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ter understanding of low back pain: a review of the mechanics of the lumbar disc. Rheum. Rehab. 14:129,1975. 79. Nachemson, A. L.: Work for all. CHa Orth. 179:77,1983. 80. Nachemson, A. L.: Personal com munication, 1986. 81. Nachemson, A. L.: Lindh, M.: Measurement of abdominal and back muscle strength with and without low back pain. Scand. J. Rehab. Med. 1:60, 1969. 82. National Safety Council: Human kinetics ... and lifting. National Safety News: 44, June, 1971. 83. Nelson, N: Technical training guide for physical demands analysis. The National Council on the Aging, Washington, 1984. 84. Nicolaisen, T., Jorgensen, K.: Trunk strength, back muscle en durance and low-back trouble. Scand. J. Rehab. Med. 17:121, 1985. 85. Nordin, M., Frankel, V., Spender, D. M.: A preventive back care pro gram for industry (Abstract). IntL Lumbar Spine Soc Meeting, Paris, May 17-20, 1981. 86. Nylander, S. W., Carmeau G.: Medical standards project Anal re port, 3rd Edition. County of San Bernardino, CA, 1984. 87. Park, K. S., Chaffin, D. B.: A biomechanical evaluation of two methods of manual load lifting. AI1E Transactions 6:105,1974. 88. Pedersen, O. F., Petersen R., Staffeldt, E. S.: Back pain and isometric back muscle strength of workers in a Danish factory. Scand. J. Rehab. Med. 7:125,1975. 89. Pilcher, O. J.: Personal Corre spondence. February 9,1979. 90. Porter, R. W., Hibbert, C., Wellman, P.: Backache and the lumbar spinal canaL Spine 5:99, 1980. 91. Quinet, R. J., Hadler, N. M.: Diag nosis and treatment of backache. Arth. Rheum 8:261,1979. 92. Ransford, A. O., Cairns, D., Mooney, V.: The pain drawing as an aid to the psychologic evalua tion of patients with low-back pain. Spine 1:127, 1976. 93. Ring, L.: Facts on backs--A Simplified Approach to Back Injury Prevention and Control Loganville, GA. Institute Press, 1981. 94. Rockey, P. H., Tompkins, R. K., Wood, R. W., Wolcott, B. W.: The usefulness of x-ray examinations in the evaluation of patients with back pain. J. Fam. Prac. 7:455, 1978. 95. Rosen, N. B.: Treating the many facets of pain. Business & Health: 7, May, 1986. 96. Rowe, M. L.: Low back pain in in dustry: a position paper. J. Occup. Med 11:161, 1969. 97. Rowe, M. L.: Backache at Work. Fairport, NY, Perinton Press, 1983. 98. Salvendy, G: Handbook of Human Factors, New York, John Wiley and Sons, 1987. 99. Scavone, J. G., Latshaw, R. F., Rohrer, G. V.: Use of lumbar spine films: statistical evaluation at a uni versity teaching hospital. JAMA 246:1105,1981. 100. Schussler, T., Kaminer, A. J., Power, V. L., Pomper, L R: The preplacement examination. J. Occup. Med. 17:254,1975. 101. Snook, S. H.: The design of man ual handling tasks. Ergonomics 21:963,1978. 102. Snook, S. H.: Workloads. Pro ceedings of an international sym posium on low back pain and in dustrial and social disablement. Back Pain Association, London, October 7, 1982. 103. Snook, S. H., CampaneDi, R. A., Ford, R. J.: A study of back injuries at Pratt and Whitney Aircraft Lib erty Mutual Insurance Company. Research Center. Hopkinton, MA, 1980. 104. Snook, S. R, Campanelli, R. A., Hart, J. W.: A study of three pre ventive approaches to low back injury. J. Occup. Med. 20:478, 1978. 105. U.S. Department of Health and Human Services: Work practices guide for manual lifting. DHHS(NIOSH) Publication No. 81-122, March, 1981. 106. Waddell, G., Main, C. J.: Assess ment of severity in low-back disor ders. Spine 9:204, 1984. 107. Waddell, G., Main, G J., Moms, E. W., et al: Chronic low-back pain, psychologic distress, and ill ness behavior. Spine 9:209,1984. 108. Waddell, G., McCulloch, J. A., Kummel, E., Venner, R. M.: Nonorganic physical signs in lowback pain. Spine 5:117, 1980. 109. Westgaard, R. R, Aaras, A.: Pos tural muscle strain as a causal factor in the development of musculo skeletal illnesses. Appl Ergonomics 15:162,1984. 110. Westgaard, R. H., Aaras, A.: The effect of improved workplace de sign on the development of workrelated musculoskeletal illnesses. Appl Ergonomics 16:91, 1985. 111. Wiesel, S. W., Cuckler, J. M., De luca, F., Jones, F., Zeide, M. S., Rothman, P. H.: Acute low back pain: an objective analysis of con servative therapy. Spine 5:324, 1980. 112. Wiesel, S. W., Feffer, H. L., Rothman, R. H.: Industrial low back pain: a prospective evalua tion of a standardized diagnostic and treatment protocol. Spine 9:199, 1984. 113. Wood, D. J.: Design and evalua tion of a back injury prevention program within a geriatric hospital. Spine 12:77,1987. 