Roundtable Meeting
Ronald Reagan Building
room "Hemisphere A"
September 7th 2000, 1 - 5 PM
AGENDA
1:00 PM Welcome Remarks, and NSC Congress and Expo (Leo Carey, NSC)
1:15 Hispanic Forum (Claudio Ramirez, PAHO)
1:25 General Orientation (Barbara Upston, MCA)
1:30 Occupational Health and Safety Presentation
Speaker: Leo Carey, NSC
- Pesticides
- Women and Work
- Construction
- Training and Education
2:00 Environmental Health Presentation
Speaker: Jim Carr, EPA
- Lead
- Asthma
- Pesticides
- Consumer Product Safety
2:30 International Workers' Health Presentation
Speaker: Claudio Ramirez, PAHO
- Agriculture
- Construction
- Informal Sector
- Manufacture and Maquiladoras
3:00 Break (Beverages and Refreshments)
3:15 Feedback on Presentations (Discussion, Q & A)
4:45 Next Steps
5:00 Adjourn - End of Meeting
GENERAL FEEDBACK
- 9/7 HISPANIC FORUM ROUNDTABLE
- Pesticides are a common theme across all three areas
- Recommendations should deal specifically with appropriations issues
- Remind participants in October that this is a sampling of issues that had to be narrowed down
- Look for solutions to cross-cutting issues:
- A national clearinghouse, specializing in Spanish language materials
- Networking between Federal agencies and the grass-roots organizations and among the grass roots organizations
- In October have display tables for information
- Create links to/from the Web page
- Involve other actors - large corporations/employers/multinationals to get $$$ - not just gov�t $
- Make clear what CBO�s can do - gather suggestions
- Take suggestions from the audience in the larger group (AM plenary session)
- Hold regional Forums
- Hold next Forum in another country
- Look for ways to bring the informal sector (international) into all other areas
- Short term is one year
- FEEDBACK
OCCUPATIONAL HEALTH
ENVIRONMENTAL HEALTH
- The CDC can be part of the solution
- California has a good training program on LEAD education - is a model
- LEAD - should be more emphasis on ceramics and home remedies
- At the Forum - give information in handouts on who can help (e.g. CPSC)
- LEAD in gasoline outside the US
- Develop educational videos on LEAD; pesticides; etc. (literacy issues)
- Revise risk assessment methodologies to address children�s exposure to pesticides - in addition to dietary
- Get Head Start involved on children�s issues
- Develop data on LEAD on construction workers clothes (take home)
INTERNATIONAL WORKERS HEALTH
- Focus on child labor
- Hazardous orders
- Piggyback on international agreements (child labor) ILO 182
- Form an Interagency Task force
- International companies should set the model/standards for informal sector (the shame factor)
- Laws should be applied to economic development zones
- Add unemployment and workers� compensation to the recommendations
RECOMMENDED ACTIONS
NOTE: The purpose of these recommended actions is to launch some ideas on a flexible approach to deal with the issues outlined during the various presentations. Hence, this is a document for discussion and your feedback is most welcomed.
OCCUPATIONAL SAFETY AND HEALTH
ISSUE 1: PESTICIDES
SHORT-TERM:
1) Strengthen enforcement of existing laws on pesticide use.
2) Amend federal pesticide laws to allow private cause of action for farm workers against those who violate worker exposure standards and other legal protections.
3) Tighten standards for cancellation of pesticide registration to include the risk posed to workers as well as consumers.
4) Improve data collection on farm worker injuries and illnesses resulting from pesticide exposure including comprehensive worker surveys.
5) Pursue funding for materials to educate farm workers and farm owners as to the hazards, rights and responsibilities of working with pesticides.
6) Fund and initiate a campaign to educate the media on how to cover farm worker pesticide issues and develop a campaign to raise the level of outrage at the health cost to farm workers who work with pesticides.
LONG-TERM:
1) The short-term initiatives should be started immediately and continued until completed.
OCCUPATIONAL SAFETY AND HEALTH
ISSUE 2: WOMEN AND WORK
SHORT-TERM:
1) Increase funding for in-depth research on the hazards and exposures specific to occupations associated with Hispanic women workers as well as the predisposition of women for particular illnesses.
