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https://clinton.presidentiallibraries.us/files/original/36677ff39b0eb836e2ab82c1f4b3bf98.pdf
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FOIA Number:
2006-0885-F
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the William J. Clinton
Presidential Library Staff.
Collection/Record Group:
Clinton Presidential Records
Subgroup/Office of Origin:
Health Care Task Force
Series/Staff Member:
Tarmey
Subseries:
1978
OA/ID Number:
FolderlD:
Folder Title:
[Policy Alternatives for Occupational Health] [loose]
Stack:
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Section:
Shelf:
Position:
S
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�employers is further compounded by the recent passage TLVs, and hence play no important role in Cal/OSHA's
of Senate Bill 198, which mandates injury prevention regulations. (See "Reproductive Health Hazards in the
programs in all worksites.
Workplace: Policy Options for California," CPS Brief
The state and national regulatory framework is also 4(1), February 1992.)
undergoing reexamination. At the national level, ConCalifornia leads the nation in developing innovative
gress is considering the "Comprehensive Occupational controls for toxic substances in the workplace and the
Safety and Health Reform Act" (S 1622, HR 3160). This environment. As the leader it enjoys the benefits of new
legislation would amend the 1970 act in two important policy innovations but also bears the costs of untimely or
ways. First, it would strengthen workers' rights to know ill-considered mistakes. Toil and Toxics provides insights
and to act in response to hazardous exposures. The into past experiences and guidelines for future efforts to
centerpiece of these changes would be requirements that control toxic substances in California and in the United
all workplaces above some minimum size establish joint States as a whole.
worker-management safety and health committees with
the authority to investigate working conditions and James C. Robinson is an associate professor of health
propose improvements. Second, the new legislation policy and economics at the University of California,
would streamline OSHA's process for establishing Berkeley. He teaches at the School of Public Health and
Permissible Exposure Limits for large numbers of toxic is also affiliated with the Institute of Industrial Relations.
substances, completely bypassing the Threshold Limit
Values. Both parts ofthe proposed amendments connote
recognition that the large number and constantly changThis information is being circulated by the Caliing nature of hazards encountered by workers have far
fornia Policy Seminar as a service to state governoutstripped OSHA's capabilities.
ment. Toil and Toxics: Workplace Struggles and
The standard-setting problems besetting OSHA at
Political Strategies for Occupational Health, analyzthe the national level are also evident in California's
es 30 years of efforts to control workplace health
program. Although it is innovative in some ways, Cal/
arid safety hazards, with an eye to identifying the
OSHA generally has been content to follow the lead of
most successful approaches. It traces the history of
federal OSHA. Most of Cal/OSHA's health standards
the right to know movement from the local level, :
are based on Threshold Limit Values, for example, and
through OSHA's Hazard Communication Stanfew confront the health hazards posed by carcinogens,
dard, to the "community right to know" provisions
reproductive toxicants, and neurotoxicants. The failings
of federal law, arid then analyzes the strengths and
of Cal/OSHA health standards are most obvious for
weaknesses of the "right to act" as embodied in
chemicals that threaten reproductive health, causing
labor law, management policies, legislation, and
infertility, sterility, miscarriage, and/or birth defects. A
the proposed requirements for mandatory; training
large number of suspected reproductive hazards do have
arid safety committees. The book then examines
Cal/OSHA PELs, which give the appearance of guaranthe strengths and weaknesses of direct governmenteeing worker safety. In actuality, however, the PELs for
tal regulation of health and safety hazards. ^ ^ :
almost all these substances were adopted from the TLVs,
The book is available through the University
based on their potential for causing acute toxicity at high
of California Press; 2120 Berkeley Way, Berkeley,
exposure levels. The scientific evidence that these
CA 94720. To order from the publisher and obtain
substances may pose chronic health hazards, such as
a 20% discount (discounted price: $23.96) phone
reproductive damage, at lower exposure levels was
1-800-UC-BOOKS.
routinely excluded from the analysis used to establish
' IJHE CALiFofelA'POLICT SEMINAR;.
* 3 % A"JOINXiPROGRAM OF THE , R
v ^UrSIVERSlfY OE CALIFORNIA V
2v AND STATE GOVERNMENT
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POLICY ALTERNATIVES FOR OCCUPATIONAL HEALTH
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tv. y •.:
James C. Robinson
Editor's note: This Brief is based on Robinson's new book, Toil and Toxics:
Workplace Struggles and Political Strategies for Occupational Health, published in 1991
by the University of California Press.
