Document p2rKoRyg80YxDdX7Jm50mJ6Xa

WOMEN IN THE WORKPLACE OCCUPA SAFETY AND HEALTH ADMINISTRATION POLICY ANALYSIS ANL' INTEGRATION STAFF JANUARY 1977 BFS 005411 Table of Cont< tits PREFACE......................................... .. ..................................... ................................... 1 EXECUTIVE SUMMARY ........................................................................................ ii INTRODUCTION....... ......................1....................................................................... A-l HESEAHCH ON TOXIC SUBSTANCES E-l AGENCY ACTIVITIES..................................... ..........................................-.......... C-I OCCUPATIONAL SAFETY ANT* HEALTH ADMINISTRATION.............. C-l NATIONAL INSTITUTE TON OCCUPATIONAL-SAFETY AND HEALTH.. C-3 C-A C-5 STATE Cl' OREGON, DEPARTMENT OH HUMAN RESOURCES .............. C-6 THE PROPOSED LEAD STAt.'DAKD ........................................................... C-3 SAFETY STANDARDS FOR WOMEN .............................................................. D-l EQUIPMENT CERTIFICATION .................. .'........................................ D-3 RECOMMENDATIONS ............................................................................. P-5 HOW OTHER COUNTRIES PROTECT WOMEN IN THE WORKPLACE------ E-l LEGAL COilSlDERATIONS r-i POLICY RECOMMENDATIONS................................ -. G-l "iT-*rYC:'' r".} ... *w* * * ** VV * * ~/ , **" * .>.# . '' GFS 005412 PREFACE The Policy Analysis Staff was faced with a particularly complex and difficult task in defining the policy consid erations relating to those groups of employees in the workplace who are deemed highly susceptible. The issue of how to protect these groups is coraplicated.by a number of factors: o Perhaps the most important concern is that the universe to be studied has never really been de fined. In effect the number of highly susceptible workers varies from substance to substance. Further more, since generally accepted professional standards (e.g., American Conference of Governmental Industrial Hygienists, "Threshold Limit Valuator Chemical Substances in Workroom A i r, "_JL . 1) have always assumed that hypersuscMWbl'lpjw'JrkVrs would be screened out by. g^e^acgyejit^treal th examinations, there nevepjjsjfeeifc^ ^ be a real problem. For these reasons, n*>Wprehensive listing of who might be affected, iTnder what circumstances, and at what exposure levels appears to exist. The Policy Analysis Staff has therefore decided the only maaageable approach to the subject is to try and define meaningful subgroups and analyze their problems separately. o Many groups simply do not want to be identified as highly susceptible. The Veterans and Handicapped Worker Program in the Office of Federal Contract Compliance Programs, Department of Labor, explains that the handicapped have resisted`being single out for special treatment. They feel that they are already more consicious of safety and health--an take more precautions than the average worker--by virtue of their having sustained a handicapping injury or .illness They are primarily concerned about fighting against the discriminatory stereotypes that exist in the minds of many employers and thus do not wish to add to their .visibility in this fashion. o "Highly susceptible" is often too sweeping a character ization. In the case of a blind or deaf person, the only requirement for differential treatment may be to make some minor adjustments in the workplace in order to insure a "safe work pattern," for example., not depending on either light or sound signals to indicate changes in the'work cycle.' Otherwise, everything would be the same as for other workers. BFS 005414 o Affected workers fear that if publicly identifi ed, as highly susceptible, employers will strengthen their efforts to employ only the healthiest candidates and that "marginal" workers might systematically find themselves screened out despite the enactment of legal safeguards. o Accident rates already are lower among the handi capped, generally because they are more carefully than other workers due to their previous work history and experiences. Moreover, many argue, if the OSHA workplace standards that currently exist were adequately enforced, such-4rsv(^eping aisles cleared and i ns tal 1 i ng ar-ypelOfairfiTdy on machines, employers could pW?tefct not only the handi cappedjrfttrteeW^^t -a^lT workers. o Highly susceptible groups are not necessarily monolithic. For example, asthmatics have differ ing opinions among themselves as to what additional protection they might need, if any. o Personal characteristics correlations may present problems. Witness sickle cell anemia ana hyperten sion in the case of Blacks, "Mediterranean anemia" in the case of Greeks and Italians, etc. In. such cases, OSHA clearly runs the risk tht extending standard coverage broadlywould cause perfectly healthy and innocent workers to be selected out of certain workplaces simply because of their race or ethnicity. 0 Finally, society is just beginning to confront basic questions on of the responsibilities which accrue to individuals in safeguarding their own health and their right to life, such as tobacco, alcohol, seat belt interlock systems, euthanasia, etc. Specifically, susceptibility to health disorders rises sharply for smokers, particularly heavy smokers, exposed to cotton dust, coke oven emissions and a host of other hazardous susbstances. Should smokers therefore be extended the same protections that other Highly susceptible groups might 'receive? ' Given the scope of the problem it makes sense, therefore, to divide the workplace issues relating to highly susceptible groups into three different policy papers. The first paper wi.ll cover "Women in the Workplace." This is, by far, the largest group of highly susceptible workers, more than 36,UU0,00U strong and growing at a rapid rate. Their susceptibility seems to relate to their capacity to bear children and, move often than not, relates more directly BFS 005415 ." . ; | ! ! 3 to the future fiealth of the fetus thatthey are carrying rather to their own proper health. Moreover, of all the highly susceptible groups, their vulnerability alone is a discretionary one. Pregnancy can be avoided. Pregnancy can also be terminated. Finally, the growing activism of women's groups is creating special pressures that make it useful to look at the special health concerns of this group separately. The second group, the handicapped, may or may not consider themselves highly susceptible as a class. Definitions of who is covered as seen above, are still imprecise. Posi tions as to the extent and types of protection are not fully evolved or articulated. The focus here also would primarily be on safety concerns. The Policy Analysis Staff held a small conference on this subject on June 22, 1y76 that provides a sound basis on which to 1 d a second paper. Completion of this paper is not^artfi^^^pated until Spring,1977. The third and final groupware ijb-ose special groups who, while covered by def-i r^wi opi of handicapped under Section 5u3 of the R e h a b*^ tl^On Act of 1973, PL 93-112 (which requires the of labor to take affirmative action in the pi acem^jpV of handicapped workers), raise special health concerns because of their medical vulnerabi1ities, for example, epilepsy, diabetes, asthmas, kidney disorders, leukemia, sickle cell anemia, etc. Since the research here will be more difficult to carry out, such a paper would not be completed before July 1977. The first paper is attached. It represents a starting