Workers Memorial Day, 2020: NIOSH Director John Howard, M.D., Reflects on the State of Worker Safety and Health

This year marks the 50^th anniversary of the Occupational Safety and Health Act that established the National Institute for Occupational Safety and Health (NIOSH) as the sole federal agency focused on worker safety and health research. The Act also charged the Secretary of Labor with setting and enforcing workplace safety and health standards, giving birth to the Occupational Safety and Health Administration (OSHA).

In 1970, when the Act became law, the need for worker protection was urgent, with approximately 14,500 workers dying each year in work-related incidents, and 390,000 becoming ill or injured. Since then, we have made tremendous strides in reducing work-related death, illness, and injury. Even so, 5,250 work-related deaths and 2.8 million injuries or illnesses in private industry occurred in 2018, according to the U.S. Bureau of Labor Statistics (BLS).

Each year on April 28^th, Workers Memorial Day commemorates workers who have died or become ill or injured due to hazardous exposures in the workplace. As technology continues its steady progression toward automation, it is changing the fundamental nature of work. We are faced with new and different risks unlike any we have seen before, in addition to some persistent ones from the past.

Addressing the Risk of COVID-19 to Workers

A new and unprecedented risk is coronavirus disease 2019, or COVID-19. On this Workers Memorial Day, I would like to honor the dedicated workers on the front lines of this pandemic.

Key workers such as healthcare personnel continue to go into work to treat people who have become ill with this life-threatening infection. Agricultural, transportation, and service workers continue to go into work to ensure that the shelves of our stores stay stocked with food and that critical medical supplies reach their destinations. And, environmental services workers and waste collectors continue to go to work to ensure that hospitals and other essential public buildings stay clean and that trash gets collected.

Other workers are doing their part, as well, to flatten the curve, or slow the spread of COVID-19 by working at home if their jobs allow it. At the same time, millions of workers have been furloughed or suffered devastating job losses as businesses shutter their doors in the face of orders to shelter in place and stay home.

As this rapidly changing pandemic evolves, CDC continually updates its guidance to protect the public’s health. At NIOSH, the National Personal Protective Technology Laboratory, a leader in research on personal protective equipment (PPE), provides the most recent guidance on the proper use of N95 filtering facepiece respirators and other PPE. A fundamental part of this effort involves guidance on proper fit testing and the critical difference between the NIOSH-approved N95 respirators and surgical masks.

NIOSH continues to work closely with our federal partners at the U.S. Food and Drug Administration (FDA) and OSHA to provide guidance for healthcare providers on how to remain safe during this public health emergency. Our goal is to provide science-based infection prevention and control recommendations for PPE that also account for the current reality of the limited supply of N95 respirators in healthcare settings.

These PPE recommendations comprise five strategies:

1. Optimizing the supply of N95s through using all steps in the hierarchy of controls.
2. Using NIOSH-approved alternatives to N95 respirators where feasible, including elastomeric, or elastic-like materials, and powered–air-purifying respirators (PAPRs).
3. Considering the use of stockpiled respirators beyond their designated shelf life and comparable respirators complying with international standards.
4. Extending the use of N95 respirators when alternatives are not available.
5. Decontaminating and reusing N95 respirators.

Protecting Workers from Old and New Risks

During these trying times, NIOSH continues to develop new knowledge in the field of occupational safety and health and to transfer that knowledge into practice. To address the reemergence of severe cases of black lung disease, especially in younger miners, NIOSH released the video Faces of Black Lung II early this year. This follow-up to a previous video about black lung disease among older miners is designed to raise awareness of the risk to miners in their 30s and 40s, and to notify them of NIOSH-sponsored health screenings. Offered through the NIOSH Coal Workers’ Health Surveillance Program, these free and confidential health screenings can detect early signs of black lung disease before extensive damage occurs.

Another persistent risk is the opioid epidemic. NIOSH maintains a multidimensional research program to protect workers from opioid misuse, which can both cause and result from work-related injury. Unintentional workplace exposure also presents a risk for some workers, especially first responders, who may be exposed through inhalation; contact with the mucous membranes in the eyes, nose, and mouth; contact with the skin; and by needlestick. Last September, NIOSH released the Illicit Drug Tool-Kit for First Responders with resources based on NIOSH recommendations to protect first responders when arriving on a scene where illicit drugs, including fentanyl, are present or suspected.

Opioid misuse can affect workers across industries, but construction workers face another serious risk: falls. In 2018, falls, slips, and trips caused 338 of the 1,008 reported construction-related deaths. Almost two-thirds of all fatal falls are from roofs, scaffolds, and ladders. Although falls remain the leading cause of death in construction, they are preventable. Each May, thousands of employers take time to stop work and focus on workplace safety by participating in the National Stand-Down to Prevent Falls in Construction. A collaboration between NIOSH, OSHA, and CPWR – The Center for Construction Research and Training, this annual campaign encourages employers to promote safety through a week of activities. Due to COVID-19, this year’s stand-down is postponed, but we can still take a moment to honor construction workers who were injured or lost their lives due to falls or other hazards.

As the events of the past few months accentuate, reducing the risk of workplace exposures is an ongoing and crucial effort that changes as new threats emerge. To explore the potential promise of collaborative robots, or co-robots, in protecting workers, NIOSH and partners are studying the safe use of this technology in industries such as agriculture, mining, construction, and healthcare.

This Workers Memorial Day, please join me on behalf of NIOSH in recognizing workers who were injured, became ill, or died because of exposures to hazards at work. And, please stay safe and well as we all do our part to stop this pandemic.

John Howard, M.D., NIOSH Director