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Public policy towards toxic exposures and injury risks in the workplace is at a
crossroads. Emphasis has traditionally been placed on direct workplace regulation by
the federal Occupational Safety and Health Administration and by Cal/OSHA in
California. Interest is now shifting to information-oriented approaches such as the
worker's "right to know" and California's Proposition 65. Both the regulatory and
the information-oriented strategies have important strengths but also important
limitations. In the coming years policy choices need to build on past experiences to
save the best of what has been tried while avoiding the costliest failures.
The debates concerning workplace hazards have direct implications for the larger
concern over environmental and community exposure to toxic substances: Can
Proposition 65, the "community right-to-know" legislation, and other informationoriented strategies, successfully mobilize public concern for environmental and public
health protection? What is the proper role for regulatory bodies such as the air and
water quality control boards and the newly created California Environmental Protection Agency with regard to toxic substances?
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Worker Responses to Workplace Hazards
As documented in Toil and Toxics, workers are aware of many of the health and
safety hazards they encounter on the job. From 30 to 40% of all workers report facing
at least one serious health or safety hazard; among blue collar occupations, this rises
to 50-60%. Twenty-two percent of workers report serious exposure to risks of illness;
7% report serious exposure to dangerous chemicals.
Worker morale is lower and industrial relations are worse in jobs with unsafe and
unhealthy conditions. Compared to workers in safe jobs, workers in hazardous jobs
are more likely to express dissatisfaction with their jobs; more likely to quit; more
likely to be absent without reason; more likely to be temporarily or permanently laid
off; more likely to go on strike; and more likely to be fired.
Moreover, workers faced with health and safety risks are substantially more likely
to favor union representation than workers in safe jobs. Those in the riskiest jobs are
�twice as likely to be unionized than workers in the safest protesting against unsafe or unhealthy conditions.
jobs. Consistent with thesefindings,nonunion workers in However, union representation has declined rapidly in
hazardous jobs express greater desire for union represen- recent years, to a point where only 12% of private-sector
tation than nonunion workers in safe jobs, and union employees are covered by collective bargaining.
representation elections occur and are won more freWorker advocates are now seeking to recreate
quently in hazardous industries than in safe industries.
through legislative and regulatory means some of the
Labor unions have dramatically increased their health institutional framework that unions traditionally providand safety activities in recent years. They have been ed. Various pieces of proposed legislation would require
bargaining for better information on exposures and employers with more than a specified number of employhealth risks, the worker's right to refuse hazardous ees to form joint labor-management safety committees
tasks, safer working conditions, hazard pay premiums, and/or would provide protections for workers disciplined
employer-paid protective equipment, and joint union- for reporting violations of safety and health regulations.
management health and safety committees. Due to In addition, OSHA's Hazard Communication Standard
increased resistence by management, however, union and California's Proposition 65 require employers to
coverage in hazardous industries has declined in recent provide various types of hazard information, a function
that traditionally fell under the employer's obligation to
years (as has union representation in safe industries).
Worker and labor union responses to information on bargain with the labor union in good faith. It is presently
workplace hazards sometimes generate conflict with unclear what effect these "right to act" efforts will have
management, with adverse impacts on economic perfor- in nonunion workplaces.
mance. For example, labor productivity (and profit rates)
are significantly lower in hazardous manufacturing Regulatory Efforts to Control
industries than in safe manufacturing industries.
Workplace Hazards
Since 1980 there has been a dramatic increase in
The major alternative to the information-oriented
public policies relating to the worker's "right to know" strategies embodied in the "right to know" and the
and "right to act" concerning workplace hazards. While "right to act" is direct control of toxic exposures by
information and worker-oriented strategies for improving governmental regulatory agencies. OSHA and Cal/OSHA
health and safety conditions have great potential, they have devoted a disproportionate share of their resources
also have serious problems. Workers already recognize over the past 20 years to the promulgation and enforcemany of the hazards to which they are exposed. By ment of Permissible Exposure Limits (PELs), which
extension, they can learn from "right to know" efforts define maximum allowable concentrations of hazardous
and will develop new and more innovative strategies. substances for the working environment. The EPA and
However, they are unlikely to ever be able to fully various state regulatory agencies have emphasized emisunderstand the risks they face, especially in an increas- sions limits and allowable pollutant concentrations for
ingly nonunion environment. The most informed and toxic substances in the general environment. Toil and
concerned workers may be the first to quit or be fired, Toxics analyzes the often tortuous history of OSHA's
leaving their less educated and less mobile coworkers controls on cancer-causing chemicals to illuminate the
without leadership.
strengths and weaknesses of the regulatory strategy in
The worker's "right to act" concerning health toxic substances policy.
