Features
SHAPING THE FUTURE: TEN YEARS OF
THE OCCUPATIONAL HEALTH
INTERNSHIP PROGRAM
LINDA DELP KATHERINE KIRKLAND
KEVIN RILEY INGRID DENIS
SARAH JACOBS MATT LONDON
DIANE BUSH ROBERT HARRISON
ABSTRACT
The Occupational Health Internship Program (OHIP) was initiated in 2003
to recruit a new, diverse generation of occupational safety and health
(OSH) professionals and to advance OSH within union and community-based
initiatives. It retains the principles of the original OCAW/Montefiore intern-
ship program while adapting to the changed landscape of the 21st-century
workplace. Case studies of OHIP projects illustrate how students have con-
tributed to key OSH policies—to regulate silica exposure among construction
workers, apply principles of green chemistry with Vietnamese nail salon
workers, and integrate OSH into “green” jobs in the recycling industry. They
have supported innovative campaigns with immigrant workers in contingent
jobs—from taxi drivers to warehouse workers. The students, in turn, have
been inspired to enter the OSH arena as professionals and worker advocates
with the potential to contribute new energy to an OSH movement.
Keywords: students; worker health and safety; labor, community and coalition strategies
In 2013, the Occupational Health Internship Program (OHIP) celebrates 10
years of placing students in the field with workers. OHIP partners with labor
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� 2013, Baywood Publishing Co., Inc.
doi: http://dx.doi.org/10.2190/NS.23.2.d
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NEW SOLUTIONS, Vol. 23(2) 253-281, 2013
unions, embracing the approach of the original internship program initiated by
the Oil Chemical and Atomic Workers Union (OCAW) and the Montefiore
Department of Social Medicine [1], while building new community-based part-
nerships to adapt to the sociopolitical realities of the contemporary workplace.
Students in the past decade have reached diverse groups of workers, many
employed in low-wage, non-union, and high-hazard jobs.
In this article we outline the dual goals of OHIP—to recruit a new genera-
tion of occupational safety and health (OSH) professionals who reflect the
diversity of the current workforce, and to support workplace and community
OSH initiatives. We describe how the program has adapted to a context that
differs markedly from that of 1976, when the OCAW/Montefiore partnership
began. We highlight examples of the impact of OHIP on the field of OSH and
on the students themselves and pose questions about how to shape the program
in the coming decade to support a vibrant OSH movement.
LEARNING FROM THE PAST: ORIGINS OF OHIP
By 2000, there was widespread acknowledgment of the impact of the OCAW/
Montefiore program. Former students were running programs at federal and state
government agencies, universities, and unions. They shaped a progressive OSH
agenda within the American Public Health Association (APHA), researched
new hazards, and developed regulations and technological innovations to
control them [1]. But their hair was graying, and by 2004 membership in the
APHA OSH section had declined by nearly half from its peak of 1,500 members
in the early 1990s [2].
OHIP was born from discussions at annual APHA meetings and took shape
through the work of dedicated volunteers, many drawn from the original OCAW/
Montefiore program. Through an existing cooperative agreement with the
National Institute for Occupational Safety and Health (NIOSH), the Association
of Occupational and Environmental Clinics (AOEC) provided funding to launch
the program officially in 2003, creating pilot projects in summer 2004. OHIP
received additional supplemental funding from the California Department of
Public Health (CDPH) and the Kazan, McClain, Abrams, Lyon, Greenwood,
Harley and Oberman Foundation. Regional coordination and mentorship
were provided by Hunter College in New York, the University of California,
Berkeley Labor Occupational Health Program (LOHP), and the CDPH in the
San Francisco Bay Area.
Principles established in the OCAW/Montefiore program became the foun-
dation for OHIP:
1. Students learn about the world of work from the point of view of workers
by interacting with them through field-based placements with “host”
labor unions and community-based worker advocacy organizations.
254 / DELP ET AL.
2. Students contribute to the OSH capacity of their host organizations by
“giving back” reports of research findings, educational, and other products.
This approach ensures mutual benefits and respectful partnerships between
students, university programs, and host labor and community organizations.
As OHIP projects and partners evolved over subsequent years, the program’s
coordinators have retained these core principles while adapting to a different
context, one that posed new challenges and opportunities.
A CHANGING LANDSCAPE
The original OCAW/Montefiore program primarily paired medical students
with labor unions to investigate hazards in chemical factories and other
industrial worksites. But the landscape of work and health had changed by the
21st century. For nearly three decades, employment in manufacturing and heavy
industry was being replaced by service sector jobs in industries such as retail,
hospitality, and health care [3-5]. Overall union membership in the United
States had declined (from 24.0 percent in 1973 to 11.2 percent in 2012), though
union membership in the public sector during this period increased [6, 7].
At the same time, the growth in subcontracting and other forms of contingent
employment meant the erosion of job security and a deterioration of the social
contract between employers and workers [8-11]. The demographics of the
American workforce had also changed. The foreign-born workforce grew in
the 1980s and 1990s, reaching 12.5 percent in 2000 [12]. Immigrants from
Latin America, Asia, and other parts of the globe contributed to cultural and
language diversity.
These changes meant shifts in the predominant profile of workplace hazards
and health outcomes [13]. Workplace harassment and violence emerged as
priorities among service-sector workers [14-16]. Production quotas, long hours,
and shift work contributed to job stress and musculoskeletal disorders [11, 13,
17]. The decline in unionization and constraints on the ability of the Occupa-
tional Health and Safety Administration (OSHA) to protect contingent workers
meant fewer institutionalized mechanisms to confront these hazards, requiring
new strategies to advance an OSH agenda [8, 18, 19].
OHIP planners understood that they could not simply replicate the OCAW/
Montefiore model of placing students with unions. They would need to respond
to this new landscape and prepare students for the realities they would encounter
as OSH professionals in the field [20, p. 5-15]. The emergence of immigrant
worker centers and other community-based worker advocacy groups in the 1990s
[21, 22] enabled new partnerships and a chance to conceptualize worker health
beyond an OSH framework based in traditional labor-management relationships.
Over the past 10 years, OHIP projects have confronted occupational health
disparities [23] and linked worker health with environmental and social justice
SHAPING THE FUTURE / 255
initiatives, an approach championed by OCAW’s Mazzocchi [24, pp. 224-238].