114. Zachrisson, ForsseU, M: The back school. Spine 6:104,1981. Reprinted with permission from Occupational Medicine: State of the Art Reviews, Vol. 3, No. 1, "Bock Pain in IVoriceis," Jan-March 1988, pp. 45-60. Published by Hanley & Belfus, Inc., 210 South 13th St, Philadelphia, PA 19107; (215) 546-7293. Please indicate how helpful and informative you found this arti cle by circling the appropriate number on the reader service card. Very 108 Moderately 107 Not very 106 We Have Hundreds Of SAFETY AWARDS & INCENTIVES Send for FREE catalogue (or ideas to promote your business: Safety Plaques Walnut Plaques Trophy Awards Custom Awards Safety Awards/Jewelry Badges Custom Emblems Custom Bronze Awards A Gifts Glassware 1933 SERIES BADGES tviltabtt in ovor 100 titles for immodtito thipmont WILLIAMS JEWELRY AND MANUFACTURING COMPANY 3152-P Morris Slreet North St Pstsrsburg, Florida 33713 (813) 823-7676 Circle 5 on reader service card Professional Safety August 1988 *31 1^0York are often less than that found in air outside the buildings and usually thousands of times less than that found in the workplaces which were the sources of the original studies. Nevertheless, regulations govern ing exposure to in-place asbestoscontaining materials in commercial and residential buildings appear to be the current focus for all levels of gov ernment The lack of any scientific study establishing danger to people living in buildings where asbestoscontaining materials were used in construction does not deter govern ment officials. (In fact, those few studies which have looked at low level exposures demonstrate no in creased likelihood of disease.) Only "anecdotal evidence" and isolated care reports are cited by the oppo nents of this proposition. When carefully considered these stories do not stand up to scrutiny. he recent and continuing on channeled into more productive ends Tslaught of regulations govern ing asbestos abatement work such as research on whether low level exposure to asbestos is really in the City and State of New Yordkangerous to a person's health. has gone largely unreported in the media What has captured media at tention, however, has been cata Asbestos--Its uses and dangers strophic incidents and debacles im Asbestos is nonflammable, mechan mediately traceable to lack of ically strong, resistant to chemicals, foresight in the issuance of these reg and virtually indestructible. Until ulations. Duplication, redundancy 1972, these properties made asbes and lack of coordination have tos the material of choice as fire marked the efforts of the state legis proofing and as a thermal and lature, attorney general, and the fed acoustical insulant eral government as well as the New Epidemiological studies demon York City Council, all of whom have strated that exposure to high occu jumped on the asbestos alarm band pational levels of airborne asbestos wagon. increased the risk of asbestosis, The result of these legislative ef mesothelioma and, in the smoker, forts is not necessarily a more pro lung cancer. These studies focused, tected public, but a replication of however, on data from people ex governmental efforts resulting in im posed to high levels of asbestos fibers positions of higher costs on real es as part of their work; they did not tate owners and their tenants. Also, it study the effects of the ordinary is likely that a greater hazard has building exposure levels on building been created with every unnecessary occupants. Indeed, attempts at removal and reinsulation with artifi measuring current building levels in cial materials generated directly or well-maintained buildings in New indirectly by these regulations. York City have been undertaken This rush to regulate without un fairly recently. derlying up-to-date scientific support Those measurements which have is a misuse of taxpayers' money, been done in well-maintained build when these monies could well be ings indicate that levels of asbestos 32 August 1988 Professional Safety Asbestos regulation In 1972, the original workplacebased studies motivated the United States Environmental Protection Agency (EPA) and the United States Occupational Safety and Health Administration (OSHA) to promul gate regulations governing demoli tion, renovation, and construction sites where asbestos-containing ma terial could become airborne as well as rules to protect employees work ing at these sites. Extensive as these federal regulations were, state legis lators were not to be outdone. They seized upon the idea of regulating asbestos as a popular cause. Indi vidual states passed their own stat utes and promulgated their own reg ulations. The New York State Legis lature joined other states in August of 1986. In 1986, the state legislature di rected the Commissioner of Labor to monitor and inspect safety proce dures during asbestos projects, to issue licenses to asbestos abatement contractors and to certify supervisors and workers who will do the actual work. Additionally, the legislature di rected the Commissioner of Health to publish rules regulating training programs which supervisors, workers and contractors must attend before they can be certified by the Commis sioner of Labor. These rules were fi nalized and became fully effective in January of 1988. Just prior to this, the New York City Council had passed Local Law t 6 No. 76 of 1985. This ordinance re quires that all "asbestos projects" be approved in advance by the City Commissioner of Buildings, and that the application for approval be ac companied by an asbestos inspection report