point rather than a conclusion. It also provides a grouping for the first time of major points--demographic, medical, legal, economic, governmental--that are necessary background for the initiation of useful dialogue. It enumerates some' first steps that OSHA might take toward the development of an official policy toward women in the workplace. However, it suffers several deficiencies. It concentrates primarily on pregnancy as the most significant and. obvious vulnerability with which working women must contend. It ignores the important question--and possibly others too--of size and weight as a potentially serious factor in protecting working women's health. It do.es not examine the'health problems of Asians and others who are also generally smaller and lighter than the average white male worker, the model that regulations have generally sought to protect. It only briefly mentions the impact of toxic substances on male semen and, from thence, on the fetus. While some of these areas of concern may appear to be unrelated to the special health concerns of working women, determining the extent to BFS 005416 4 which men, Asians and other identifiable groups are affected by the same toxic substances as women of childbearing capacity will permit a better assessment of the dangers associated with particular exposure levels of toxic substances and demonstrate the breaoth of adverse impact that they might have on workers. These questions are not explored here because they would appear to be more appropriately handled by the Task Force on i ! BFS 00541? INTRODUCTION The increasing number of women in the workplace,.when coupled with the demographic trends that emerged*over the past five years, is not only an indicator of societal changes but also poses significant questions for the Occupational Safety and Health Administration (OSHA). Thirty-six million women--46 percent of those 16 years of age and older--are working or actively seeking work today. This is a 74 percent increase since 195b.. The respective increase of working men is only 19 percent. (Total u7s7~Population gain since 1955 is 2b percent. L) Almost all American women will work at some time during their lives. A substantial number will work as many years as men, if not longer. This represents an impressive change in female employment patterns. In or^e^i^p assure a safe and healthful work environment ^or'^Slwrtltf)'60 million working Americans covered 1 e^Jyration, OSHA must begin to address the^'*^Lns4 health concerns relating to working women ar1^^^|wu^thi 1 dbeari ng considerations. Twenty years ago the majority of women between ages of 18 and 24 worked three or four years before getting married and raising children. After they left the labor force to have a family, many never returned. Today, most younger women are working, and fewer working women are leaving the labor force to have children. Those electing to raise a family remain out of the workforce for much shorter periods of time. The number of working mothers with children under six years of age has increase 24 percent over the past 2U years, between 194U and 1974, the number of single women working increased . WalX Street Journal^, Hay 3, 1976, p. 1. U.S7 Census Bureau, Population Reports. BFS 0054 IS AL by 1.6 million. Thu number widowed, divorced and separat ed women in the labor lorce roue even more sharply--up by . 3.b million. The most noticeable rise, however, has been among married women--!) fivefold increase between 1940 and 1974--4.2 million to HU.4 million.* Currently, 60 percent of all women working arc married. While the primary cause of the rising numbers of working women is financial need emanating from either increases in the cost of living or rising expectations, other significant socio-economic factors also .help to explain the heightened expectations of women at work and the ensuing changes in o Increased opportunities have arisen in the service ' and clerical professions, jobs traditionally held by women. o Landmark 1 egis1 ation/court decisions have prohibited employment discrimination based on sex. o Social prejudice against women working has been disappearing. o Ueclining birthrates and greater utilization of day care services hdve reduced child care responsibilities, thus freeing women to work. o Rising divorce rates ^nd decreasing. marri ace rates J have increased the number of women who must now work in order to support themselves and, in many cases their families. -LilX. nnlia tJ f. -* 11 .* # :: BFS 005419 A-3 Given that 'the basic structural changes that the labor force is undergoing seem likely to continue, greater numbers of women will continue, greater numbers of women will continue^to be exposed to uorkplace hazards. As women begin to understand better the risks of exposure, their concerns about health and childbearing capacity wi 11 increase. This attention, coupled with the existing state of knowledge and stanoards as to the effects of workplace hazards un women, presents OSliA with a diffcult challenge. There is also a complicating factor. Major v/omenls interest groups have reacteo forcefully against^A(iM>roposed protec tive regul ations ,. rel ati ng^o -ai Yh e mAnJgi teJneal th or that of the fetus, whiffy their job and promotion opportunities. TcS^qtres ti on, then, is how should OSHA move to deal with women in the workplace? While the answer is not clear, a start must be made. A thorough investigation of the scientific, legal and economic implications involved in assuring women a safe and healthful workplace is required. Recently, the national Instutute for Occupational Safety and Health (MlOSH) estimated that 1 million women between the ages of lo and-3*1 years of age are exposed to chemicals which may have a damaging effect on all otherwise normal pregnancy.1 More than UiU,UUU unique toxic substances are in use today in the 'workplace and 4,U0U new chemical compounds are being added each year to the registry of chemical substances with poisonous effects'.- The number of workers exposed to toxic substances is a cause for concern. Uut of even greater concern is the current lack of knowledye as to what constitutes a safe t -- - -------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------- * , BFS 005420  A-4 level of chemical traces in the workplace environment or at what level'of chemical assimilation does damage to health begins, especially as regards the reproductive process. In general, most chemicals are not now systematically tested to determine their potentiality for causing-cancer (carcingens mutations or chromosome alterations (mutagens), or malformatioi of a fetus (teratogens). Even under the new Toxic Substances l trol Act, it is not clear to what extent health tests will lake these concerns into consideration. In addition, the incidence of female and fetal reactions to toxic substances in the workplace is almost impossible to determine without monitoring programs covering maternal health difficulties and birth defects and^without information systems supplying the occupational Tjv^d^es of both parents, There simply does not no^^xi gnff^gn reliable data, especially studies Farticular subjects of exposure over a Vf yea rs, to provide definitive guidance. Yet, tV existing evidence, as discussed in Section B, signals clear risk of danger and seems to support NIOSH's warning that many working women may be damaging their health as well, as that of any offspring. For example, research has poin.ted to the fetus as perhaps the most susceptible part of a pregnant woman's body. Even in the absence of incidence data, it seems