These approaches have attracted a diverse group of students with the potential
to infuse the OSH field with new ideas and energy.
OHIP IN THE WORKPLACE
AND COMMUNITY
A defining characteristic of OHIP projects and students is their diversity.
Collectively the body of projects over the last decade provides a window into
the challenges confronting the contemporary workforce and the importance of
university, union, and community partnerships.
Nine students were placed with labor unions in New York, New Haven, and
the San Francisco Bay Area in 2004, the first year of summer intern placements.
They worked in teams to investigate chemical hazards in janitorial and graffiti
removal work, heat stress in public school kitchens and in a polyurethane-coating
fabric factory, and overhead drilling in the construction trades. Academic
mentors oriented and provided guidance to students from graduate and under-
graduate programs in nursing, medicine, industrial hygiene, and other health
science programs. The program broadened to include projects in the health-care
and hotel industries in Los Angeles the following year and, subsequently, to
include students from urban planning, labor studies, and political and social
science programs.
Since 2007, a NIOSH Training Program Grant has provided core funding
for graduate student placements supplemented by funds from a variety of other
sources such as The California Wellness Foundation (see Acknowledgments).
OHIP has expanded to other geographic regions where university or public
health department-based OSH professionals can place and mentor the students
for their nine-week internships with host labor and community organizations.1
Over the past 10 years, 158 students have worked on 80 OHIP projects across
11 geographic sites. In addition to the original program sites, OHIP projects have
taken place in Albany, New York; San Diego, California; Seattle, Washington;
Boston, Massachusetts; Concord, New Hampshire; Chicago, Illinois; and
Portsmouth, Ohio. AOEC provides a summary list of OHIP projects and sites
on its website [25].
Approximately 38 percent of OHIP interns have been undergraduates who
are paired with graduate students. More than three-quarters (82%) have been
256 / DELP ET AL.
1 Hunter College in New York City; the University of California, Berkeley; the University
of California, Los Angeles; San Diego State University; the University of Washington;
the University of Massachusetts at Lowell; the University of Illinois-Chicago; and the
University of Maryland. More recently, partners affiliated with the Council of State and
Territorial Epidemiologists (CSTE) and the Tony Mazzocchi Center of the United Steel
Workers Union have provided academic and technical support for projects.
women, and 68 percent have been minorities. The majority (85%) are fluent in
a second language and 17 percent speak a third language.
Labor unions continue to play a central role as OHIP host organizations,
connecting students with union members and providing access to worksites.
Forty-nine OHIP projects in the last 10 years, about 61 percent of all projects
nationwide, have been with members of 19 separate unions. These unions repre-
sent workers in the private and public sectors, in manufacturing, construction,
oil refineries, and nuclear weapons facilities, and in service sector jobs in
education, health care, food service, industrial laundries, and the hotel industry.
OHIP coordinators have also partnered with 27 community-based host organi-
zations and worker centers. Students have worked on 31 projects with non-
union workers, particularly immigrants, minorities, women, and youth—about
39 percent of all projects nationwide.
STUDENTS SUPPORT WORKER HEALTH CAMPAIGNS
In the past decade, students have researched chemicals, ergonomic risk factors,
and temperature extremes; they examined the effects of speed-up, long workdays,
repetitive motion, job stress and workplace violence; and they confronted the
SHAPING THE FUTURE / 257
National OHIP orientation construction site visit, L.A. 2012.
limited legal protections for workers in the informal sector. We describe
strategies adopted by the OHIP host organizations and supported by the students
to protect workers from these hazards and to position them with tools to
take action.
Collective Bargaining, Regulations and
Compensation: The Role of Labor
Three case studies illustrate student support for union campaigns to improve
workplace health and safety conditions: collective bargaining in the airline
industry, advocating for a regulation to prevent silicosis, and streamlining
nuclear workers’ access to compensation.
Case Study 1: Collective Bargaining in the Airline Industry
In 2008 and 2009, OHIP students’ research on the impact of lean produc-
tion processes informed the labor union UNITE HERE’s collective bargaining
campaign for airline catering crews. The union represents workers at the largest
in-flight airline catering companies in the world, LSG Sky Chef and Gate
Gourmet [26].Workers prepare and package the food served on airline flights,
deliver it from the kitchen to the airplane, and load it onto flight attendants’ carts.
Many airline catering service employers have adopted a lean production approach
to cut costs, a manufacturing philosophy that originated in the auto industry to
eliminate waste as raw materials are processed into a final product. The students
were charged with researching the effect on workers.
Separate teams of students surveyed 159 workers over two summers and
observed lean production processes firsthand. They documented stress and mus-
culoskeletal injuries from speed-up and worker monitoring. Workers reported
trouble sleeping, headaches, and symptoms of cold stress injury such as tingling
hands and face and burning sensations in the eyes. Almost three-quarters of
those surveyed reported they were not allowed to leave the cold pantry area to
rest and recover if needed [27].
UNITE HERE leaders shared results with regional union stewards throughout
the country to prepare for collective bargaining, posted the 2008 OHIP report
on their website, and educated stewards about how the lean production model
increased workload. In 2010, the union modified the OHIP survey to obtain
worker input on other hazards and training needs in 12 cities, and developed a
“Safety First!” worker leadership campaign. They successfully negotiated health
and safety committee language in master collective bargaining agreements
that applied to airline catering crews nationwide. In addition, local union
agreements increased staffing levels and decreased workloads in the kitchens,
integrated ergonomic evaluation and training, and provided floor mats and pro-
tective clothing in the cold rooms.
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OHIP projects in New York State also supported collective bargaining as
part of the Public Employee Federation’s Violence Prevention Project and the
Professional Staff Congress’s Indoor Air Quality Project at City University of
New York (American Federation of Teachers Local 2334). These examples
illustrate the ability of labor unions to negotiate safety contract language for
their members that is more protective than the standards promulgated by
OSHA. The next case study provides an example of Building Trades unions’ role
in advocating for a California Division of Occupational Safety and Health
(Cal/OSHA) standard to protect California workers from silica dust, a standard
that would apply to their members and beyond.