2) Fund, develop and deliver better training and education targeted for Hispanic women both in terms of rights as well as hazards and exposures expected in the workplace.
3) Support adoption of an OSHA ergonomic standard.
4) Develop recruitment strategies for Hispanics in occupational safety and health professions. For example, pursue strong language in the NIOSH appropriations report that directs NIOSH to develop such strategies.
5) Support increased funding for affordable childcare and eldercare.
6) Support increased access to health care for all.
LONG-TERM:
1) The short-term initiatives should be started immediately and continued until completed.
OCCUPATIONAL SAFETY AND HEALTH
ISSUE 3: FALLS IN CONSTRUCTION
SHORT-TERM:
1) Develop death and injury prevention effort that specifically address the concerns and needs of Hispanic workers.
2) Develop collaborative intervention efforts with organizations representing the Mexican work force in order to encourage and facilitate improved practices on both sides of the border.
LONG-TERM:
1) Developing effective disease and injury prevention interventions for all sectors of an increasingly diverse construction workforce requires improved evaluation of global practices, cross-border movement of workers, and efforts to gain for all workers the highest achievable standards of practice which minimize or eliminate occupational injury and disease.
Note: A fourth issue will be added to the agenda for discussions during the Hispanic Forum in October: Training and Education.
ENVIRONMENTAL HEALTH
ISSUE 1: ASTHMA AND HISPANIC CHILDREN
SHORT AND LONG TERMS:
Strategies to control asthma in Hispanic children should incorporate lessons learned from the successful efforts currently underway in Hispanic communities. A multidisciplinary approach will be necessary and could include the following components:
1) Research. More studies need to be conducted to identify the risk factors and social reasons contributing to the high incidence of asthma in Hispanic children. Monitoring studies of asthmatics in Hispanic communities will be critical. Better information is needed on the differences in access to health care, patient-doctor communication, recognition of symptoms by parents and teachers, and peer acceptance of medication to the disproportionate asthma burden among Hispanics. Both the influence of indoor and outdoor air contaminants on asthma development and the key air contaminants exacerbating symptoms in established asthmatics need to be better understood. Research on preventive strategies, such as an "asthma vaccine," has especially high potential for reducing asthma development among high-risk populations and in developing countries.
2) Prevention. Efforts should focus on mitigating the risk factors that trigger or exacerbate asthma in Hispanic children. These efforts could include supporting and expanding environmental justice programs/grants, such as those that target brownfields and urban industrial centers; supporting and funding federal/state programs working to lessen poverty and substandard housing; and supporting programs working to alleviate distressed living conditions in colonias along the U.S./Mexico border. In Latin America, efforts should also focus on reducing the use of leaded fuels and wood burning stoves.
3) Treatment. Many Hispanic children have asthma that is undetected or under-treated. These children need access to proper health care, treatment, and clinical trials. Health professionals who treat Hispanic children need to be educated on asthma diagnosis and management techniques, as well as the cultural and social factors that could influence their patients� treatment.
4) Education. Education within the Hispanic community is of critical importance. Education is needed to help individuals recognize asthma symptoms, understand the health effects of asthma, and seek and maintain treatment. Education campaigns should also help people understand the factors that trigger or exacerbate asthma, and could also be linked to related issues (e.g., ozone alert days, substandard housing, anti-smoking campaigns). Research has shown that outreach should focus on educating not only the child asthmatic, but also the child�s primary caregivers. Day care centers, schools, and community and youth organizations are prime targets for reaching children and their caregivers. In addition, teenagers might be recruited to help educate younger children and to form support groups within their own age groups. Other strategies could focus on increasing the promotion of successful programs and tools within the Hispanic community, such as The American Lung Association�s Open Airways for Schools and EPA�s Indoor Air Quality Tool Kits for Schools. In addition, the most useful educational materials now being published by the many organizations dedicated to asthma and allergy issues should be translated into Spanish.