fair to assume that, if the pregnant worker is' subjected to even low-level toxic exposure, complications or special health problems as a re suit of rapid cell division, effects of toxic substances crossing the placenta and the complexity of the fetal growth process could be caused. The threshold limit values, the current health standards, are now set at levels that protect only the average adult white male worker, Moreover, the American Conference of Governmental industrial Hygientists makes it clear in a recent publication that such standards are not to be considered safe for workers with a special suscepti1ity. SFS 005421 A - 5. Threshold limit values (TLVs) refer to airborne concen trations of substances and represent conditions under which it is believed that nearly all workers may be repeatedly exposed day after day without adverse effect. because of wide variation in i ndi vi dual susceptibility; however, a small percentage of workers may experience discomfort from some substances at concentrations at or below the threshold limit; a smaller percentage may be affected more seriously by aggravation of a preexisting condition or by development of an occupational illness. tests may be used to p"E i b 1 e to a variety of irritants, hemolytic chemicals, qr^a|iTli'i=fc$$yar1ates, carbon disulfide). These tests may bevuPsttdj?tar screen out by appropriate job placemen the hyperreag^tVve worker and thus in effect improve the "coverage^ of the TLVs. {Emphasis added.) While the ACG1H did not have the problems of working women of childbearing capacity in mind, the basic point that it makes it valid in this regard: standards that are set for the average worker will not necessarily protect workers with special conditions that might make them more susceptible to exposure to a particular toxic substance. ^ Journal^ of Occuga tinal^ Medicine 15: 564 , 1973 ; Ann. N.Y. Aca Sci., 151, Art! 2: 96b,"l96. ^ "Threshold Limit Values for Chemical Substances in Workroom A Adopted by ACG1H for iy75B, p.l. BFS A-6 In order to protect the pregnant worker and the health of her current or future fetus, the primary concern of women of childbearing capacity, it would seem that the approaches for employers are limited: o to lower the toxicity of the workplace to a safe level for all workers--which raises financial, technological and competition problems; o to warn women of childbearing capacity of the potential dangers they might face on the job they are entering-- which does not absolve employers from legal 1iabi1ity; to bar such women from employment in areas which may have deleterious effects on future generations--which exposes employers to potential suits on the grounds or discrimination; or, to transfer all pregr^rwt wS^enrAt^safer jobs during their peri oi^of^tento/o ra iftp' tfi sabil i ty--which raises real feasibility for some employers and still enO^^/pVtentially exposing women to toxic substances durThg the most dangerous period of their pregnancy, the first 6 to 8 weeks. The apparent straightforward approach to solving the problem-uniform protective regualtions for wom'en--conf 1 i cts with numerous recent court decisions which have overturned: dual weightlifting standards, restricitons on night hours for women, mandatory pregnancy leaves, etc. These rulings have asserted the need to treat women as separate individuals with different capabilities rather than as a class. But many industries continue to ban any woman of childbearing capacity from employment which might affect her health or that of the fetus. The Federal Government, through OSHA, should not adopt such a course of action. Major women's interest groups have already expressed their concern to the BFS 005423 A- 7 Solicitor of the Department of Labor with regard to the proposed lead standards, arguing that OSHA should adopt only those standards that would protect all workers and , in particular, should avoid issurance of a special standard for women of childbearing age. OSHA needs more and better information about the numbers of women at risk in particular industries and the types of risks faced to help resolve the dilemma of protecting the health of women workers wi th-ou^f^rS^l osi ng their employment or advancement possibil i tje. 'VrejL? tire research projects studying the ef f ectt r* cntekj ctfrs on the female reproductive capacity are few'Hifc-c&^ti'on to the scope of the problem. Moreover, v ^ ljyW oe f f o r t s are aimed at investigating the effects cJ^SeRemica 1 s found in the workplace on the male reproductive capacity. Scientists note that cumulative effects of chemical may take a life-time or even several generations to determine. Reliable data and methodologically sound correlations are hard to find. Every source interviewed by the Policy Analysis Staff agreed on the need for these data, improved data collection systems, and more careful analysis of the effects of toxic substances on women and men. i Section 17(kl of the Occupational Safety and Health Act states OSHA must demonstrate for a "serious violation" that: ` there is a substantial probabi1ity that death or serious physical harm coul'd result from a condition which exists... (emphasis added) "Substantial probability" basically means "beyond a reasonable doubt based on reliable evidence." The need for more evidence is therefore clear. Without such evidence on the levels of toxic substances to which women of childbearing capacity can safely be exposed, employers will remain fearful of lawsuits. Employers, especially large corporations. BFS 005424 I are being counselled to take positive steps to protect themselves from liability suits stemming from alleged incustrial inalpractices.The simplest ano most effective remedy here is to screen out all potenjt^M problems. For example, to limi t their 1 i abi 1 ity,-rftjfSS^^pct by excluding all women of chi 1 dbeari ng cap*fi:Yty irora the workplace. Employers conclude That^ii^j wodjnen "Tre, potentially, in a constant state olrfand therefore present too great a risk. As an lata shows that the fetus/infant can be harmed by exposure to some toxic substances like lead both before pregnancy (the body's capacity to cleanse itself of excess lead is slow) and after birth (the excretion of lead through breast feeding). It is no surprise, that employers are therefore, beginning to behave more conservatively in regard to whom they hire. Although this is not related uniquely to women of childbearing capacity, they are currently bearing the brunt of corporate protectiveness. There is evidence that companies in lead-related industries already have taken steps to exclude women of childbearing capacity from exposure to toxic substances. Moreover, the Lead Industries Association recently recommended that the industry employ no nursing, pregnant or fertile women until more data becomes available on the effects of lead on female reproductive systems.* The Dow Chemical Corporation has decided not to hire any women for jobs where they might be ^ exposed to known human teratogens and' transplacental carcingens. }. The Spokeswoman, July lb, 197b, p. 7 L lbio. ~ ~ ~ ~ BF5 005425 A-9 Exxon Corporation will probably recommend that no women.of childbearing capacity be hired in a job where they are exposed to benzene until the effects of. such exposure on women become clearer.