Case Study 2: New Silica Standard, Age-Old Hazard
The [silica] project was a great learning experience that allowed us to use
our skills in occupational health and taught us about building relation-
ships with organizations like the BAC Local 3 and the Roofers Union and
Apprentice programs. Their support was crucial in accomplishing our project
goals and learning about the different trades.
—Cassandra Porchas, 2011, now a practicing industrial hygienist
OHIP students contributed to a union education campaign and Cal/OSHA
standard to control hazardous levels of silica dust, a known hazard for more than
100 years. The Bricklayers and Allied Craft workers union (BAC Local 3) was
concerned about worker exposure during cutting, grinding, and other operations
on materials such as stone, brick, and cement. In 2005 and 2006, OHIP students
worked with the BAC local union and the California Department of Public
Health’s Occupational Health Branch (CDPH OHB) to assess work practices and
silica exposure using surveys distributed at job sites, local union meetings, and
other social and work gatherings. They developed worker education materials
and created a silica hazards/preparedness assessment checklist which was dis-
seminated to union members and contractors. BAC Local 3 used the information
to create a union-based silica hazard awareness program and to support state
legislation to ban dry cutting of masonry materials. A worker safety standard
was subsequently promulgated by Cal/OSHA in 2008. It requires employers to
use wet methods and/or local exhaust ventilation when cutting masonry materials,
the second such standard nationwide [28].
A 2011 OHIP team evaluated silica dust control measures since the adoption
of the Cal/OSHA standard. They visited job sites with Local 3 representatives to
take photographs and shoot video footage, and they interviewed a variety of
stakeholders. Together with the OHB, they recommended targeted education
and enforcement and highlighted the need to integrate worker health into
pre-construction planning and tool design. They also worked with BAC Local 3
and the Roofers Union apprentice programs and contractors to produce a widely
distributed video, Don’t Let Silica Dust You! [29].
SHAPING THE FUTURE / 259
Other OHIP teams focused on heat exposure standards in New York and
California. In 2004, students assessed heat conditions in New York City public
school kitchens on behalf of AFSCME, the American Federation of State, County
and Municipal Employees, District Council 37. The union took this information
to Albany in support of legislation to set heat stress standards; it was passed by
the State Legislature but vetoed by Governor George Pataki. A 2007 OHIP team
assessed employer compliance with California’s new heat illness prevention
standard for outdoor workers [30], interviewing workers from different occu-
pations as well as union and community representatives, and accompanying
Cal/OSHA inspectors to construction and agricultural sites. They also investi-
gated heat exposure among parking lot attendants (Teamsters Local 952 members
at the Angel Stadium of Anaheim), and proposed practical solutions for access
to shade and water to the new labor–management health and safety team. An
OHIP team in Los Angeles measured heat and humidity levels in industrial
laundries. Results were used by UNITE HERE Local 52 to advocate for
controls in high-heat areas to protect a group of indoor workers excluded
from protection under Cal/OSHA’s outdoor heat standard.
Case Study 3: Workers Right to Compensation in
the Nuclear Weapons Industry—The End of an Era
In 2012, OHIP students learned firsthand about the hazards of work at
Department of Energy (DOE) nuclear weapons complex facilities, a remnant
of the Cold War era. Their research and educational skills improved worker
access to compensation for chronic illness from decades of handling radioactive
and hazardous materials without adequate protection. While the federal govern-
ment offers medical screening and compensation to former DOE site workers
under the Energy Employee Occupational Illness Compensation Program
Act (EEOICPA), the program is complex, bureaucratic, and difficult for many
workers to navigate.
The students were placed with United Steelworkers Union (USW) Local 689 at
the DOE’s Portsmouth Gaseous Diffusion Plant in rural Ohio. The vast majority
of OHIP projects since 2004 have been located in urban areas; this project in
Portsmouth, OH, was the first to send students to an industrial worksite in a rural
setting. They interviewed former site workers about their job histories, potential
work exposures, and experience navigating the EEOICPA system, identifying
medical needs and challenges workers faced obtaining the compensation to which
they were entitled. They then developed a pamphlet illustrating the process to
submit claims and file appeals, factsheets highlighting recognized exposures
and related illness for every employee category at the Diffusion Plant, and a docu-
ment to educate physicians about EEOICPA. The USW is now disseminating
information to workers at six DOE nuclear weapons facilities around the country,
many in the process of being decommissioned and dismantled.
260 / DELP ET AL.
I had no idea what to expect. The only person I knew affiliated with unions
was my husband’s grandfather. This has been one of the most rewarding
experiences of my life. It has reinforced in me the importance of advocacy for
all individuals, but especially workers, who are often unaware or misguided
regarding their rights. OHIP has inspired me to continue working in public
health. No matter how heartbreaking some days are, there are always suc-
cesses that can make the tears worth it.
—Erica Hunter-Wallace 2012
Immigrant Workers, Contingent Jobs:
Role of Worker Centers
Day laborers, domestic workers, and those classified as temporary workers
or independent contractors often fall outside the protection afforded by
organized labor and may also lack protection under OSHA in cases where there
is not an identifiable employer. Immigrant workers are frequently overrepre-
sented in these contingent jobs. Given these hurdles, community-based worker
centers and other advocacy groups have developed creative strategies to improve
working conditions.
We describe two OHIP case studies with workers from industries charac-
terized by contingent employment relations—taxi drivers in New York, Los
Angeles, and San Diego who are classified as independent owner-operators,
and warehouse workers in Southern California, where the classification of
many workers as temporary employees has posed challenges to holding corporate
retail giants accountable for working conditions.
Case Study 4: Taxi Drivers—
Multiethnic Alliances of Owner-Operators
Six OHIP projects since 2004 in New York, Los Angeles, and San Diego
have examined hazards in the taxi industry ranging from long hours in poorly
designed cabs to harassment and assaults to limited restroom access. Taxi
drivers in these cities consist primarily of immigrant men from around the world
who have worked collectively to improve working conditions despite their
classification as independent owner-operators.