hazards and other workplace concerns is embodied in the
Shortly after its creation in 1971, OSHA adopted as
framework of U.S. labor law, which relies traditionally on mandatory PELs the voluntary exposure guidelines
labor unions as collective representatives of individual ("Threshold Limit Values") of a private, industryworker interests. Union activities in health and safety oriented organization. These startup standards gave the
have increased substantially over the past three decades, agency something to enforce, but proved a burden to
and include collective bargaining, worker training, and further progress. Instead of developing a strategy for
the establishment of joint union-management safety analyzing and regulating large numbers of toxic subcommittees. Central to labor union activities is the stances, OSHA was content to enforce the TLV-based
grievance and arbitration mechanism, which provides startup standards and focus its efforts on analyzing and
some protection for individual workers disciplined forregulating a small number of additional substances. Thus
the 1970s were consumed by elaborate and expensive
rulemaking procedures for a few carcinogens, such as
asbestos, coke oven emissions, vinyl chloride, acrylonitrile, arsenic, and benzene, and for two other hazards,
lead and cotton dust.
The regulatory proceedings of OSHA's first decade
were important in elucidating many of the important
toxicological, epidemiological, economic, and legal
dimensions of occupational hazards and their control.
However, implicit in OSHA's regulatory strategy was
the untested assumption that the primary problem was
due to a small number of widely prevalent substances. It
is now clear that the risks to occupational and environmental health result from large numbers of substances,
only a few of which are widely prevalent at high exposure levels. OSHA's energies were consumed by its substance-specific regulations, however, leaving it no
resources to grapple with the very large number of other
potential problems. A similar dissipation of energy
occurred at the EPA, especially with respect to toxic air
pollutants regulated under the Clean Air Act.
By the end of the 1970s, OSHA was changing its
regulatory orientation towards a new approach for
chemical carcinogens. The proposed "Generic Carcinogen Policy" of 1980 would have established guidelines
for expeditiously assessing the risks posed by suspected
substances and mandating protective measures for those
found to pose unacceptable dangers. The EPA was
engaged in similar endeavors under the authority of the
clean water and clean air acts. These efforts ended,
however, with the presidential election of Ronald
Reagan in November 1980. Subsequently OSHA abandoned the proposed new policy and began to weaken the
standards it had promulgated during the 1970s.
After several years emphasizing deregulation, OSHA
gingerly began to consider establishing some new regulations for occupational carcinogens. The Hazard Communication Standard, implemented for the manufacturing
sector in 1983, mandated employee training programs in
all worksites using carcinogenic substances. OSHA
developed four substance-specific carcinogen PELs
during the decade, covering benzene, ethylene oxide,
asbestos, and formaldehyde.
The centerpiece of regulatory policy for the 1980s
was the Air Contaminants Standard, which established
new Permissible Exposure Limits for over 400 hazardous
substances. Ironically, however, this new regulation
embodied a reversion to OSHA's first effort. Virtually
all of the new exposure limits were taken from the
Threshold Limit Values. What might have been acceptable public policy in 1971, when there were no realistic
alternatives, constituted clear policy failure in 1989. In
the interim, the TLVs were shown to have been based
often on poor scientific evidence and developed by
corporations that had direct financial interests in the
toxic substances in question. Alternative recommendations were available from the National Institute for
Occupational Safety and Health, the National Toxicology
Program, and the International Agency for Research on
Cancer. OSHA largely ignored these scientifically based
recommendations.
Current Issues in Occupational
Health Policy
California and the nation face important choices in
dealing with toxic substances. Every week new scientific
evidence is available concerning potential adverse health
effects from commonly used materials, many of which
play central roles in the economy. It is impossible to ban
every pesticide, plastic, heavy metal, or artificial fiber
that poses some risk to someone at some time. Rather,
we must develop efficient and equitable means for
prioritizing individual substances for control. As argued
in Toil and Toxics, two basic approaches are available:
indirect control through information and guarantees of
the "right to act," and direct control through governmentally enforced exposure and emissions limits.
Given the long history of ignorance and coverup
concerning toxic substances, it is not surprising to
observe the current widespread emphasis on the worker's and the public's "right to know" and "right to
act." California leads the nation here as elsewhere in
toxics policy, especially since the landslide adoption of
Proposition 65, the Safe Drinking Water and Toxics
Enforcement Act of 1986. Employers were initially
exempted from the warning requirements of Proposition
65, since it partially overlaps with the federal and state
Hazard Communication Standard. After lengthy deliberations, however, the courts have ruled that Proposition 65
applies to occupational exposures to carcinogens and
reproductive hazards and not merely to exposures
through consumer products and the general environment.