^ What, about reoucing the level of exposure so that all workers can work in safety? Would it not be easier simply to protect everyone? While logical, industry claims this is selaom feasible. Retrofitting existing plants is usually a costly and difficul' -xnumber of years of useful plai Impossible to amortize the aodi tional. i^efewien^uefchre the plant is closed down. SometillS,\\tlje^tecTmology is just not available. With certain substances, it is difficult to keep the workplace sufficiently free of hazardous traces to avoid the hyper-reactive- ness of the susceptible worker, particularly that of a fetus whose tolerance level is extremely low and whose mutation risk, because of the rapid cell division taking place early in the gestation process, is substantially higher. Finally, the substantial capital investments necessary to bring American industry into compliance with standards set at levels to protect all workers, including the highly susceptible groups, could create great financial difficulty. In many cases, operating costs would probably increase. FI ants that operate at the margin or those saddled with captial formation problems would be particularly hard hit and could be forced to shut down. In summary, then, some balance will .have to be struck between the difficulties caused by major operating changes and the need for substantial capital investment, on the one hand, and the risks of damaging future generations, on the other. While the industrial state cannot realistically be dismantled--witness the recent environmental concessions-- the nation also cannot ignore the great potential for ; .w. BFS 005426 A - 1U The Policy Analysis Staff has discussed the issue of protecting women in the workplace with a variety of organizations and agencies. The legal, economic and political implications of providing a safe working environment for women of childbearing capacity, particularly pregnant women, are manifold. Many believe that the need to protect the health of working women may be incompatible with the goal of^rtxGding equal opportuniti for women to pursue employment '$55.of jobs in all industries. A senior elfecutface %xempl i f ied the predicamer which employers finve-s' iifhen he proclaimed that his, company would ralffi^^ fate*1 V'charge of sex discrimination than run the riskvpfc*"* deformed baby. This point of view seems widely heldby members of the business community. The facts defining the problem remain: o The existing research data cautions that exposure to certain toxic substances can adversely affect the entire reproductive process. o Women of childbearing capacity are being denied certain jobs and are not being given equal opportu nity to compete with men for employment in the more hazardous and often higher paying jobs. o Employers receive little guidance from the Federal government on how to. comply its conflicting require ments to promote safety in the workplace while having to hire more women in the very occupations that appear most hazardous to their health. This paper describes OSHA's possible role in dealing with the issues associated with the exposure of working women to toxic substances in industrial workplaces. . Various policy options will be presented for consideration. While there will be no perfect or easy solution, the Policy Analysis Staff outlines steps that OSHA can take to protect the health of working women, deny them an equal opportunity in the workplace. 1 BF5 005-427 EXECUTIVE SUMMARY On July 10, 1976, an explosion occurred at the Icmesa Chemical Plant outside Seveso, Italy. A highly toxic chemical, dioxin, was released into the atmosphere. At first, the villagers thought little of the incident. Then cats, dogs, and chickens started to die. Soon afterwards, human symptoms began to appear. Eight hundred people ultimately had to be evacuated for their safety. A senior health official warned risk that existed: their chi-&afen V^omen the substantial ght now be born deformed because of the exposuj^&o^he poisonous gas that escaped from the factory. Whe^g^-they were employees in the plant or simply lived in the community, the risk would be the same. Although abortions are usually illegal in Italy, Justice Minister Paolo Bonifacio would later rule that women from Seveso might have abortions if a doctor oecided that their mental health could be endangered by the worry of carrying a deformed fetus.^ A freak accident? An isolated incident? It would appear that this is no longer true. For example, John F. Finklea, M.U., Director of the National Institute for Occupational Safety,and Health (NIOSH), has estimated that one million American women of prime childbearing age are currently exposed to chemicals which '2 may have a damaging effect on a normal pregnancy. From numerous reports in The- Washington Post, July-August 1976 Hearing, House Appropriations Subcommittee'for Labor - HEW, May 4, 1976. BBS 00542S -2-. This exposure to risk represents a big change. The meaning' 1 of the new labor force statistics is, in fact, only beginning to make itself known. More women are working today than ever before. Forty-six percent of all women over the age of 16 years--36 million women--are in the current U. S. labor force. A growing number of these women are coming into contact with toxic substances--substance$ that might affect the reproduc tive system or harm the fetus. Many of them are in the midst of having a family. Sixty percent of all women working are married. Thirty-nine percent of all birthf have been found to be unplanned. Sixty percent of fiSkrvfc&fr women who work will continue to do thei'r first pregnancy. Since the maximum dangerW^Vne fetus from toxic exposure tends to occur at the very beginning of pregnancy, normally before a woman would even realize that she was pregnant, the special susceptibility of women in the workplace raises valid questions. While the evidence is sketchy, there is good reason to be con cerned about the special health problems that may face women of childbearing capacity in the workplace. As the public becomes more aware of the problem, it islikely that increasing pressure will be brought to bear on OSHA to provide the Nation's women workers a safe and healthy work environment. The question is how to achieve that objective. iI BFS 005429 - 3- Most of the solutions proposed to date will not .work. Banning women from high-risk workplaces appears illegal. Setting stan dards at levels that would be safe for all workers usually does not turn out to be either technologically or economically feasible. Monitoring women workers to detect pregnancy raises questions of privacy and practicality. Defining the exact nature of the hazards to which the human reproductive system may be exposed proves to be extremely costly and very difficult. So the problem of how to deal with the sxrfccial health concerns of . this highly susceptible group * ^wdmen, remains. Industry worries abilities it may face from employing women. '..'omen's g about discrimination in hiring, promotions and work assignments. Unions worry about seniority and transfer rights at full pay for women members during pregnancy. Individuals worry about their health, their offspring and their financial needs. There is no central place where the relevant facts relating to women in the workplace have been gathered. The legal issues are complicated. The medical research generally cited appears to be scanty and contradictory. Finally, the role of OSHA in this area is not clear. The Preface explains in greater detail why it was necessary to divide the treatment.of highly ^ '* susceptible groupsinto three subgroups, the first one of which, working women, is considered here. It is against this backdrop that the Policy Analysis Staff undertook this study. BFS 005430 In developing a policy on women in the workplace, it concludes that OSHA should keep the following objectives in mind; o All workers should be assured, to the extent feasible, a safe and healthy workplace en vironment. o Discrimination against certain groups of highly susceptible workers should be dis couraged. o o nological constraints facing industry should be recognized. o Employers and employees should be clearly informed of the special health needs of women, especially regarding human reproduction. \ o Equitable transfer provisions without loss of seniority or pay should be available .for the temporary diability of childbearing when ever employers cannot medt these special needs. 