The projects reflect diverse strategies to confront the challenges these workers
face in different urban contexts. In Los Angeles, a 2008 team interviewed
workers and led body mapping activities to identify work-related health prob-
lems in conjunction with the Los Angeles Taxi Worker Alliance (LATWA)
Health and Safety Committee. One outcome was a health fair, organized by a
year-round intern with the Committee and the South Asian Network to
provide medical screening tests, health information, and referrals for nearly
100 drivers and family members. The OHIP report, “Banned from Bathrooms,”
raised awareness of affronts to drivers’ dignity and was presented at Taxi
SHAPING THE FUTURE / 261
Commission hearings. In San Diego, results of a 2012 taxi driver survey helped
the United Taxi Workers of San Diego (UTWSD) advocate for reforms to taxi
lease arrangements.
The summer spent working alongside the NYTWA as an OHIP intern was
probably my most memorable to date. I’ve never met a group of people more
dedicated and passionate in fighting for the rights of others. Hearing drivers
recount their experiences was . . . an eye-opening look into the industry.
—Matthew Brouillette 2012
Students with the New York Taxi Workers Alliance (NYTWA) worked in
a different context. NYTWA was founded in 1998 to provide a collective voice
for drivers classified as independent contractors and so excluded from basic
labor law protections. They then pursued additional avenues for collective action
by joining the New York City Central Labor Council in 2007. In 2011, the 15,000
member alliance received a union charter from the AFL-CIO, the first granted
to an organization of independent contractors and a “step toward a new kind
of labor movement for the excluded workers, the workers without rights
and benefits” [31]. Against this backdrop, OHIP contributed to building the
NYTWA’s capacity to integrate OSH into their campaigns.
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OHIP intern Rebecca Reindel interviews N.Y.C. taxi driver, OHIP 2008.
The 2008 team members examined ergonomic risk factors through taxicab
“drive-alongs” and interviews with more than 200 drivers using a questionnaire
they developed with worker input. NYTWA presented recommendations to
change vehicle design to the city’s Taxi and Limousine Commission (TLC).
The students also collaborated with the NY Committee on Occupational Safety
and Health (NYCOSH), one of a national network of grassroots labor-based
coalitions [32, 33]. They assessed other hazards, laying the groundwork for the
2010 team, which documented risk factors for harassment and violence by
interviewing drivers who had themselves been victims. Results supported the
Taxi Driver Protection Act, proposed state legislation to increase penalties for
assaults on drivers. In 2012, a third team explored the link among long hours,
sedentary work and lack of exercise as well as barriers to restroom access. The
OHIP projects, along with the NYTWA struggle for health care, highlight the
need to integrate OSH into a comprehensive approach to drivers’ health.
I now work for the 1199 SEIU Healthcare Union as a Research Assistant
and one of the many reasons I chose this position is because of the great work
accomplished by unions, which I experienced as an intern at the NYTWA.
—Toral Patel 2012
Case Study 5: Warehouse Workers Confront
“the Permanent Temp Economy” [34]
I learned how to develop educational materials on different subjects—
ergonomics, dangerous heavy machinery, slips/falls, chemicals and heat . . .
that could be easily understood by a working-class Spanish-speaking
audience, and that could be taught in brief training sessions by workers
themselves.
—Kim Aguirre, 2011
OHIP students’ support for warehouse workers laid the foundation for Cal/
OSHA citations that held warehouse operators and staffing agencies jointly
responsible for worker safety. The 2011 OHIP team was placed with Warehouse
Workers United (WWU) in Southern California [35], home to the largest con-
centration of warehouses in the world. An estimated 114,000 workers handle
goods destined for the shelves of retail giants nationwide while earning low
wages and few benefits [36]. Many are hired through temporary staffing
agencies, creating a climate of job insecurity. WWU staff recognized the need
for OSH capacity to confront job hazards—machine safety, ergonomic injuries,
exposure to chemicals and dusts, production pressures, and temperatures that
soared during summer months.
The students, one the daughter of a warehouse worker, analyzed the results
of a needs assessment survey with 103 workers, conducted in-depth worker
interviews, and assisted with a community forum to highlight hazards of the job.
Their research informed WWU’s worker education curriculum and testimony at
SHAPING THE FUTURE / 263
local and statewide hearings [37, 38]. They also drafted a Cal/OSHA complaint,
researching relevant Cal/OSHA standards and summarizing potential violations
of the Hazard Communication and Personal Protective Equipment standards
based on worker interviews. Despite fear of employer reprisals, three workers
signed the complaint while more than 30 signed a petition of support. The
Cal/OSHA citations had a ripple effect throughout the Southern California
industry where temp staffing agencies are common.
Kim and I hit just about every aspect of occupational health from data
collection, analysis, researching standards, contributing to a paper, drafting
a complaint and developing educational materials. . . . I even got to meet
the new Chief of Cal/OSHA, Ellen Widess . . . and she said the complaint was
so well written. I was thrilled.
—Karla Dominguez St. Pierre, 2011
Other students have worked with immigrants in contingent work settings
such as day laborers in Seattle, port truck drivers in Los Angeles and Oakland,
street vendors in Chicago, and domestic workers in Los Angeles and Chicago.
They contributed energy and ideas to support workers who confront the hazards
of precarious work arrangements and to larger movements such as the Domestic
Workers Bill of Rights and the Food Chain Workers Alliance effort to link
workers’ rights to food policy [39, 40]. OHIP interns have secured employ-
ment with organizations that are members of both of these national alliances
(specifically, IDEPSCA, Instituto de Educación Popular del Sur de California,
and Restaurant Opportunities Centers United).
Coalitions: Workers, Social and
Environmental Justice Movements
Students have worked on projects to integrate OSH and workers’ rights into
coalitions that frame worker health as part of social and environmental justice
movements. We highlight two OHIP projects with nail salon and recycling
workers as examples of coalition-based OSH strategies. Both challenged groups
external to the workplace to assume responsibility for working conditions. The
California Healthy Nail Salon Collaborative solicits the support of consumers
and manufacturers in its bid to rid the industry of acknowledged toxins; the
“Don’t Waste LA” campaign asserts the City’s responsibility to integrate worker
safeguards into the waste and recycling hauler contractor bidding process. Both
projects also grapple with questions of how worker health can be integrated
with green chemistry and green job initiatives.
Case Study 6: Healthy Nail Salons—Green Chemistry in Practice
There is a gap of Asian American community health activists within the
OSH movement. We have a responsibility to our communities to fill that
264 / DELP ET AL.
gap by providing mentorship, guidance, and opportunities to emerging
activists and advocates. The students built relationships, trust, and leadership
within the community. We hired Duyen Tran and Nina Nguyen, two of the
former interns, to continue working with the Collaborative.