5) Community Alliances. Community organizations have proven invaluable in educating families and schools about health issues, distributing outreach materials, galvanizing support within a community on environmental issues, and serving as catalysts for change. Strategic alliances should be cultivated with community group leaders, who could then receive training, education, and information for distribution within the community.
ENVIRONMENTAL HEALTH
ISSUE 2: LEAD POISONING AND HISPANIC CHILDREN
SHORT AND LONG TERMS:
In the United States, the interagency President�s Task Force on Environmental Health Risks and Safety Risks to Children has proposed a coordinated federal program to eliminate childhood lead poisoning, focusing on lead paint hazards (Eliminating Childhood Lead Poisoning: A Federal Strategy Targeting Lead Paint Hazards [at www.hud.gov/lead]). Following are other recommendations on how to address lead poisoning in Hispanic and other high risk communities:
1) Enforce Lead-Safe Maintenance. Housing codes and code inspections should include chipping and peeling paint and the presence of lead-contaminated dust, as well as their underlying causes (e.g., moisture and friction surfaces).
2) Build a Cadre of Painters and Remodelers Trained in Lead Safety. Training is needed to deliver specific, detailed knowledge about working safely with lead paint and collecting environmental samples. Making practical information and basic training in lead safety widely available through various media will facilitate reaching maintenance workers, painters, homeowners, and others.
3) Increase Resources. HUD should expand its Lead Hazard Control and Healthy Homes Grant programs to reach many more housing units than is possible at existing funding levels.
4) Build Community Capacity. To maximize their long-term effectiveness, lead poisoning prevention strategies should be designed to involve community members, build community capacity, and reap community-wide benefits. For example, increasing job training and employment opportunities in lead-safe maintenance and rehabilitation brings multiple benefits, including improved skills for the residents involved; greater economic self-sufficiency; and reduced unemployment, delinquency, and crime.
This program�s implementation would result in the creation of 2.3 million lead-safe homes for low-income families with children during the next 10 years. This could significantly benefit Hispanics in the United States, about 27 percent of whom are poor and who make up about 22 percent of the poor people living in the United States. Continued outreach and education to address lead-glazed ceramics and lead-based remedies will also benefit Hispanic families.
A strategy for reducing childhood lead poisoning in Latin America must address a variety of lead sources and will vary from country to country. Foremost in any strategy should be the elimination of lead in products with potential for broad exposure: gasoline, paint, plumbing supplies, ceramic glazes, food cans, printing ink, fertilizer, and children�s toys. The following recommendations were made by the Committee to Reduce Lead Exposure in the Americas (Board on International Health of the Institute of Medicine, USA, and National Institute of Public Health, Mexico, Lead in the Americas: A Call for Action, 1996):
- Move toward the elimination of lead in gasoline, ceramic glazes, paints, and food can solder.
- Strictly limit workplace exposures to lead and releases from macro- and microindustrial (family-based) industries.
- Implement surveillance of high-risk populations and environmental monitoring.
- Focus on interventions shown to be cost-effective and sustainable in countries of the Americas and elsewhere in the world.
- Conduct evaluation research so the success and cost-effectiveness of prevention and control strategies can be assessed on a regular basis.
- Ensure the involvement of all parties having a direct interest in reducing lead exposure, including government agencies, large and small industries, organized labor, health care providers, and community groups.
The hemispheric conference Preventing Lead Poisoning in the Americas: Health, Environment, and Sustainable Development (Santiago, Chile, 1998 [www.globalleadnet.org/pubs]) set forth recommendations to strengthen community right-to-know activities to give the public information about the harmful effects of products containing lead; to monitor and control products containing lead as part of regional efforts to establish a Free Trade Area of the Americas; and to establish and enforce protective standards to limit lead exposure. The Alliance To End Childhood Lead Poisoning�s Global Lead Network advocates that progress on lead poisoning prevention be included in "indicator" programs, which are becoming an important tool for measuring achievement of environmental protection and sustainable development. This would provide a means for non-governmental organizations to hold policy makers accountable for implementing international and regional commitments on phaseout and environmental source control.