which must be submitted to the Commissioner of the City De partment of Environmental Protec tion. The Council charged the Com missioner of the City Department of Environmental Protection with the responsibility of issuing regulations regarding the certification of asbestos handlers, supervisors and inspectors. Further, the Commissioner was also required to certify training programs which would prepare people to take an examination for certification. Since then, the Congress, pur suant to the Asbestos Hazards Emergency Response Act of 1986, has directed the EPA to prepare similar training and certification re quirements for contractors and ex perts who will conduct asbestos abatement activities in schools across the country. These regulations took effect in October of 1987. If these laws sound redundant, they are. Once all federal and state requirements are finally promul gated, local certifications of currently licensed inspectors and handlers may be preempted. Reflection of these laws causes one to wonder what it will cost us for the creation of new bureaucracy? Will additional hazards be created by unnecessary removal? Where will all the removed asbestos go? And, will the bureaucratic red tape generate an underground or black market industry for asbestos removal? Results of government regulation As a result of all these redundant regulations, there is a growing hys terical reaction to the disclosure that asbestos may be found in a building. Owners, lessees, and those who ad vise them are afraid of lawsuits and are prone to remove asbestos even in those circumstances when it may be unwise. Additionally, disclosure of the presence of asbestos has driven the prices of some buildings down ward, while increasing maintenance costs. Finally, the excessive red tape imposed by the regulations discour ages compliance with the law and compels people responsible for abatement to look to cheaper uncer tified contractors, who may in fact create a greater health hazard by using improper methods to abate the asbestos presence. The final promul gation of the New York State rules may cause real estate owners and those responsible for the removal of asbestos to drown in red tape. Confusion reigns. As of this date, no law at any level requires removal of asbestos in a building unless it is to be demolished. In fact, it is not exactly clear what course or alterna tive is legally mandated once asbes tos is found in a building. No stan dard exists at any level which gives precise directions and offers some degree of protection to real estate owners who turn to the various levels of government for guidance. By vir tue of the structure of the New York City regulations, the decision is left, by default, in the hands of an "as bestos investigator" whose only qualifications may be completion of a city-certified training course and a rudimentary training in the sciences Lack of insurance, guaranteed addi tional work and income, a poor un derstanding of direct, indirect and hidden costs involved, and a biased and limited understanding of the sci entific literature have motivated these investigators to recommend removal when it is not at all necessary--and may, in fact, be imprudent What is clear is that conflicting reg ulations without clear-cut standards result in hysteria, haphazard proce dures, and dangerous attempts to "cut comers." It also extinguishes the availability of insurance and al lows the litigious among us to find new victims. New horizons The New York State Attorney Gen eral's regulations promulgated in Au gust of 1986 are forerunners of what may come in the future. They require building owners who are in the pro cess of converting their building from private ownership to condominium or cooperative ownership to fully dis close the presence of asbestos in a building. Initially (before it was judi cially revoked as being beyond the authority of the attorney general), these regulations also required that the owner create an escrow account for pay for any asbestos abatement which might take place. Lurking in the future is similar governmental regulation of all build ings. The City has .directed the Commissioner of the Department of Environmental Protection to study public and commercial buildings to determine if the presence of asbes tos-containing material in these buildings requires special regulations. The federal government has directed the EPA to make the same inquiry. Finally, in April of 1987, Senator Stafford of Vermont introduced S.981 which would require regula tion no matter what the studies show. It is time for the federal govern ment, the state and the city to pause and to call a halt to unnecessary and duplicative regulations. A critical evaluation of all these regulations is necessary and coordination is re quired. Moreover, a careful look at the validity of the alleged hazards of low level exposure, and the safety of asbestos substitutes must be under taken before prudent rules can be enacted. Excessive regulations increase the likelihood of people attempting to flaunt