1 i |! BFS 0054J1 5- - A policy that successfully incorporated these objectives would provide the most reasonable amount of protection possible at this time. While it represents a compromise, it should benefit more of the affected parties than any other solution that has been proposed. It should also leave all parties in a better position than they are in today and prov-ide industry and the unions with a set of groundrules under which they can successfully operate. However, such a policy can neither be developed nor enunciated by OSHA alone. OSHA does not have juri-^SjKTid=rr to address all of these issues. It will therefare^ave to work out a joint arrange ment and have the Equa'^r^y^oVn'ent Opportunity Commission, the Office of Federal Coptyact Compliance Programs and other appro priate Federal agencies issue their guidelines simultaneously in order to achieve all the objectives cited above. The Policy Analysis Staff provides;additional background informa tion in this paper on this proposal and discusses the major problems that this issue presents to OSHA. It also suggests' a' number of steps that OSHA could immediately take to address the special health concerns of women of childbearing capacity in the workplace. It appears feasible and responsible for OSHA to take the initiative now, perhaps using the proposed lead standard as a precedent, to move toward the establishment o*f a re*sponsib* le position regarding the protection of highly susceptible groups. BFS 005432 POLICY RECOMMENDATIONS GOVERNMENT RESEARCH o NIOSH has agreed to include considerations of repro ductive pathology for men as well as women in future criteria document recommendations and research planning. OSHA should continue to track the NIOSH effort to assure that an adequate data base is being developed for the standards development process. o Center for Disease ContridT smarting to integrate occupational da La?, jtnt^ongoi ng HEW birth defects moni toring systems. ^OSHA should actively cooperate with the various projects in this area. o OSHA should review the NIOSH health priority list to determine how criteria for teratogenesis and/or mutagenesis could be effectively included in the process of determining a substance's rank. PRIVATE SECTOR RESEARCH ANU DEVELOPMENT o OSHA should urge industries to devote a larger percentage of their research and development expen-s. ditures to developing new and safer production 1I methodologies, .for example, in lead smelters to 4 protect highly susceptible workers. I I j BFS 005433 -7- o OSHA should search for demonstration projects relating to the development of new technologies to control occupation hazards in high-risk industries and help promote private sector involvement. INFORMATION SYSTEMS/DATA COLLECTION o OSHA's National Emphasis Program reporting forms have been redesigned to include retrieval of data by sex categories to permit correlation of occupational illness and injury data as well as occupation. o OSHA should urge the Bureau Statistics to investigate the feasibijtjlfy. cSr requesting that Section VII of OSHA Survey/^FoFto N'o. 103 require employers to submit for qe^i^^tabl i shment a) a breakdown by sex of the acci dents-^and illnesses, and b) a breakdown of the /, hours worked by males as compared to females, identifying the percentages working fulltime in each category. ADVISORY COMMITTEES AND POLICY DEVELOPMENT o OSHA should set up a short-term Women in the Workplace Task Force to advise it on the special concerns of working women. OSHA should also establish a longer term interagency Special Working Group on Women in the Workplac It would staff the above Task Force and cievelop policy recommendations. It would also coordinate policy Pevel and implementation with, all related civil - rights agencies. BFS 005434 -u- o Any meaningful policy on women in the workplace should not be developed or enunciated by OSHA alone since it does not have the jurisdiction to address all of the issues involved. A joint arrangement should be worked out with the Equal Employment Opportunity Commission, the Office of Federal Contract Compliance Programs and related Federal agencies to issue guidelines simultaneous ly once policies have finalized. More women who are active in appointed to OSHA Advisoj v ^ EDUCATION AND INFORMjJ^jSr) lis area should be ttees as members. o OSHA shou5^o" develop an employer/employee educa tional kit - posters, counselling pamphlets, handouts about particular hazards and symptoms to look for, and supplemental materials - for the employer's and union's use to inform all employees of potential risks related to the re productive process. o In conjunction with EEOC, OFCCP, NIOSH and related agencies, "800" toll free telephone lines could`be ' set up to.inform women of'protect!on afforded by regulations and problems raised by specific health risks related to women in certain workplaces. BFS 005435 -9- SAFETY STANDARDS FOR WOMEN o OSHA should address safety problems relating to working women at the same time it considers their special health concerns. o OSHA should encourage NIOSH to conduct anthropometric studies-and supply manufacturers of safety equipment respirators, hard hats, safety shoes - with data on the different body structure of men and women in order to correct current problems with unsafe and poorly fitting protective devices. o OSHA could develop a cv aaump^^-di rected toward employees, promoting the use sf ilfety devices around potential hazards. O' o OSHA and N^eSH should study the need to set up a certi fication laboratory to provide uniform testing services for manufacturers of safety equipment and consider disseminating NIOSH testing and certification results to make known those safety devices that best meet OSHA standards and protect women and men equally well. INTERNATIONAL RELATIONS o The Policy Analysis Staff will continue its- research on related efforts and effectiveness in other industrialized countries. Ongoing liaison with the International Labor BFS 005436 -10- Organization and these countries, however, should ultimately be assigned ttt_tlw(bandards Completion Projet^wiiTftlQ. ^ cwyjAJndMdrri with the 1nternational Technical Exchange Office, should have the responsi bility for keeping all relevant OSHA personnel in formed of current developments. BFS 005437 RESEARCH ON TOXIC SUBSTANCES The effects of toxic substances on working women were first examined in depth during World War I in research performed by Dr. Alice Hamilton... After documenting that certain substances such as lead, radium and cotton dust caused damaging effects to the fetus or induced miscarriages, Dr. Hamilton recommended the enactment of legislation ta^g^tect women who, in increasing numbers, were entering industrialsjjbs'fl3j)'JWig the war."