ENVIRONMENTAL HEALTH
ISSUE 3: Hispanic Farm Children and Pesticides
SHORT AND LONG TERMS:
Regulatory:
1) Develop new rules designed to protect human health and the environment: focusing in those directly exposed such as children many of whom are in low income in farm workers communities and urban areas.
a) Promoting the health of children requires that they be safeguarded from harmful environmental exposures, harmful micro-organisms from water, air, soil and food, and accidents. This also includes the environmental health hazards in the immediate environment of the child, and health hazards created by changes in the global climate.
b) Understand that Farm workers represent the population most at risk from overexposure to pesticides, they are essential for a productive agricultural sector and their health is vital to the economy.
Educational Opportunities and Training:
2) In order to implement regulatory measures, it is important to design effective training tools for the target populations of farm workers, farm owner/operators, and pesticide applicators.
3) Training the workers in both countries can decrease their risks to exposure from pesticides and can reduce the incidence of pesticide poisonings among this segment of the population.
4) Develop a training program designed to the Farm worker�s ability to compete and have access to certification and accreditation programs.
5) Farm owners and supervisors need to be trained in appropriate pesticide health and safety preventive measures and the medical community needs the capability to adequately diagnose and treat pesticide-related illness and injury.
6) Commercial and private pesticide applicators need to perform tasks in ways that protect themselves, avoid exposures to workers and bystanders, and do not harm the environment.
Partnerships:
7) Develop partnerships: government, private sector, industry and non-governmental interest groups.
Gateway Information:
8) Provide access to developing countries biomedical information resources and databases, and collaborate on proposal preparation and research implementation with colleagues in industrialized countries.
9) Develop mechanisms for a Global Environmental On-line Workshops that provide dialog and exchange of information and interpretation of regulations and laws.
10) Engage in developing partnerships with the health care community to integrate their governments and academia environmental health messages into educational and practice settings.
11) Design an Implementation Plan for Las Americas Environmental Health Strategy for Health Care Providers to improve the recognition, diagnosis, management, and prevention of adverse health effects from pesticide exposures.
12) Develop friendly tools for all parts of society communities, individuals, business, state and local governments, tribal governments to have available access to accurate information sufficient to participate effectively in managing human health and environmental risks.
13) Facilitate technical processes, access to agriculture data base and medical information for the occupational and environmental
ENVIRONMENTAL HEALTH
ISSUE 4: CONSUMER PRODUCT SAFETY
SHORT AND LONG TERMS:
1) Adopt injury prevention as an overall goal of your organization or community. Then set a specific, achievable goal in one area. For example, inform and educate new and expectant parents and child care providers about how they can reduce the risk of SIDS; use CPSC's safety information or hold one or more baby safety showers. When you meet that goal, set another one.
2) Network widely with other organizations -- local, state, federal (such as CPSC and EPA), and private (such as the National Safety Council and SAFE KIDS) -- that are concerned about safety. Find out what resources they offer -- information, expertise, programs, publications and other materials, money -- that could help you achieve your goal.
3) Develop partnerships with other organizations to help you achieve your goal. A partner may be obvious, such as the local office of a national safety group or the local health department; less obvious, such as a religious organization; or an organization with no stated or obvious interest in safety, such as a union or a retailer. Don't limit yourself to one partner in achieving your goal.
4) Use grassroots programs to help you achieve your goal and adapt them to suit your circumstances. Because they involve more people working together at the local level, grassroots programs can increase the likelihood of achieving your goal and reducing preventable injuries and deaths in your community.
INTERNATIONAL WORKERS' HEALTH
ISSUE 1: AGRICULTURE SECTOR
SHORT AND LONG TERMS:
1) Make Structural Changes to Agricultural Legislation: Provide adequate minimum wage; improve housing; promote the right of farm workers to organize labor unions and engage in collective bargaining; stricter child labor laws in agriculture; assure workers right-to-know what chemicals and other hazards are used at work; strengthen legal protection against premature re-entry onto fields sprayed with pesticides; ban pesticides that are known carcinogens, reproductive toxicants or neurological toxicants; and promote transition from toxic pesticides to sustainable pest control methods.
