flexible schedules; if an analyst decides to work late to finish a project, the secretary has to stay as well. What to do? Suggestions ranged from "fire 'em" to "say nothing before calling in legal counsel." Five commentators examine Wellington's options and its legal obligations.

Employee Grievances↗