—Lisa Fu, California Healthy Nail Salon Collaborative,
OHIP Host Organization, 2010, 2012
OHIP students worked with the California Healthy Nail Salon Collaborative
[41] to promote use of safer chemicals in nail salons, part of a fast-growing
industry with an estimated $7.3 billion net worth nationwide in 2012. The
industry depends largely on Vietnamese women immigrants, many of child-
bearing age, who comprise up to 80 percent of certified nail technicians in
California and 43 percent nationwide [42]. Concern about toxic chemicals in
nail salon products has emerged, particularly those containing the so-called
“toxic trio”—toluene, dibutyl phthalate, and formaldehyde—which have been
linked to cancer and reproductive harm [43].
OHIP students helped create grassroots worker and consumer pressure to
eliminate the toxic trio. In 2010, they surveyed 93 Vietnamese-American salon
owners and workers in Los Angeles, Orange, and San Bernardino Counties
about chemical exposure and other OSH concerns. The 2012 team then surveyed
more than 500 consumers in the City of Santa Monica about their knowledge
of “three-free” products and their willingness to patronize “greener” salons. The
students’ outreach efforts culminated with a number of “salon parties” around
the city. The students recruited Collaborative supporters to fill a salon with
paying customers for up to two hours. While doing manicures, salon technicians
and owners were part of on-site health and safety workshops conducted in
Vietnamese by the students. They created a colorful scrapbook with infor-
mation and pictures from past salon parties to recruit new salons to participate
in the project.
Staff from the Collaborative used the students’ survey findings to inform
statewide policy initiatives leading to an ordinance in San Francisco to recognize
nail salons that voluntarily adopt less toxic products. Eight salons have been
recognized under the program, and efforts have begun to bring similar programs
to Santa Monica and Marin County. The campaign has been highlighted in
Vietnamese-language media outlets and results used to inform safer nail salon
chemicals policy nationally.
Case Study 7: Good, Green, Safe Jobs in the Recycling Industry
OHIP interns validated the concerns workers had and gave them the con-
fidence that things could be different. They came up with the slogan,
“somos basureros pero no somos basura” [we pick up trash but we are not
trash] and helped lay the groundwork for a “Recycling for Justice” convention
with 150 workers.
—Peter Olney, ILWU, OHIP Host organization, 2012
SHAPING THE FUTURE / 265
OHIP students in the San Francisco Bay Area and Los Angeles contributed
to community-based campaigns to integrate environmental and worker health
standards into municipal waste collection and recycling. The industry is poised
for expansion, stimulated by zero waste and other “green” initiatives. The waste
management and remediation industry currently employs over 350,000 workers
nationwide; employment in California is expected to grow 19 percent to 21,700
by 2018 [44, 45]. These “green” jobs, however, are often neither good nor
safe. Wages are not sustainable, and sorters at waste recycling facilities are
frequently exposed to chemicals, discarded hypodermic needles, broken glass,
and fecal matter, as well as odors, dust, noise, and rodents. Local mandatory
recycling ordinances threaten the health of workers if OSH standards are not
put in place.
Four OHIP student teams contributed to unique labor-environmental-
community-university coalitions that are adopting innovative strategies to
promote good, green, safe jobs for drivers and sorters. Students in the San
Francisco Bay Area worked with the East Bay Alliance for a Sustainable
Economy (EBASE) and the International Longshore and Warehouse Union
(ILWU) Local 6, which represents about 340 waste recycling workers in
the region [46, 47]. Students in Los Angeles worked with the Los Angeles
Alliance for a New Economy (LAANE) and Teamsters Local 396, which repre-
sents most drivers in the region and recycling sorters at a large Anaheim, Orange
County, facility.
Across these four projects, students surveyed waste recycling workers in
Alameda, Los Angeles, and Orange Counties, mapped facilities in each region,
and investigated worker safety and environmental standards applicable to the
industry. Collectively these projects contributed to education, research and
policy initiatives to create safe and sustainable jobs for recycling workers. In
Los Angeles, data collected by the students documented violations of Cal/OSHA
safety standards, ultimately leading to citations against both the recycling facility
operator and the staffing agency. Like the warehouse industry citations described
above, these citations sent a message of joint employer responsibility for worker
safety. Worker safety has become a core component of the “Don’t Waste LA”
policy campaign for a city ordinance to establish a waste and recycling franchise
system [48]. The system would require franchise bids to include worker health
and safety measures and provide avenues for greater oversight by the City. In
the Bay Area, efforts are underway to train ILWU Local 6 members who work
in recycling facilities and to promote municipal policies similar to those proposed
in Los Angeles.
This internship has been an incredible learning experience. . . . I have become
aware of how vital unions are to maintaining basic human rights. I certainly
did not realize how commonplace it is for workers, especially those who
do not speak English, to be exploited even here in the Bay Area. . . . I have also
been inspired by the power of organization and group effort to effect change,
266 / DELP ET AL.
and especially the important role that health and safety plays in motivating
workers to fight to improve working conditions.
—Lindsay McCormick, 2012; currently an Association of
Schools of Public Health Environmental Health Fellow
in the Environmental Protection Agency’s Office of
Children’s Health Protection
OHIP students have also supported innovative coalitions in other parts of the
country during the last decade. Coalitions for Occupational Safety and Health
(COSH) developed projects to reach young workers in Boston and refugees
in New Hampshire and New York; the Chinese Restaurant Workers appealed
to San Francisco consumers to improve working conditions through a workers’
rights rating system; and the Los Angeles Coalition of Community Health
Centers began to integrate OSH and worker advocacy with patient care in
South Los Angeles. Other students supported car wash workers on the Health
and Safety Committee of the Community-Labor-Environmental Action Network
(CLEAN) to improve conditions in the car wash industry through educational
skits and comic books. The CLEAN campaign stands as one of the most inno-
vative models of immigrant worker advocacy; building OSH capacity was critical
to that campaign.
OHIP interns brought a level of technical knowledge on issues like chemicals
that organizations don’t normally get from student interns. The other thing
of value was the direct interaction between students and workers, and the
fact that the students shared their knowledge but took direction from workers,
not vice versa.
