Nearly four decades after the passage of the Occupational Safety and Health Act of 1970, it is difficult to find anyone who will argue that it has delivered on its promise to provide safe and healthful working conditions. In 2005 and 2006 I traveled across the country and met with people experienced in worker health and safety to share ideas about what we can do to protect workers better.

There was considerable agreement about the need to strengthen OSHA’s basic functions and use them more creatively – more inspections, stronger enforcement, renewed rulemaking, and a strategic focus on the protection of low wage, high risk, unorganized workers.  There was also substantial agreement that the OSHAct itself needs some important changes, including coverage for all public employees.  However, there was also a sense that while these steps are necessary, they will not be sufficient and that we can’t expect real success by simply trying harder to do more of the same.

In January 2007, I completed a draft paper summarizing what I’d heard and learned.  In addition to suggestions for stronger and more creative implementation of the OSHAct, and for some fine tuning of the OSHAct , I put some ideas on the table for qualitatively different ways of moving ahead. The Project on Scientific Knowledge and Public Policy (SKAPP), which funded this work, posted the draft at www.DefendingScience.org, and I invited Pump Handle visitors to post comments in response. A thoughtful discussion ensued, and the comments and questions helped me revise my work. The American Journal of Public Health accepted my article for publication, and “Getting Home Safe and Sound: Occupational Safety Health Administration at 38” has now been published online (PDF here) and will appear in the next issue of the journal.

I don’t consider the AJPH article as a finished work.  Instead, it is an invitation to further discussion and debate.  With that in mind, I call your attention to one subject that I am certain will get a mixed, and in some cases a frankly negative, reaction.  This is the concept that there would be an OSHA rule requiring comprehensive safety and health programs in every workplace; that every workplace would get inspected and have its program certified annually; and that OSHA would license and oversee private, third parties to do these certifications.  OSHA would continue to enforce the law, respond to complaints and do other inspections. 

I put this on the table fully recognizing that if not done right the use of third parties  might open the door to the abuses and harmful impacts of privatization of public services and industry capture of government agencies.  But if done right, this might be a way to extend the reach of the OSHAct beyond what can ever be achieved by increasing the agency staff and budget and more cleverly or aggressively deploying its enforcement and rulemaking resources.  The question I am putting forward, then, is “what would it take to do this right?” Is there a combination of checks and balances that would work?  On the other hand, if you think there is no way to do this right, that it is just too dangerous politically or too flawed conceptually, then we need to hear your thoughts about alternatives. The discussion about OSHA needs to continue, because workers deserve better.

Michael Silverstein, MD, MPH is a Clinical Professor of Environmental and Occupational Health at the University of Washington School of Public Health. He has served as Assistant Director for Industrial Safety and Health with the Washington State Department of Labor & Industries (1997 – 2005); Director of Policy for the US Occupational Safety & Health Administration (1993 – 1995); and Assistant Director for the Occupational Health and Safety Department of the United Automobile Workers Union in Detroit, Michigan (1976 – 1990). Dr. Silverstein received his MD from Stanford Medical School, MPH from the University of Michigan, and AB from Harvard College. He is board certified as a specialist in occupational health and has also practiced family medicine.