* ^ Such federal legislation was newf As soon as the war ended, men returned home, replacing many of those-women who were working in industrial jobs. The issue then lay dormant until the start of World War II, when the need to employ women in large numbers, particularly in the heavy industrial sectors of the economy again arcse. Exposure of women to industrial chemicals and other workplace hazards quickly prompted reconsideration of the problems highlighted by Dr. Hamilton. The U. S. Army undertook a comprehensive study on the occupational health problems of women, which again supported the contention that special steps should be taken by in dustry to protect women workers. The study not only cited physical stress * * *. * * as a danger but also identified benzene, carton monoxide, carbon disulfide, 1 Alice Hamilton, -Co Women in Industry Need Scecidi Legislation?*, Publication tf12, BLS 1912. Alice Hamilton, Women Workers and Industrial Poisons. Bulletin Mo. 57, 5L3 1926. "Canid Lang, "A reporter at large: a most valuable accident",J The New Yorker, >!ay 2, 1950. r'n/ di*vV"r' s.'-'J-w.-*' ---v-'-V.*, -"tf BFS 0054JS B-2 hydrocarbons, lead, mercury and radiation as being hazardous to the health of women. This research, while not definitive,- forms the basis for much of the current concern about the special health problems of women of childbearing capacity in the workplace. In spite of the Army study's conclusions, the war ended without the adoption of any remedial legislation and the problems of women workers largely disappeared as a matter of occupational health priority. According 2 to a 1975 report, little additional research regarding the impact of toxic substances on women has been performed-siS[cedespite-the growing numbers of women enter^a ijEhe or!Ite. Consciousness of this lack in women's groups friers, has led to demands to begin addi tional research efforts in this area. Understanding of the effects that chemicals, drugs and workplace substances can have on both the fetus and the reproductive systems of men and women has increased over the past few years. For example, originally, the placenta was assumed to adequately protect the fetus from exposure to unhealthy substances. However, exposure to rubella germs, usage of thalidomide, diethylstibesterol, etc. and in gestion of substances like lead and mercury is now known to cross the pla cental barrier and enter the blood of the fetus causing damage. Another example arose, v/hen on July 22, -1976, the Food and Drug Administration required that the most widely prescribed tranquilizers in the.United States- valiura, librium, miltewn and equanil--bear a label warning against use of Anna Baetjer,' Women in Industry: Their Health and Efficiency, 19**6 Prepared in the U. S. Army Industrial Hygiene Laboratory. Vilma Hunt, -Occupational Health Problems of Pregnant Women, A report and recommendations for the Office of the Secretary, HEW, April 1975. r" -v^*- BFS 005439 the drugs in almost all instances during the first three months of pregnancy. Studies had suggested that they may be associated with the development of cleft lip and other congenital malformations when used during this period. Other examples abound, raising questions about the adequacy of worker protection, particularly for women of childbearing capacity: Low level exposure of pregnant workers to radiation has been found to increase the risk of cancers in their 2 offspring. Female anesthetists acquire liver disease up to two times morv frequently than unexposed counterparts'^ GaIso, the incidence of congenital abnormal-id: 2Uee;s atoghfr liveborn offspring of female anesWTfca^ >as''Souble that of unexposed female physicians A number of studies have found that women exposed to lead experience greatly increased numbers of abortions, miscar riages and stillbirths. Lead absorbed into the bloodstream of a pregnant wcman crosses the placenta and enters the 4 fetus. Vinyl chloride has been found to produce angiosarcoma of the liver net only in female workers exposed to the sub stance, but also in their offspring.^ Wall Street Journal. July 23, 1976, p. 3- International Labor Office, Encyclopedia of Occupational Health And Safety. Vcl. 2, 1972, p. 1155. ' 3 Ad Hoc Committee on the Effect of Trace Anesthetics, American Society of Anesthesiologists, "Occupational1 Disease Among Operating Scorn Personnel", Anesthesiology. Vol. Hi, October 197H, pp.* 321-340. 4 C. R. Angle and M, S. Kclntire, "Lead Poisoning During Pregnancy", American Journal of Diseases of Children 103: H36-H39, 1954. Federal Register. October 19757 p. **5526. Irving Selikoff, testimony at on Dangers 01 Vinyl Chionce, Senate August Commerce Committee 21, 1S74, p. 26. Hearings r :fr* BFS 005440  Organic (methyl) mercury exposure causes teratogenic effects . to women's offspring. The ability of methyl mercury to pene trate the placenta has been found to cause a high percentage of children with cerebral palsy and severe mental retardation with no effects to the mother.1 Carbon disulfide at certain levels has been shown to cause 2 frequent miscarriages. Cases of benzene exposure suggest that there is an increased rate of birth defects and miscarriages among exposed women. This chemical can also cross the placenta and enter the 3 bloodstream of the fetus. Such research documenting the serious effects that certain workplace substances can have on pregnant women and women of^cfti^afe^aring capacity is responsible for the increased coMertrr of groups and labor unions that OSHA prot^Jfe^RgniJti*^workers as fully as male workers. Looking at the issue from another perspective, some are alleging that men are being discriminated against by focusing the majority of standards and regulations protecting future parents on women alone. The data base currently available on the adverse impacts that some toxic substances can have oh male reproductive capacities is beginning to force a recon sideration of the, scope of this question. It is interesting to note that some of the same substances have a damaging effect to male reproductive capacities as those associated with female reproductive problems.. Joset Karkany, Congenital HaIformations: Notes and Comments, Chicago, pp. 123-129. W. Ehradt, "Experiences with the employment of women -exposed to carbon disulfide". International Symposium on Toxicology, 1966. Ethel Browning, Toxicology and Metabolism of Industrial Solvents, New York, 1965. BFS 005441 *4 B-5 Ninety percent of a group of males exposed to lead at a storage battery plant whose blood lead levels were over 75 micrograms per 100 grams of blood (ug/lOOg), higher than the proposed OSHA standard, showed abnormal sperm tests. Decreased fertility, loss of libido and decreased ability to produce healthy sperm existed among workers with lead levels as low as 30-50 ug/100g.^ Wives of men who have been exposed to vinyl chloride show greater risk of congenital malformations, miscarriages, and stillbirths than those whose husbands have not been exposed to this substance. Studies in four other countries have also shown that polyvinyl chloride (PVC) workers ex posed to vinyl chloride monomer (VCM) hava^gScs^^^ve chromo some aberrations. There is a p^si^i^ityJ^CTefore that male exposure to PVC cary-eaiifce. tagenic effect that will endanger future^^KfcrkcffX^ons.^ Wives of male anesthetists have had a significantly high number of babies with birth defects. The risk for such wives has been 1.25 times that'of wives of unexposed medical 3 personnel. Radiation can kill sperm production in the male testes and has been shown to cause a higher rate of sterility among J radiological technicians than the general population (Japan). In addition, gene mutations and chromosome aberrations are passed through male sperm exposed to radiation.