—Chloe Osmer, Former Director, CLEAN Car Wash Campaign;
currently AFL-CIO
As illustrated above, OHIP projects with labor, community groups, and
coalitions have strengthened worker campaigns and contributed to the larger
OSH movement. By providing students with opportunities to learn from a variety
of partners, OHIP is preparing a new generation of young OSH professionals
to be responsive to the realities of the 21st century workplace.
OHIP’S IMPACT ON STUDENTS
The concept of OHIP as a two-way street or learning exchange between
students and workers has been framed as two sides of an equation [1]. Students
contribute to their host organizations and campaigns and, in the process, learn
about the reality of work and OSH careers. As one student said, “The knowledge
that I have gained from OHIP will forever impact the way I view jobs.” Efforts
to track the trajectory of former students reveal the program’s influence on
students’ perceptions of work and health and their decisions about future career
SHAPING THE FUTURE / 267
paths. In this section, we highlight some of those influences on students’ pro-
fessional and personal lives.
OSH Careers
A key measure of success is the extent to which former students pursue careers
as occupational nurses and physicians, industrial hygienists, safety engineers,
or other OSH professionals. A recent NIOSH survey provides evidence of a
workforce shortage. While employers expect to hire more than 25,000 OSH
268 / DELP ET AL.
OHIP intern, Meena Hasan visits a N.Y.C. transportation
worksite, OHIP 2009.
professionals over the next five years, academic programs are projected to
graduate only 13,000 students [49]. Given these workforce needs, OHIP can
play a vital role.
Results from a 2011 anonymous survey of former interns from 2004-2011
(the survey was sent to 124 former interns, of whom 65 responded) indicate that
OHIP encouraged or supported a number of them in their pursuit of OSH careers.
Twenty-eight percent of survey respondents are working in a job in OSH or
a related field while another 20 percent are looking for a job in the field and
32 percent are in related graduate programs (see Figure 1).
Students described their interest in pursuing careers in the OSH technical
and policy arenas:
OHIP was a great opportunity for on-the-ground public health work and a
way to learn personal stories from workers. . . . Being connected with a union
[NYTWA] that workers trust was very helpful. . . . The contacts I made
through OHIP definitely helped me network. . . . I’m now an Industrial
Hygienist with U.S. OSHA in Washington D.C. . . . I write standards
for chemical exposure and injuries in workplaces and develop guidance
materials for workers and employers, to help them better understand our
standards and other serious hazards we do not have the authority to regulate.
I returned from OHIP focusing my thesis on work related to OHIP and
have regularly attended conferences, where I see OHIP leaders.
SHAPING THE FUTURE / 269
Figure 1. OHIP intern follow-up survey: 2004-2011.
I’m currently pursuing my master’s degree in Occupational and Environ-
mental Health at UMass Lowell. I am also a research assistant on the same
project I did half of my OHIP project on regarding silica/noise in construction.
I anticipate graduating in spring 2012 and was just accepted to commission
as an industrial hygiene officer in the Navy.
I’m pursuing an MPH in Environmental and Occupational Health Science
at Hunter College with an anticipated graduation date of May 2012. I’m
working as a Consultant with the World Trade Center Health Registry
with the New York City Department of Health analyzing the health effects on
workers and residents exposed to the dust and other hazardous air pollutants.
Linking OSH to Careers in Other Fields
Not all students will pursue careers as OSH professionals, but many survey
respondents indicated that their OHIP experience informs their professional
work in other fields. Knowledge of the connection between work and health in a
variety of professions facilitates reaching “that large proportion of the American
workforce outside the sphere of influence of OSH professionals” [20, p. 5]; that
is, workers employed in small businesses or in the informal sector. OHIP provides a
lens to help focus on this work-health relationship. (In the following comments,
text set in italics illustrates how students applied that lens in a variety of settings).
I’m a family nurse practitioner in a community clinic. While I do not primarily
focus on OSH, I see a lot of MSD [musculoskeletal disorder] injuries and
pain caused or exacerbated by workplace environments.
Many of the medical issues we see in the clinic are secondary to workplace
environments. Either depression/anxiety due to a high stress job, or a back
injury secondary to heavy lifting at the workplace. I am now actively asking
patients the type of work they do and identifying whether their medical
complaints may or may not be related to their work.
I am currently a part of an inter-agency advisory committee, where I am
able to partly represent the OSH perspective for a group that generally has
other parties of the public in mind. It forces me to constantly be thinking about
workers and what is best for them, and integrating that into public decisions.
Learning from Workers
A core OHIP principle is the importance of learning from workers—about
specific hazards and health effects, about power dynamics, labor relations, and
the role of worker organizations. OHIP was conceptualized as a program of
mutual learning and benefit—for the host organizations and for the students.
This concept is fundamental to respectful and collaborative community-based
participatory research. Survey responses demonstrate how OHIP teaches students
the importance of this approach and how they can apply it regardless of the
professional fields they choose:
270 / DELP ET AL.
Asking workers questions about their jobs and health and safety was
eye-opening. To see the stress of job performance outweighing personal
health and safety made me want to help educate the work force, and has
given me a new outlook to many different types of jobs.
OHIP emphasized the importance of the workers’ role in making a difference
in the workplace. As I continue work/study in the field, I see how important
it is to get worker input on OSH issues/hazards.
It gave me a connection to my job site and changed the somewhat negative
perception of unions I previously had.
I learned more about how labor and immigration policies shape occupational
health, and it gave me an interest in policy areas I had not thought much
about before.
I am much more analytical of workplaces and cognizant of work power
relations.
SHAPING THE FUTURE / 271
OHIP Intern Maria Vigil interviews S.F. home care
worker, OHIP 2008.
Making Connections between OSH and
Personal Experiences
Participation in OHIP resonated personally with a number of students, helping
them analyze their experiences within a larger sociopolitical context and connect
with their roots [50]:
OHIP allowed me to find my professional and personal niche. . . . I felt
connected. It also put me in touch with my roots . . . my father is a union
tradesman and my mother works for a city water department. I was able
to connect my career passions with my personal ones and find something
I truly care about.
While doing my project, I learned that my father had become injured on
the job and that laws were broken when they let him go without providing
appropriate medical attention. Thanks to this program, while helping others
I was able to learn to help myself and my family.
