Barbara Materna, PhD, CIH, Chief

Occupational Health Branch

CIHC Annual Meeting – December 4, 2006

Update from the Occupational Health Branch, CA Dept. of Health Services

Overview

Intro to the Occupational Health Branch

New California Department of Public Health

Activities in 3 key areas

How to contact us

OHB Programs & Leaders

Occupational Health BranchBarbara Materna, PhD, CIH, Chief

Hazard Evaluation System and Information Service Julia Quint, PhD, Chief

Occupational Health Surveillance and Evaluation Program

Robert Harrison, MD, MPH, Chief

Occupational Lead PoisoningPrevention Program

Michael DiBartolomeis, PhD, Chief

HESIS established in 1978

OHSEP - 1985

OLPPP - 1991

Role of Public Health Elevated

California Department of Health Services

CaliforniaDepartment ofPublic Health

CaliforniaDepartment of

Health Care Services

Effective 7/1/2007

Division of Env. & Occ. Disease ControlOccupational Health Branch

OHB Focus Areas & Project Examples

New and emerging health & safety issues– Lung disease in food flavoring workers

Special needs of low-wage, immigrant, and underserved workers– Fatalities among Latino workers

Protecting both workers and the environment from toxic substances– Partnering on asthma– Partnering on pollution prevention

Serious Lung Disease Linked to Diacetyl (butter/food flavor chemical)

NIOSH investigations in microwave popcorn industry & animal toxicity studies

2004: 1st case of bronchioloitis obliterans found in CA in flavor manufacture

OHB assisted Cal/OSHA Medical Unit, began industry-wide focus

April 2006: 2nd case found

Outreach Effort Initiated

Diacetyl Hazard Alert in English and Spanish

Case summaries, resources, customized letters to employers, health care, worker organizations

Outreach hampered by lack of info on diacetyl users

Phone survey to locate all CA manufacturers (30)

Industry Special Emphasis Program

Collaboration between OHB, Cal/OSHA Consultation, NIOSH & industry trade association

Companies to have IH assessment, medical monitoring & implement controls – or get inspected

OHB to evaluate medical surveillance programs & results, follow up with suspect cases

Disease Highlights H&S Gaps

Hazard information withheld by manufacturer for years; not listed on many MSDSs

Not all employers acted on 2003 NIOSH Hazard Alert & other outreach efforts calling for:– Medical surveillance programs– Local exhaust ventilation– Respirator programs– Hazard communication

Health care providers misdiagnose serious breathing problems in young nonsmokers who handle diacetyl & other flavor chemicals

Additional Diacetyl Activities

NIOSH technical assistance to recommend engineering control solutions

Petition & Advisory Committee for diacetyl standard

CDHS collected inadequate MSDSs for referral

OHB project with UCSF to assess & improve spirometry quality

Need for outreach to food manufacturing industries (users of diacetyl-containing flavors)

Investigating Latino Fatalities for Prevention

NIOSH-funded OHB project based in Los Angeles

187 Latinos killed statewide in 2005 (41% of total)

Collecting new information during investigations

Focus on identifying causes & ways to prevent incident

Case Example:Death of 17-year-old Latino Laborer

Worker was guiding forklift driver moving pallets into curing oven.

On the job for 1 month; generic safety training only.ID said his age was 21.

Flimsy pallets collapsed. Worker crushed by falling material.

Recommendations Made

Ensure use of pallets that support weight of items stored.

Ensure employee training on safe work practices – and verification of skills through testing.

Establish work policies that comply with youth employment standards.

Employers should:

More Outreach to Latino Workers

Translating more materials into Spanish

Partnering with other organizations for distribution

Speaking at industry & professional meetings to reach employers of Latinos

Partnering on Asthma Prevention

OHB has identified & investigated cases of work-related asthma since 1993

Many agents affect both workers & others in the same environment

OHB works with others in CDHS & a broad coalition on statewide asthma prevention efforts

Occupations with Highest Asthma Rates & Related Exposures

Correctional officers

Firefighters

Special ed teachers

Health technicians

Welfare eligibility clerks

Respiratory therapists

Machine operators

Chemical technicians

Police supervisors

Bus drivers

Pepper spray, smoke, dust

Smoke

Mold, dust, indoor pollution

Glutaraldehyde, paint, latex, dander, dust, cleaning chemicals

Roofing tar, paint, dust

Latex, cleaning chems, glutarald.

Solvents, inks, acids, glues

Solvents, inks, isocyanates, HCs

Pepper spray, mold, smoke

Diesel exhaust

Work-related Asthma in California, 1993-2004 (N=3,479)

Workplace Asthma Integrated into Statewide Prevention Efforts

Collaborating with environmental health & others: www.CaliforniaBreathing.org

Updating state Strategic Plan for Asthma

Evaluating new data sources to ID work-related cases:– hospital discharges – emergency depts.– Workers’ Comp Info System

Partnering on Pollution Prevention

Pollution prevention consistent with IH goal of eliminating / substituting out hazards, or controlling at the source

Environmental & occupational health professionals often work in “silos” -- can result in unintended, conflicting outcomes

OHB linking with environmental groups & agencies to support efforts that protect the environment and workers

Evaluating Use, Toxicity & Safer Alternatives for New Solvents

U.S. EPA-funded collaboration with the Institute for Research & Technical Assistance

Studied uses and toxicity of 5 solvents & assessed possible safer alternatives:– N-propyl bromide (NPB or 1-bromopropane)– N-methylpyrollidone (NMP)– Decamethylcyclopentasiloxane (D5)– Parachlorobenzotrifluoride (PCBTF)– 1,2-trans-dichloroethylene (DCE)

N-Methyl Pyrrolidone in Paint Strippers

Marketed as “safer” alternative to methylene chloride in paint strippers

NMP is a Prop 65 developmental toxicant, not regulated in workplace

Less toxic benzyl alcohol-based strippers shown to be acceptable alternative

Occupational Health Internship Program

Interns hosted in SF Bay area & Los Angeles:www.aoec.org/OHIP

Focus on field experience, learning workers’ perspective on H&S

OHB projects on:– Heat illness– Silica in bricklaying– Restaurant hazards– Garment work & ergonomics

Seeking new staff in OHB

Industrial hygienist for asthma & pesticide illness prevention projects (open now, www.phi.org)

Research Scientist III for Safe Cosmetics Program (new civil service position)

Contacting OHB

Website: www.dhs.ca.gov/ohb

Sign up for email list by sending your info to occhealth@dhs.ca.gov

850 Marina Bay Pkwy., Bldg. P, Richmond, CA 94804; (510) 620-5757

Telephone helplines, toll-free for CA callers:– Workplace Hazard Helpline: (866) 282-5516– Lead in the Workplace Information Line:

(866) 627-1587– Asthma & Pesticide Illness Helpline: (800) 970-6680