^ 1 .1. Lancranjair., "Reproductive Ability of Workmen Occupationally. Exposed to Lead", Archives of Environmental Health, August, 1575. p. 356-401. 21 Peter Infante, "Genetic Risks of Vinyl Chloride". Lancet, April 3i 1976. p, 734-5. ^ Ad Hoc Committee on Trace Anesthetics, Lancet, April 3* 1976, pp. 734-5 Von W. Schottek, 1969 (in German). National Academy of Sciences, "The Effects of Population1 2s of Exposure to Low Levels of Ionizing Radiation", November 1972, ':'7TTf^vr-'"*- "Fvi-,.";"---TMrrr'Tv-*-" ittt BFS 005442  Male workers exposed to carbon disulfide for 3 years were found to have decreased libido in addition to trouble achieving and maintaining erections.1 4 Fourteen males who worked at a Virginia plant manufacturing the pesticide Xepone are now sterile.^ In these studies, the levels of toxicity in the work environment were not always clearly defined. This makes it difficult to compare the results with the levels defined in OSHA standards.^ The research, nevertheless, clearly indicates that men and women carry traces of toxic substances from the work environment^ which have the po tential to damage future generations. values should, therefore, be established at lev^^e ffot only for all workers, but also for any fetuses that^^C&^velop. What those levels may be and to -l what extent such substances affect men as well as women are questions that still need to be answered. While the lack of reliable data makes it'difficult for OSHA to reach sound judgments in this area, OSHA may nevertheless find It awkward to cite this deficiency as the reason for its delay in acting in this area. OSIIA's authorizing legislation clearly charges it with the responsibility for generating such data. The Secretary of Labor, ir. cooperation with the Secretary of Health, Education, and Welfare, shall issue regulations requiring employers to maintain accurate records of employee exposures to potentially toxic materials cr harmful physical agents which are required to be monitored or measured............ I. Lancranjan, "Alteration of Spermatic Liquid 7 patients Chronically Poisoned by C5 Medicine del Lavoro, Vol. 63. PP- 29-33. ''972. 2 The Spokeswoman, July 15, 1S"6, p. 8. 3* The above research studies were referenced in Andrea Kricko's, "A Woman's Guide to Job Health Hazards", joint publication of Labor ____ Occupational Health Program, University of California at_ Berkeley, and Public Citizen's Health Research Croup, i.976. ~1 " ! :---- 7---- --------------------:--:--- --" . 1 - . ."7--.--T' r BFS 005443 OSIIA muse therefore assure the collection of sufficient data on work- * place exposure of both men and women to toxic substances in order to adequately protect their reproductive systems from any harm. At the Society of Occupational and Environmental Health's "Women in the Workplace" Conference (June 17-19, 1976), Washington, D. C., the one * recommendation that all representatives and participants agreed on _ ------ was the pressing need for further research in this area., OSHA and NIOSH can take several steps to fill some of the -ag&5=in the research by pro viding additional resources for mo^^ezt^j&v^ studies on workplace sub stances suspected of be teratogenic or mutagenic. NIOSH needs to undertake more longitudinal studies relating to effects of occupational environments on the reproductive systems of women and men. Research is needed to clarify the relative risks of exposing women and men to suspected workplace substances by identifying their transplacental teratogenic, mutagenic and carcinogenic effects and esta blishing safe threshold limit values. A better data base is needed to permit meaningful research on the workplace hazards impacting on reproductive systems . Improved information must be gathered by clinics and hospitals on abortions where the fetus evidences any malformation or physiological problems, miscarriages and irregular births and be cross-referenced with occupational histories of the parents. . The Center for Disease Control system for collecting data on birth defects should be brebdened to include occupational' information on both parents. 1 / : ' , J. BF> 005444 AGENCY ACTIVITIES Several agencies are looking into the particular concerns of women of childbearing capacity exposed to toxic substances in the work environ ment. The different perspectives and approaches may provide some in sight into questions facing 05HA and assig^M the development of new policies in this area. . OCCUPATIONAL SAFETY AMD H^^ADfilUISTRATIQN (OSHA) The proposed lead S^^Kd represents CSKA's principal effort to address the "increased susceptibility" of some classes of workers. As was dis cussed in the previous section, research on lead has documented the damaging effects of lead on children, the fetus and persons with sickle cell trait, kidney problems, etc. The Department of Labor's Solicitor's Office questions whether the research is reliable and conclusive enough to withstand litigation from employers who would be adversely affected by such a standard. The due process procedures in the OEKA standard setting process necessitate the full consideration and careful balancing of conflicting claims in order to protect the interests of all affected ' parties: employers, consumers, employees. Since compliance with the proposed standard would involve' the commitment of substantial resources, consensus is usually hard to achieve. "5? .* ------- - -------- -- --~r-7--_ . . 1 . --- T--5--- *i ---rrr- *, .r''" BF5 005445 The standards development office has also investigated the effects of ionizing radiation on occupational health to determine a level considered safe for women of childbearing capacity and to identify the economic consequences of requiring employers to comply with this level. The com plex scientific, legal and social issues involved here have caused OSHA to carefully examine its definition of what are considered to be safe toxic levels in the workplace. Lead and ionizing radiation have been the subject of more research than most substances. Data exists on the damaging effects that these substances can^iv^^n women of childbearing capacity. Even so, the absence of<^^liaart research on the precise toxic effects that these two subst^gi^^have on the reproductive capacity of working women and meort&iSSjje^s CSHA's efforts to develop standards that would make the workplace fully safe for all Americans. Economic and technological constraints would still play a large role in the standards development process .were such research-available, but the lack of comprehensive workplace data is still the biggest problem in this area. In 1975, OSHA started to publish a series of pamphlets describing the hazards of certain toxic substances. Each pamphlet explains the effects, dangers, and methods of protection related to exposure to various work place substances. Pamphlets on lead, beryllium, mercury, vinyl' chloride and carbon monoxide contain information for both workers and the public. None of these, however, mention any special health problems for women of childbearing capacity or suggest protective measures.to be taken. A revision of this educational material to include information on the po tential dangers that highly susceptible groups such as pregnant women face in the workplace should be undertaken. : VM.V-*.vCv- /_> . v "* V7 *. f ***.\ . w rl* "( 1 * * *.