I learned a great deal about working with both a grassroots organization
and an academic institution. I felt a strong connection to the community of
Chinese immigrant restaurant workers that I was working with and to the
community organizers who were working to advocate to them.
A compelling example comes from Karla, a 2011 OHIP student with Ware-
house Workers United in Southern California. The internship enabled her to
see her father’s experience as part of a larger system of worker abuse:
My father has worked in the warehouse industry ever since I can remember.
He worked mostly in the shipping and receiving department and even had
an injury. Still, I did not have an idea just what my father had to endure . . .
until I began this internship. It wasn’t until [my project partner] and I were
analyzing the needs assessment [questionnaires] that I broke down and cried
thinking about the horrible working conditions and the abuse and intimi-
dation. . . . All I seemed to do is imagine my own father facing the same
treatment . . . and I became determined to dive right in and make a difference.
[See Case Study 5 above for more details.]
Fostering Community
OHIP has produced a fledgling community of young OSH professionals
and activists who understand the value of worker involvement in OSH programs
and policies. Responses to the 2011 follow-up survey indicate a degree of
connectedness that persists after the internship, and a desire to strengthen
those connections. Of 65 respondents, 83 percent keep in touch with other
OHIP students, 62 percent with their academic site coordinators or mentors,
and 48 percent with their host organizations. Respondents turn to their OHIP
academic mentors for “career advice and to discuss worldly events”; they
maintain contact with their host organizations (“I receive regular updates from
the union and stop by the union office when I visit NYC”); and they maintain
272 / DELP ET AL.
connections to former students personally and via Facebook, where “we ‘tag’
ourselves on posts that are related to social injustice including OSH topics.”
And one former student wrote her graduate thesis on data collected from OHIP
and “gave the information back to the union.”
Respondents expressed a desire for further connection and community-
building, an “alumni contingent coming together periodically to share about
our work or just reconnect and share resources.” OHIP coordinators plan a
session at annual APHA conferences where selected students present their
OHIP projects. This has contributed to a sense of community and provides a
mechanism for students to network with experienced OSH professionals, but
participation is limited due to resource constraints. Fostering connections could
enhance retention in OSH professions and worker advocacy organizations, con-
tributing to the broader OSH community.
Lessons Learned
A review of OHIP student demographics over the past decade indicates that the
program has attracted students from a broad range of disciplines and contributed
to racial and ethnic diversity among OSH professionals. Survey results above
demonstrate progress towards the goal of recruiting a new generation of OSH
professionals who understand the importance of workers’ perspective in the OSH
arena. The national-regional structure has been critical to the success of OHIP; to
recruitment, orientation, and follow-up activities. The AOEC provides overall
organizational infrastructure, and the national coordinator is herself a former
OHIP student. At the regional level, students’ projects are developed through
partnerships between university or public health programs and labor/community
host organizations to ensure a mechanism for follow up with workers after the
summer ends. In several cases, student teams have been placed with the same
organization for multiple years, further enhancing OHIP’s contribution to
meaningful change in specific workplaces and industries.
Despite 10 years of success, challenges abound. Resource constraints limit the
number of student placements; there are far more qualified applicants than there
are resources to place and support them as interns and as OSH professionals.
Bateson describes how students in the original intern program secured jobs with
NIOSH, in union health and safety programs, and at academic and public health
institutions [1]. Some of these programs were supported directly by funds from
OSHA’s New Directions worker training program initiated in 1978 or indirectly
by trained workers who, through their unions, created a demand for OSH profes-
sional services and for government regulatory action.2 However, the landscape
SHAPING THE FUTURE / 273
2 Deutsch notes that OSHA’s New Directions program contributed to an increase from
15 union health and safety staff in 1978 to almost 100 in 1981 and an increase from four to
38 university-based health and safety training programs for workers and employers [51].
for OSH professionals changed as it had for workers. The sociopolitical context
described above, with its decline in unionization and increase in contingent
work, also affected the viability of OSH programs at universities and in unions,
limiting the capacity of existing OSH professionals to mentor and supervise
OHIP students and the potential for students to secure future employment in those
programs. Funding for the OSHA New Directions program plummeted in the
1980s with serious repercussions for unions, university programs and COSH
groups [52, pp. 20, 25, 26].3 NIOSH funding has also been unstable; the 2000
NIOSH budget was less in real dollars than it was in 1980 [54] and, more recently,
budget cuts threatened to eliminate the 17 NIOSH Education and Research
Centers that support graduate programs for OSH professionals [55], in direct
contradiction to the expressed need in the field [49].
These resource constraints similarly restrict our ability to convene the
students beyond an initial three-day orientation each summer. There is a clear
need for longer-term relationships and evaluation of the program at several
levels: 1) systematic follow-up with individual students to track their career
trajectories and provide ongoing mentorship; 2) evaluation of the degree to which
OHIP students contribute to the OSH capacity of the host organizations and to
strengthened university-labor/community partnerships; and 3) analysis of the
needs and contributions of students from different disciplines.
A key question is whether a nine-week internship is sufficient to support
changes to the long-term career trajectories of student participants. Additional
support in the form of one- to two-year fellowships with placements in labor
or community organizations could serve as a “transition period”; that is,
provide an opportunity for the students to gain further experience and explore
the field while the host organization also explores further avenues to integrate
OSH into its programs, potentially hiring the former students to assist in that
process. Such a pipeline for former students would reinforce and strengthen
OHIP’s role in addressing vital OSH workforce needs. Identifying funding
sources will require creative collaborations, which are most likely when
labor, community, academic and professional organizations prioritize OSH
and exert the necessary influence with the employer community and with govern-
ment agencies.
PAVING THE ROAD TO THE FUTURE
Emerging from the activism of the 1960s and the labor movement’s success
in passing the Occupational Safety and Health Act (OSHAct), the original
274 / DELP ET AL.