It is still not clear, however, how the requirements for
clear and reasonable warnings concerning several hundred officially listed toxic substances will be enforced in
the California workplace. The pressure on California
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Health Care Task Force Records
Creator
An entity primarily responsible for making the resource
White House Health Care Task Force
Is Part Of
A related resource in which the described resource is physically or logically included.
<a href="https://catalog.archives.gov/id/10443060" target="_blank">National Archives Catalog Description</a>
Description
An account of the resource
<p>This collection contains records on President Clinton’s efforts to overhaul the health care system in the United States. In 1993 he appointed First Lady Hillary Rodham Clinton to be the head of the Health Care Task Force (HCTF). She traveled across the country holding hearings, conferred with Senators and Representatives, and sought advice from sources outside the government in an attempt to repair the health care system in the United States. However, the administration’s health care plan, introduced to Congress as the Health Security Act, failed to pass in 1994.</p>
<p>Due to the vast amount of records from the Health Care Task Force the collection has been divided into segments. Segments will be made available as they are digitized.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+1"><strong>Segment One</strong></a><br /> This collection consists of Ira Magaziner’s Health Care Task Force files including: correspondence, reports, news clippings, press releases, and publications. Ira Magaziner a Senior Advisor to President Clinton for Policy Development was heavily involved in health care reform. Magaziner assisted the Task Force by coordinating health care policy development through numerous working groups. Magaziner and the First Lady were the President’s primary advisors on health care. The Health Care Task Force eventually produced the administration’s health care plan, introduced to Congress as the Health Security Act. This bill failed to pass in 1994.<br /> Contains 1065 files from 109 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+2"><strong>Segment Two</strong></a><br /> This segment consists of records describing the efforts of First Lady Hillary Rodham Clinton to get health care reform through Congress. This collection consists of correspondence, newspaper and magazine articles, memos, papers, and reports. A significant feature of the records are letters from constituents describing their feelings about health care reform and disastrous financial situations they found themselves in as the result of inadequate or inappropriate health insurance coverage. The collection also contains records created by Robert Boorstin, Roger Goldblatt, Steven Edelstein, Christine Heenan, Lynn Margherio, Simone Rueschemeyer, Meeghan Prunty, Marjorie Tarmey, and others.<br /> Contains 697 files from 47 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+3"><strong>Segment Three</strong></a><br /> The majority of the records in this collection consist of reports, polls, and surveys concerning nearly all aspects of health care; many letters from the public, medical professionals and organizations, and legislators to the Task Force concerning its mission; as well as the telephone message logs of the Task Force.<br /> Contains 592 files from 44 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+4"><strong>Segment Four</strong></a><br /> This collection consists of records describing the efforts of the Clinton Administration to pass the Health Security Act, which would have reformed the health care system of the United States. This collection contains memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, newspaper articles, and faxes. The collection contains lists of experts from the field of medicine willing to testify to the viability of the Health Security Act. Much of the remaining material duplicates records from the previous segments.<br /> Contains 590 files from 52 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+5">Segment Five</a></strong><br /> This collection of the Health Care Task Force records consists of materials from the files of Robert Boorstin, Alice Dunscomb, Richard Veloz and Walter Zelman. The files contain memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, statements, surveys, newspaper articles, and faxes. Much of the material in this segment duplicates records from the previous segments.<br /> Contains 435 files from 47 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+6">Segment Six</a></strong><br /> This collection consists of the files of the Health Care Task Force, focusing on material from Jack Lew and Lynn Margherio. Lew’s records reflect a preoccupation with figures, statistics, and calculations of all sorts. Graphs and charts abound on the effect reform of the health care system would have on the federal budget. Margherio, a Senior Policy Analyst on the Domestic Policy Council, has documents such as: memoranda, notes, summaries, and articles on individuals (largely doctors) deemed to be experts on the Health Security Act of 1993 qualified to travel across the country and speak to groups in glowing terms about the groundbreaking initiative put forward by President Clinton in his first year in the White House. <br /> Contains 804 files from 40 boxes.</p>
Publisher
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William J. Clinton Presidential Library & Museum
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2006-0885-F
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Paper
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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[Policy Alternatives for Occupational Health] [loose]
Creator
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White House Health Care Task Force
Health Care Task Force
Jason Solomon
Identifier
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2006-0885-F Segment 3
Is Part Of
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Box 37
<a href="http://clinton.presidentiallibraries.us/items/show/36148" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/12092971" target="_blank">National Archives Catalog Description</a>
Provenance
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Clinton Presidential Records: White House Staff and Office Files
Publisher
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William J. Clinton Presidential Library & Museum
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Adobe Acrobat Document
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Reproduction-Reference
Date Created
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3/16/2015
Source
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42-t-12092971-20060885F-Seg3-037-013-2015
12092971