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"EACH YEAR BETWEEN 50,000 and
100,000 Americans die from diseases caused by on-the-job exposure to toxic
chemicals, wastes, fumes, dusts or industrial processes, which is more
American lives lost each year than were lost either in Vietnam or in Korea.
It is shameful and it need not be. The resultant health care costs to families,
to governments, to employers, run into hundreds of millions of dollars.
The cost in terms of human misery cannot be measured. It does not have
to happen." WITH THESE WORDS, Sen. Howard Metzenbaum, D-Ohio, introduced
the High Risk Occupational Disease Notification and Prevention Act of 1987.
The bill would have provided a low-cost program for notifying and medically
monitoring workers who are considered to be at high risk of contracting
an occupational disease resulting from workplace exposure to toxic substances
or processes. The two-year battle to pass the legislation ended, however,
when Republican senators Dan Quayle of Indiana and Orrin Hatch of Utah
filibustered the bill. When a final vote to end debate failed on March
29, 1988, the bill was pulled from the Senate floor. According to Congressional
Quarterly, Quayle called his strategy one of "dragging feet and killing
time." Together, Sens. Quayle and Hatch introduced almost 100 amendments
to the bill as part of that strategy. Quayle voted against closing off
debate each of the four times a motion for cloture was introduced. "We
have at least 40 [cloture] votes we can hold," said Quayle.
Quayle's actions
were in marked contrast to the position he took just six months later as
the Republican vice-presidential nominee. In the debate with Democratic
counterpart Sen. Lloyd Bentsen, D-Tex., Quayle insisted "We're committed
to ... the safety of our working men and women." According to Metzenbaum,
there are twice as many occupational disease-related deaths each year as
there are homicides and suicides combined.
The Centers for Disease Control
(CDC) estimates that over 19 million people have been exposed to toxic
substances in the workplace during the past 20 years. The issue of occupational
notification resurfaced in 1984, when the National Institute for Occupational
Safety and Health (NIOSH), in a series of 66 studies, identified between
200,000 and 300,000 workers at increased risk of contracting cancer or
other diseases. The study results placed NIOSH in the unique position of
being the sole possessor of health information that could be vital to hundreds
of thousands of workers. NIOSH requested funding to inform the workers
identified in the studies, but was turned down by the Department of Health
and Human Services (HHS), which oversees NIOSH operations. HHS contended
that NIOSH had "no legal obligation" to notify the subjects of their studies.
HHS continued to refuse NIOSH's request,even after the Cdc asserted that
NIOSH had an ethical obligation to inform the workers.
Despite the fact that the government today knows of over a quarter million workers at roughly
250 worksites around the country who are at risk of contracting occupational
disease, there is no national program for identifying, notifying and monitoring
these workers. "Sadly, the Reagan administration has turned its back on
the occupational heath crisis," said Metzenbaum during a hearing on his
bill. "The Reagan administration has cut NIOSH's budget to identify and
control occupational hazards by 38 percent since 1981." NIOSH requested
funding to initiate a worker-notification program in 1985,1986 and 1987,
but was turned down by the Reagan administration each time.
Metzenbaum's bill authorized $25 million a year for notifying workers in high-risk populations,
with at least $4 million to have been set aside for research, training
and education aimed at improving methods of identifying, monitoring and
treating those found at risk. According to the majority report of the Senate
Committee on Labor and Human Resources, the $25 million budget was sufficient
to notify up to 300,000 workers a year. The bill also included provisions
for providing grants to medical schools for occupational medicine and health
programs. The bill offered protections against loss of pay or benefits
if monitoring determined that workers should be transferred to less hazardous
work, and against future discrimination based on health status. It would
have also established 10 health centers to offer training and technical
assistance to physicians and other professionals monitoring the notified
workers, and a hotline that notified workers could call.
Dr. Philip J. Landrigan of the Mt. Sinai Medical Center, who conducted a year-long analysis
of occupational disease in New York State, estimates that between 5,000
and 7,000 occupational disease-related deaths occur and 35,000 new cases
of occupational disease arise each year in New York State alone. In testimony
before the Senate Labor Committee, Dr. Landrigan concluded, "Prevention
is $6 million a year, the cost of disease $600 million. We are talking
about prevention adding up to one percent or less of disease costs."
The Senate Committee of Labor and Human Resources passed Metzenbaum's bill
by a vote of 11-5 on July 17, 1987. The House of Representatives passed
a similar version of the bill on October 15,1987 by a vote of 225-186.
But Quayle and Hatch made sure the full Senate never voted on it. Virtually
the entire health community disagreed with Quayle's assessment of the bill
as "flawed." American Cancer Society vice-president John R. Seffrin, Ph.D.,
testified, "The American Cancer Society estimates that over 165,000 Americans
will die in 1987, just because their disease was detected too late. Obviously
a systematic intervention effort within America's work force to monitor
and detect cancer early would result in an annual net reduction in lives
lost to cancer." The American Cancer Society suggested that between 8,000
and 25,000 occupational cancer deaths could be prevented this year through
early detection and medical intervention, according to the committee report.
Much of the business community opposed the bill, however, fearing that
it would lead to numerous worker compensation claims and lawsuits. "[A]
refusal to tell workers that they should seek medical assistance to prevent
a disabling disease for fear that they might bring a lawsuit would be simply
unconscionable," the committee report countered. Although the Senate Committee
amended the bill to preclude use of information furnished through the proposed
notification program in lawsuits, the amendments failed to placate the
bill's corporate opponents, among them the National Association of Manufacturers,
the U.S. Chamber of Commerce, General Motors, Proctor and Gamble, Goodyear
Tire and Rubber Corporation and Uniroyal, Inc.
David Shernoff is an intern with Multinational Monitor.
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