3 The National Institute of Environmental Health Sciences Worker Education and Training
Program (NIEHS WETP) has since played a critical role in supporting labor, university and
community-based programs. And OSHA’s current Susan Harwood worker training program
has, since FY 2001, made approximately $10 million available each year [53].
internship program was shaped by labor’s clout, Mazzocchi’s vision, and
Montefiore’s progressive academic leadership. Students, primarily from
medical programs, researched chemical hazards and health effects in an era
before Right to Know. Their findings supported unions and the growing network
of COSH groups who were mobilizing for workers’ basic right to information
about chemicals and for more responsive government agencies [33, pp. 156-176;
56; 57, pp. 228-233]. More than 30 years later, an evolving labor movement
continues to lead the fight for worker protection, but now with a broader coalition
of community, immigrants’ rights, and environmental and economic justice
movements that have emerged to confront the challenges of changing workforce
demographics and shifting employment relations.
OSH in the 21st century must expand beyond the traditional paradigm that
defines it as a field primarily requiring technical skills such as those of industrial
hygiene, occupational medicine and nursing, or engineering. These skills are
essential but not enough. OSH professionals must reclaim Mazzocchi’s per-
spective—to understand how OSH plays out within a political and economic
context. A redefined OSH paradigm must include a vision of OSH as social
justice.4 This requires new partnerships, innovative strategies, and links to other
disciplines. The future of OHIP is intertwined with the future of OSH which,
in turn, operates in the larger context described above. We remain true to the
philosophy of the original internship program—to instill in students the impor-
tance of learning from and advocating for workers. At the same time, as OSH
professionals we must in turn learn from the students. As we celebrate the
10th anniversary of OHIP and the 100th anniversary of the APHA OSH section,
we will need to integrate OSH into movement-building partnerships, a path
that OHIP teams are beginning to pave.
ACKNOWLEDGMENTS
OHIP has been funded in part by a NIOSH Training Program Grant that
has sustained OHIP projects in multiple sites over a number of years. Cali-
fornia projects have been funded in part by a grant from The California
Wellness Foundation (TCWF). Additional support from the California
Department of Public Health Occupational Health Branch, the National
Institute of Environmental Health Sciences, the Center for Construction
Research and Training (CPWR), the Centers for Occupational and
SHAPING THE FUTURE / 275
4 OHIP graduate student interns from public health and urban planning programs
passionately argued at the 2012 San Francisco APHA meeting for an expanded view of
OSH during discussions at OSH Section business meetings. They urged section leaders to
frame OSH as a social justice issue, a perspective also articulated in the quote from an
undergrad intern: who tags’ other interns on Facebook posts that are related to social injustice
including OSH topics.”
Environmental Health at UC Berkeley and UCLA, the Kazan, McClain, Abrams,
Lyon, Greenwood, Harley and Oberman Foundation, and other donors has helped
the program grow and expand over the years. Many of the host labor unions and
community organizations have also contributed to student stipends and program
administrative costs. The views of the authors of this article do not necessarily
reflect those of the funders.
OHIP is also made possible by untold hours of unpaid organizational and
individual efforts on the part of national and site coordinators, advisory board
members and the many workers and community members who teach the students
about their world. They are far too many to name; see the OHIP website
(www.ohip.aoec.org) for a list of all projects and host organizations.
We thank the reviewers of this article for their thoughtful comments. David
Kotelchuck and Pyser Edelsack provided wise insight from their perspective as
former site coordinators and mentors for students in the New York Area. Chuck
Levenstein and Robin Baker, who helped initiate OHIP 10 years ago, raised
critical questions for the decade ahead. Chloe Osmer, OHIP mentor from the
CLEAN car wash campaign, continues to be an ardent supporter in her position at
the AFL-CIO; her comments, and those of Pamela Vossenas from UNITE HERE,
were valuable from the perspective of the OHIP host organizations. Former
interns Ingrid Zubieta, Rebecca Reindel, and Chloe Green contributed personal
and professional comments about the impact of OHIP based on their experiences
in the field. Thanks to Gabriela Garibay, UCLA MPH student, for input and for
her careful attention to formatting details. We thank David Harrington from
the CDPH for contributing the Silica case study and Katy McNamara and Judie
Guerriero for their feedback.
AUTHORS’ BIOGRAPHIES
LINDA DELP is Director of the UCLA Labor Occupational Safety &
Health Program (LOSH) and adjunct faculty in Community Health Sciences.
She has a PhD and MPH from the UCLA School of Public Health. She
is Co-Principal Investigator of the OHIP NIOSH grant. Contact her at
KEVIN RILEY is Director of Research and Evaluation at the UCLA Labor
Occupational Safety & Health Program (LOSH). He has a PhD in Sociology
and an MPH from the UCLA School of Public Health. He is site coordinator
and mentor for OHIP projects in the Los Angeles area. His email address is
SARAH JACOBS is Special Projects Coordinator at the UCLA Labor
Occupational Safety & Health Program (LOSH) and national OHIP program
coordinator. She has an MPH from the UCLA School of Public Health and is a
former OHIP intern. Her email address is [email protected].
276 / DELP ET AL.
DIANE BUSH is Program Coordinator at the UC Berkeley Labor
Occupational Health Program (LOHP). She has an MPH from the UC
Berkeley School of Public Health. She is site coordinator and mentor for
OHIP projects in the San Francisco Bay Area. Send mail to her at
KATHERINE KIRKLAND is Executive Director of the Association of
Occupational and Environmental Clinics (AOEC). She has a DrPH and MPH
from George Washington University. She has been administrator of OHIP since
it was founded. Send mail to [email protected].
INGRID DENIS is Program Coordinator at the Association of Occupa-
tional and Environmental Clinics (AOEC). She has an MA from the University
of Cincinnati and MSW from the University of Maryland. She is the OHIP
administrative program coordinator. Email: [email protected].
MATT LONDON is a Health and Safety Specialist and Project Coordinator
at the New York State Public Employees Federation. He has an MS from the
University of Cincinnati. He is the OHIP East Coast program coordinator. You
can reach him at [email protected].
ROBERT HARRISON is Clinical Professor at UC San Francisco and
Chief of Occupational Health Surveillance & Evaluation Program at the
California Department of Public Health. He has an MD from Albert Einstein
College of Medicine and an MPH from UC Berkeley. He is the Principal
Investigator of the OHIP National Institute for Occupational Safety and Health
grant and played a key role in the founding of OHIP. Contact him at
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Direct reprint requests to:
Linda Delp
UCLA-LOSH
10945 Le Conte Ave., Suite 2107
Los Angeles, CA 90095
e-mail: [email protected]
SHAPING THE FUTURE / 281
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