** ; ** * J,'* --.. ^ 01. . ; -; - r-.. `V*i t BFS 00544S NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY ADD HEALTH (NIOSH) C-3 NIOSH, as the research arm that develops criteria documents for OSHA, has identified 181 substances that cause teratogenic or mutagenic effects in animals as a first step toward conducting further epidemiological studies.1 NIOSH has also indicated that it will give "special emphasis" to women in future research. To date, this activity has consisted of two "Women in the industry, government and the scientific community. NIOSH has chartered additional research related to the effects of lead, vinyl chloride monomer (VCM), polyvinyl chloride (PVC), and other toxic substances on reproduction. Many of the important questions have been addrasrotF^see attachment B), but the Policy Analysis Staff believes that -fhe^^ibroi/ing areas need further attention: / The health prioJ^i^i)li!:-which ranks chemicals in the order in which they will be reviewed', based among other things on the number of people exposed and the severity of such exposure-- does not include criteria for teratogenesis and/or mutagenesis when determining placement on the list. Criteria documents do not require that studies on the effects of threshold limit values on reproductive systems be completed t before proposing what constitutes levels of toxicity in the workplace. Congress has expressed an interest in strengthening NIOSH efforts regarding women's health, particularly Congressm1an, Obey (D-.W.is. .c.) through his work on the House Appropriations Committee. Appropriations for NIOSH to conduct more extensive research on the effects of the workplace environment on women--$6 million for FY 1978-82^--have been included in the 1977 Labor- HEW appropriations bill. ------"Women. Vorkers__and Job Health Hazards", Job Safety and Health, April 1975. bfs 005447 C-3A o OSHA should consider the concept of informed consent with regard to susceptible groups, such as women of childbearing age working in lead exposed processes. Such a consent form could include information that the emplow^J^A ^^n informed of the inherent risk involved^ job and that he or she understood the risk In nut still chose to undertake such work. Both employers and employees would have to under stand that such a consent would not include any waiver of the right to workers' compensation should the need arise. % BFS &0544S c-; NUCLEAR REGULATORY COMMISSION (NRC) The NRC has recommended radiation exposure limits during pregnancy through the distribution of its Guideline 8.13* "Instruction Concerning Prenatal Radiation Exposure".^ The NRC maximum dosage regulation for all occupations exposed adults requires exposure not to exceed 1.25 rems per calendar quar ter, or 5 rems per year, while the occupational exposure of a pregnant worker recommended not to exceed .5 rem during the nine month term. The level has not been .lowered to *-5 renuor an worker^. Since 1.5 rem had been found to be the "lowest practicable 1 l"\cbz*sridering the cur- rent technological and economic capacjjjftes^fothe industry, NRC in effect merely pointed out the dange^^^j^^ approach shifts the burden of identification and special protection for pregnant workers to its licensees. Title 10, Part 19 of the Code of Federal Regulations requires NRC licensees to "inform all individuals of health protection problems associated with radiation exposure". However, no effective measurement of this effort to lessen radiation exposure has been made to.date. Whatever success it might have would have to depend on educating employers about their responsibilities, training employees to be aware of potential risks and encouraging employees to take preventive safety precautions. ENVIRONMENTAL PROTECTION AGENCY (EVA') - EPA is represented on the Interagency Panel cn Mutagenesis which reviews . * research related to mutagenic factors and the adverse affects of toxic substances. The meetings are useful to learn about and exchange research information among different agencies. ) U. S. Nuclear Regulatory Commission. Regulatory Guide, Office of Standards, November 1975. J7T" BFS 005449 C-5 EPA's Office of Radiation Programs, like OSHA and NRC, is also highly it concerned about the effects of radiation on the fetus. EPA is attempting to develop a relative risk table to use in educating potential employees working in radiation areas. These tables would describe the risks f working with radiation as compared to other jobs and would have to be considered by all employees before accepting such a position. While this idea is a good one, the lack of statistics on working women has made it difficult to gather enough information<jp^^r^^ans, illnesses and injuries broken down by sex and ^dulS^y,3 ccaatteeggories to develop the tables and supporting educational-THat The results of this effort will be <5 VJ interesting to observei^Sducstional outreach programs would- seem to be a better tool for assuring safety than simply depending on governmental inspections. EPA evidences continuing commitment toward obtaining the views of special groups such as women and minorities by their one-third representation on the agency's 19 advisory committees for the agency. NATIONAL CANCER INSTITUTE (MCI) NCI and other Department of Health, Education and Welfare laboratory workers handle, on a daily basis, substances suspected of being car cinogenic. . The fear of the effects of such exposure on the fetus was responsible for the development of an unwritten policy regarding the utilization of pregnant workers in the laboratory. Discussions between the NCI doctor, the supervisor and the worker relating to safety proce- > *' ' dures and job transfer possibilities are required before.the on-set of pregnancy. Although few, if any, of the substances at NCI are known to cause cancer, a pregnant laboratory worker is transferred to a safe, temporary position at no loss 7"*l,r. TV- V BFS 005450 C-6 in pay as soon as she becomes aware of her pregnancy and so Informs management. This procedure is common with other temporary disabilities such as heart attacks or any serious Illnesses requiring gradual recovery. NCI Has purposely adopted this medically conservative course of. action t minimize the potential exposure of a fetus to any suspected carcinogens, mutagens or teratogens that might be under study in their facilities. STATE OF OREGON, DEPARTMENT OF HUMAN RESOURCES The Policy Analysis Staff located only one example of standards with mandator pregnancy protections in the United States, The Radiation Control Program in Oregon's Department of Human Resources passed a ruling in 1972 that utilizes dual standards - one for pregnant womeH^pS^ne for'all other workers. It states that no licensee or registraftt shall knowingly ex pose a fetus to more than .5 rem for /theemire gestation period. The responsibility for impleraenting^fe&^^r^uing lies with the employer. The State has had.no trouble witJ3j)rsuits, women refusing to tell employers when they are pregnant, or the relocation of pregnant workers to jobs . at equal pay during the gestation period. However, most of the estimated 3,000 women affected by the ruling work in hospital or dental facilities where the*practice of transferring pregnant workers has been an unwritten policy for years. Although there have not been any discrimination cases concerning this standard, a director of radiology at one hospital did express surprise at the existence of such a standard. His opinion was that most`employees were simply not aware of the dispa'rity in the standard. In spite of the mandatory nature of this regulation, there is some question whether even this policy fully protects -the fetus since the most hazardous BFS 005451 effects of radiation occur in the first six to eight weeks, often before a woman discovers she is pregnant. * 1 "IT ' *** *' ` BF5 00545.