2) Establish a National Policy on Agricultural Health and Safety: Each country should have a national policy that addresses the protection of its workers and includes preventive measures to minimize or eliminate hazards. Consideration should be given to the environmental impact of agricultural policies and support give to a primary health care and public health system. The national policy should include appropriate compensation plans for agricultural worker illness and injury, with a component for rehabilitation services. Also, there needs to be support for an improved system of monitoring occupational injuries and illnesses. Support for an adequate enforcement and inspection system is very important. A national policy also needs to include a sustainable approach to agriculture that stresses safer pesticide use, the use of integrated pest management practices, protection of the environment, and the assurance of agricultural worker occupational health and safety.
3) Primary Focus on Integrated Pest Management (IPM) and More Sustainable Practices: National agricultural policies should support: the development of less toxic pesticides; the use of safer pesticide formulations; the use of safer application techniques; the development of adequate toxicity testing and risk assessment; and the development of suitable exposure and biological monitoring techniques to assess impact on humans and the environment. In addition, national agricultural policies should: support training and supervision for pesticide application; require certification and training of pesticide applicators; restrict the sale of highly toxic products; promote proper health risk management and health surveillance at the work site; educate pesticide users; train workers on pesticide hazards utilizing community-based methodologies, safe work practices and personal protective equipment use; and plan for pesticide medical emergencies.
4) Develop International Collaboration Among Stakeholders: There are numerous examples of cross-national public health initiatives, which address international occupational health issues. These initiatives deal with: training health care providers, health and safety professionals, workers and farmers; providing technical assistance regarding health care delivery and preventive technology; providing collaboration on research projects; facilitating information exchanges and education campaigns. There is a need for collaboration among all the stakeholders and affected groups in tackling the issue of occupational health and safety among agricultural workers. The occupational health and safety professionals, grower and community-based farmworker representatives, governmental officials and other non-governmental groups from all countries of the Americas need to come together to discuss issues of common interest and formulate actions plans and national policies.
INTERNATIONAL WORKERS' HEALTH
ISSUE 2: MANUFACTURE SECTOR (MAQUILADORAS)
SHORT TERM:
In the short term, the methodological limitations to evaluate this sector should be curbed. In order to analyze the relative importance of the maquila sector across different countries, public authorities should homogenize social, economic, environmental and health indicators in the maquila sector. It is nearly impossible to achieve any conclusion with profound policy implications with the current disparity and diversity in data. To this end, technical and financial assistance will need to be provided to these authorities with regard to the setting of appropriate surveillance and monitoring systems.
Promote intersectoral and interagency initiatives with a view to develop occupational health and safety programs in the maquila sector (including industrial hygiene programs).
Lobby governments in Mexico and Central America to review and enforce existing OSH laws regarding the manufacture sector, and pressure them to establish independent monitoring groups that would inspect maquiladoras and monitor the proper enforcement of the relevant laws in target regions of high injury and death rates.
Assist NGOs in providing appropriate training in labor rights and in occupational and environmental risk identification and control to maquiladora workers. Since such initiatives cannot be conducted inside workplaces, use churches and community center outside of work hours.
All organizations, intergovernmental, federal, and civil society should seek to create solidarity networks both through national and through cross-border coalitions.
LONG TERM:
Address health and social problems that affect the workforce employed in the maquiladora sector, such as violence, housing, basic sanitation infrastructures, and water treatment plants.
Include the issue of maquiladoras explicitly in FTAA negotiations and in other regional meetings that gather high-level officials such as the Summit of the Americas.
Encourage gender sensitive research and health interventions in this sector.
National and international awareness campaigns regarding the maquiladora sector have had mixed results (consumer-led campaigns such as those against Nike and GAP have been positive as a whole and should be replicated as much as possible), and more research should be done to determine how the political, legal, social and economic structures and idiosyncrasies of a given country affects the success and failure of such campaigns.
INTERNATIONAL WORKERS' HEALTH
ISSUE 3: INFORMAL SECTOR
There have been several case studies and international meetings on the issue of social security and social protection for the informal sector (including, inter alia, Tockman, Mesa-Lago, Urmeneta, PAHO-ILO). Such attempts have been even more limited when dealing with the informal sector in the area of health promotion and protection, and they have traditionally not been developed with a comprehensive strategy. Hence, the protection of the health and welfare of informal sector workers is a challenge which should be faced with an integrated approach to health promotion, social protection and quality employment creation and has, therefore, to be part of a strategy to improve the basic living conditions of the urban poor.