the rules. Moreover, it is quite clear that neither the federal, the city nor the state governments have made the commitment or have the resources to strictly enforce these regulations. Violations and danger ous attempts to bypass these rules which the current climate seems to encourage cannot be entirely moni tored, even though the City Depart ment of Environmental Protection and City sanitation workers have been on the lookout for such viola tions. The federal government, the state and the city must defuse any poten tial hysteria that this legislation and regulation has caused. In particular, governmental agencies should avoid being stampeded into promulgating more unnecessary and potentially dangerous regulations governing public and commercial buildings where asbestos-containing material is found in good condition, but where no construction, renovation, or de molition work is being done. An up-to-date critical scientific analysis which objectively evaluates the evi dence of whether exposure to inplace asbestos-containing material causes illness is required. O Please indicate how helpful and informative you found this arti cle by circling the appropriate number on the reader service card. Very 111 Moderately 110 Not very 109 Professional Safety August 1988 33 Professional Safety is pleased to announce a new feature titled, "Q & A" that will appear in the magazine every other month. The questions and answers are chosen by Dr. George L. Head, CPCU, ARM, CSP, CLU, FIRM, vice president of the Insurance Institute of America and di rector of the ALCM program. The sample questions and answers used in the column are taken from the Associate in Loss Control Management (ALCM) designation pro gram. This month's question is from a De cember 1987 examination. Dr. Head is a member of several professional and industry associations, including the Risk and In surance Management Soci ety, the Society of CPCU, the American Risk and Insur ance Association, and the National Fire Protection As sociation. He is a Member of ASSE's Lower Delaware Valley Chapter. This month's question explains how use of the criti cal incident technique for analyzing actual or poten tial accidents can provide information that supple ments data from OSHA records of these occurrences. f'k One of the challenges in improving the genU* eral level of workplace safety in industry has been to develop statistical measures which truly re flect the level of such safety. It has been suggested that computing work injury frequency and severity rates (even by the procedures prescribed by the fed eral Occupational Safety and Health Administration) does not provide an accurate measure of workplace safety in a particular organization. Further, some be lieve that appropriate use of critical incident tech niques (also known as "critical incident review techniques") can reveal more reliable information about workplace safety than can accident frequency and severity rates. (a) Give three reasons why workplace injury fre quency and severity rates computed according to OSHA procedures may not accurately reflect the 34 August 1988 Professional Safety level of workplace safety in a particular organi zation. (b) Explain why critical incident techniques are likely to reveal more information about work place safety in a particular organization than do work injury frequency and severity rates. A (a) A particular organization's OSHA accident frequency and severity rates may not properly reflect its actual level of workplace safety because: First, OSHA procedures allow managers consider able discretion in classifying injuries (such as be tween total/partial and permanent/temporary); second, the accuracy of OSHA severity rates are somewhat dependent upon the extent to which em ployees may be returned to light-duty work, less de manding than half their original responsibilities, to "improve" a particular organization's reported statistics; third, OSHA rates do not show the dollar costs of workplace accidents, even though these dollars ar guably are a given entity's best measure of workplace safety. (Note: Other equally valid answers could be given.) (b)(1) Proper use of critical incident techniques in volves drawing upon a random sample of observ ers/workers from a particularly hazardous workplace environment and questioning them about accidents and/or incidents they have experienced or seen. Their responses can help categorize the causes of accidents, or the hazards of potential accidents, into groups which depict chains of accident causation germane for a particular organization. Accident pre vention efforts then can be focused on breaking these specific chains. (b)(2) Unlike OSHA records, the information gen erated by the proper use of critical incident tech niques includes: First, hazards that have not yet produced accidents (only incidents) but which still need to be controlled to enhance safety; second, detailed chains of causation for specific occurrences; third, as an implicit consequence, possible ways to 'prevent future accidents.