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Will Obama administration embolden OSHA?
New administration may be favorable to worker rights
Will the Obama presidency bring mandates for safe patient handling? More citations from the U.S. Occupational Safety and Health Administration? Recognition of new hazards?
With the economy and the war in Iraq at the top of the policy agenda, President-elect Barack Obama hasn’t gone on record about worker safety and health. But the power change from Republican to Democratic administrations indicates a probable swing toward greater regulatory enforcement and an increased emphasis on the worker perspective.
"We don't have a lot of information about his agenda - if there is any agenda - on worker safety," says Celeste Monforton, MPH, DrPH, research instructor at the George Washington University School of Public Health. "We can speculate on what things we hope would be important.
"One of the top things for worker safety advocates would be protection for public employees who aren't currently covered under the [Occupational Safety and Health] Act."
Some 8 million workers not covered
About 8.6 million workers currently aren't covered, including health care workers at public hospitals in states that are under federal OSHA or don't have state laws that cover them.
Efforts were made in the Clinton administration to extend health and safety rules to public workers, but it was attached to other provisions, including tougher OSHA penalties and a requirement for employers to create health and safety committees.
"In '94, the Gingrich Congress took over, and it swung the opposite way with recommendations to gut OSHA," Monforton recalls. "In the two-year window of opportunity to get public sector employees covered, it didn't happen."
Meanwhile, under the Bush administration, OSHA has emphasized compliance assistance to businesses and alliances with professional organizations. An Obama administration might shift toward programs that educate workers and their rights to a safe workplace, she says.
"I'd like to see more focus on building the knowledge base, the skills and the capacity of workers to advocate for themselves for safer workplaces," Monforton says.
That should include a greater emphasis on enforcement, says Bill Borwegen, MPH, occupational safety and health director of the Service Employees International Union (SEIU).
"In the last eight years, there's become an incredible imbalance between enforcement and employer assistance," he says. "The bottom line is that the agency that Richard Nixon created was a regulatory agency. Just like we're seeing in the banking and investment industries, less regulation is not necessarily a good thing."
In past transitions to a new administration, there have been dramatic shifts in the focus related to worker health and safety. The Clinton administration issued an ergonomics standard in its waning days, and the rule was then rescinded by Congress shortly after George W. Bush took office.
An emboldened OSHA may initiate a new ergonomics standard - although the Congressional Review Act restricts OSHA from issuing a similar standard without express permission from Congress. Or Congress may turn more serious attention to the Nurse and Patient Safety and Protection Act, which was introduced in the House of Representatives in 2006 but has not been the subject of hearings.
"I'm hopeful that the new administration will make a difference," says Anne Hudson, RN, a back-injured nurse from Coos Bay, OR, who founded WING USA (Work Injured Nurses' Group), which advocates for safe patient handling.
"I would like to see a broad-sweeping reform to help all workers. It's so badly needed," she says. But whether a general ergonomics standard moves forward, health care-specific legislation on safe patient handling still is needed, Hudson adds.
With both the economy and health care ranking as top priorities for the new administration, some health care worker safety issues should be a natural fit. Beyond regulation, hospitals need to get the message that safe patient handling is essential to recruiting and retaining nurses amid a growing nursing shortage, says Nancy Hughes, MS, RN, director of the Center for Occupational and Environmental Health at the American Nurses Association in Silver Spring, MD.
Tight hospital budgets may imperil some initiatives. "With the [ailing] economy, we have some concerns about how projects will move forward, including safe patient handling programs," says Hughes, noting that hospital construction projects need to incorporate safe patient handling elements, such as tracks for ceiling lifts.
Yet ultimately safe patient handling protects the patient and saves money by reducing injuries, she says.
As Hospital Employee Health went to press, worker advocates remained concerned about a Bush administration effort to add new hurdles to OSHA rule making. In July, the U.S. Department of Labor's assistant secretary for policy proposed a "risk assessment" rule that would require OSHA to publish an Advance Notice of Proposed Rule-making and to seek public input "when developing risk assessments for health standards regulating occupational exposure to toxic substances and hazardous chemicals."
"It would add an additional step in the rulemaking process," says Monforton, who notes that OSHA rules generally take eight to 10 years to develop and finalize as it is. "It would be additional years of delay in getting a rule out."
If the rule is implemented in the final days of the Bush administration, it's unclear what steps an Obama administration could or would take to change it, she says.