By Adam Finkel

I am always on the lookout for examples of how laypeople and/or experts fail to appreciate the enormity of the risks workers face.  As someone who came to OSHA from a background in environmental health policy, where an excess lifetime fatality risk greater than one chance per million is often seen as unacceptably high, I am still amazed at the unfinished business on the occupational agenda.  I sent the letter below to the New York Times on March 14th, and it was not printed amid a group of other letters focusing on more lurid aspects of Eliot Spitzer’s downfall.  I appreciate columnist Nicholas Kristof calling attention to the hazards of “the oldest profession” (well, except for agriculture, perhaps), but I wish more people understood that as intolerable as a 1% lifetime risk is, it is by no means confined to one particular occupation.

To the Editor:

I hope it is possible, without in any way minimizing the admittedly “staggering” mortality rate among prostitutes (“Do As He Said,” Nicholas D. Kristof, March 13), to point out that prostitutes do not, in fact, “face the most dangerous occupational environment in the United States.”  The 2004 American Journal of Epidemiology article Mr. Kristof cited* estimated that prostitutes in Colorado Springs faced an average risk of 1.1% of being murdered during their careers, and an overall risk of 2.3% for all occupational fatalities combined.  Many groups of U.S. workers face higher risks of premature death even than this. 

Bureau of Labor Statistics data from 2006 show that among the ten riskiest occupations, fishing workers face a fatality risk of 6.4% per working lifetime, logging workers (#3) a risk of 3.7%, and roofers (#8) a risk of 1.5%.  The U.S. Occupational Safety and Health Administration (OSHA) recently finalized a regulation governing workplace exposure to hexavalent chromium, and estimated that under the new permissible level, welders, foundry workers, and others face a lifetime risk of about 2.5% from lung cancer alone-thus making it legal for employers in these industries to impose fatality risks larger than the risks Mr. Kristof admirably deplores elsewhere.

Adam M. Finkel

*(J.J. Potterat et al. (2004), “Mortality in a Long-Term Open Cohort of Prostitute Women.” American Journal of Epidemiology, 159(8): 778-785.)

Adam M. Finkel is currently Professor of Environmental and Occupational Health at the UMDNJ (Univ. of Medicine and Dentistry of New Jersey) School of Public Health, and a Fellow at the University of Pensylvania Law School and Executive Director of the Penn Program on Regulation. From 1995 to 2000, he was Director of Health Standards Programs at OSHA, and from 2000 to 2003 was Regional Administrator for OSHA in the six-state Rocky Mountain region.  He has degrees in biology, public policy, and environmental health sciences from Harvard University, and is a Certified Industrial Hygienist.