The following actions are thus being proposed in order to effectively tackle this problem both in the short and in the long terms:
SHORT TERM:
Governments and NGOs across the region should be encouraged to develop strategies in order to progressively extend social protection and improve working conditions of informal workers. Such strategies should include multi-sectoral preventive measures to safeguard the well being of the population working in this sector.
While protective approaches cannot significantly change the social situation, they can dramatically reduce its pernicious effects on informal sector workers allowing them to perform safer tasks under healthy and protected conditions. Innovative means to prevent occupational accidents and diseases and environmental hazards need to be developed through cost-effective and sustainable measures at the work-site level.
In order to raise the productivity of informal sector workers it is necessary to develop measures that effectively combine services to enable micro-enterprises to increase their income and services to assist them in protecting their health and improving their working conditions. One example of such measures could be the provision of micro-credits for workers in the informal sector, who traditionally lack a collateral in order to qualify for loans in the first place. Another example consists in providing training programs in order to allow for capacity-building within the informal sector. The informal sector needs to be informed on how to negotiate, how to draw up a contract, how to comply and deliver the goods.
From a research standpoint, international organizations, universities, think-tanks, and other institutions who conduct studies about this sector should find a common working definition of the informal sector and develop basic (social, economic, environmental, and health) indicators in order to assess the scope and state of the informal sector, in addition of allowing for cross-country comparisons.
Given the size of the labor force, the diversity of operations and various social demographic characteristics of the informal sector operators, substantial efforts are necessary in order to obtain adequate background information on the OSH problems of the informal sector workers. Hence, it is necessary from an occupational health standpoint to conduct case studies aimed at identifying, evaluating, controlling, reducing and communicating the main risk factors in the workplace. Also, it is important to identify what groups are the most vulnerable in this sector, such as children, women, the elderly, and migrant workers, and put forward interventions targeted at these groups.
Finally, as this sector is not covered by national recording, notification and compensation systems, there is scarce information on occupational accidents and diseases arising from hazardous working conditions which could be used for the identification of priority areas of prevention. Therefore, to obtain such information it would be necessary to carry out ad-hoc surveys or to include OSH modules in national household and similar surveys. This would contribute to cover gaps, validate existing data, enlighten earlier unmapped areas and produce more reliable estimates, in order to propose preventive and control measures against accidents and diseases in the informal sector.
LONG TERM:
Overall, support to the informal sector should be viewed as part of a long-term strategy aimed at increasing the formal sector jobs and strengthening the conditions and principles which regulate labor relations, working conditions and employment opportunities in order to allow economic integration, social cohesion and democracy.
Furthermore, real and deep-rooted institutional reforms, backed by political support, must be adopted in order to harness the potential of informal sector workers. These necessary institutional reforms must be based on three conditions: the operation of open and efficient markets; the simplification and elimination of state procedures, regulations and controls; and the creation of more open, inclusive and democratic political processes, in which all citizens participate by gaining access to information and input into proposed laws and regulations (analogous to a checks and balances system). For the members of the informal sector, political participation will be based on obtaining full, secure property rights.
Awareness campaigns should be created in order to foster cooperation between the formal and the informal sectors. For instance, the formal sector must establish ways and means to subcontract into the informal sector, but they are not aware of what talent actually exists in the informal sector. They do not know how to approach the informal sector, to subcontract to the informal sector. They would rather employ people and then sack them again when the going gets tough. Such campaigns, combined with the training programs already advocated in the short term, should effectively solve such barriers to cooperative actions.
In the long term, the solutions should imply deep-rooted changes, such as the creation of productive and sustainable jobs, the legalization of informal work, and the elimination of the adverse and perverse consequences of policies aimed at increasing economic growth and national competitiveness in a globalizing world.
Note: A fourth issue will be included in the agenda for discussions during the Hispanic Forum in October 18th-19th: Construction Sector.
