Alternative paradigm proposed for health and safety system

As the health and safety system strives to keep up with today’s working world, the University of Washington’s Dr. Michael Silverstein has proposed a  novel solution involving private workplace inspectors. He presented this idea at the Institute for Work & Health’s annual Nachemson lecture.

Published: February 12, 2013

Adopting an innovative prevention-based model that supplements traditional government oversight with a role for private-sector inspectors may enable regulatory standards and practices to keep pace with the changing world of work. This is according to Dr. Michael Silverstein, professor of Environmental and Occupational Health at the University of Washington’s School of Public Health, and long-time public administrator of occupational health and safety programs.

Silverstein laid out his idea to roughly 140 attendees at the Institute for Work & Health’s annual Alf Nachemson Memorial Lecture, held in Toronto last November.  Supportive of the recommendations in Ontario’s 2010 Report of the Expert Advisory Panel on Occupational Health and Safety, Silverstein suggested his plan shares many of the report’s tenets and may have legs north of the U.S.-Canada border.

Today’s workplace very different

Today’s workplace is markedly different from that of the not-so-distant past, according to Silverstein. The kind of workplace for which America’s Occupational Safety and Health Act (1970) was created is getting harder to find, he said.

For Silverstein, the key features of this changing world of work—all of which pose new challenges to worker health and safety— include:

  • older, heavier and more chronically ill workers;
  • new chemicals and other hazards, such as chemotherapy drugs in health care settings;
  • more work-related musculoskeletal disorders;
  • structural changes in the labour market, such as a shift from manufacturing  to services and health care;
  • more vulnerable workers, including an increasing number of newcomers;
  • increasing non-traditional work, such as temporary and contract work; and
  • declining union representation.

The trouble, according to Silverstein, is that the health and safety system hasn’t kept up with these changes. It’s basically gridlocked. There are too few inspectors for the number of workplaces.

Silverstein’s approach: A “different paradigm” 

This disconnect could be addressed through “a different paradigm,” Silverstein suggested. He outlined a plan that includes three key components.

First, every workplace would be required to implement a comprehensive health and safety program that includes management commitment, employee participation, training, exposure assessment, hazard control and medical surveillance. Programs like this only make sense if there’s a requirement to find and fix hazards, with plans for fixing them and a timetable for doing so, Silverstein said.

Second, every workplace would be required to obtain annual or periodic certification that its program was, in fact, being implemented and in compliance. Business owners would be required to sign a personal declaration of compliance and would bear some liability in the event of negligence or disregard of the law, Silverstein added.

Third, private-sector individuals or organizations would be engaged to conduct certifications and inspections. They would be licensed to operate under rules established by the government, and government agencies would audit them and continue to do their own inspections. There would have to be strong checks and balances to avoid the dangers—e.g. conflicts of interest and corruption—that become possible when governments delegate functions to the private sector, Silverstein added.

Silverstein, one-time head of health and safety at the United Auto Workers, acknowledged that this third point ruffles some feathers. Here’s where my friends in the U.S., especially in organized labour, jump  off the boat, because it sounds like privatizing essential government services, he said.

However, Silverstein pointed out that the role of government agencies needs to change. There’s no way for any government agency to inspect every workplace with any reasonable frequency, he said. He also pointed out that variations of his plan are already successfully up and running in the U.S. For example, private-sector firms are designated to inspect aircraft on behalf of the Federal Aviation Administration.

Values, engagement essential to good public policy

The end goal of his plan, Silverstein said, is to inform and contribute to sound public policy that facilitates prevention. This is done by finding the basic underlying causes of workplace injury and illness, intervening in the most potent ways possible and then evaluating whether the intervention worked. 

Engagement is key in this process. Prevention is more than public health science and professional competence, Silverstein said. It requires engagement in the politics of organizational behaviour and social change. We have to participate, not as scientists or union reps, but as citizens who have a stake in the political process.

Values are also essential. Good public policy takes place not simply as something that flows out of good science or evidence, he said. It only takes place at the intersection of evidence, values that people bring to the table, and the nature of the political process.

You can hear the full 2012 Nachemson lecture, while viewing the slides, by going to: