Protecting Youth at Work

Health, Safety, and Development of Working Children and Adolescents in the United States

Committee on the Health and Safety Implications of Child Labor

Board on Children, Youth, and Families

Commission on Behavioral and Social Sciences and Education National Research Council

Institute of Medicine

NATIONAL ACADEMY PRESS
Washington, D.C.
1998



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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States Protecting Youth at Work Health, Safety, and Development of Working Children and Adolescents in the United States Committee on the Health and Safety Implications of Child Labor Board on Children, Youth, and Families Commission on Behavioral and Social Sciences and Education National Research Council Institute of Medicine NATIONAL ACADEMY PRESS Washington, D.C. 1998

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, D.C. 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. 200-96-2544 between the National Academy of Sciences and the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; by Grant No. 030461 between the National Academy of Sciences and the Robert Wood Johnson Foundation; by Purchase Order No. 7W-0522-NANX between the National Academy of Sciences and the U.S. Environmental Protection Agency; by a grant from the Wage and Hour Division of the U.S. Department of Labor; and by Contract No. 98-0168(P) between the National Academy of Sciences and the Maternal and Child Health Bureau of the U.S. Department of Health and Human Services. In addition, the National School-to-Work Office of the U.S. Departments of Education and Labor supported this study through an interagency agreement with the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. Library of Congress Cataloging-in-Publication Data Protecting youth at work : health, safety, and development of working children and adolescents in the United States / Committee on the Health and Safety Implications of Child Labor, Board on Children, Youth, and Families, Commission on Behavioral and Social Sciences and Education, National Research Council, Institute of Medicine. p. cm. Includes bibliographical references and index. ISBN 0-309-06413-9 1. Children—Employment—Health aspects—Government policy—United States. 2. Teenagers—Employment—Health aspects—Government policy—United States. 3. Industrial hygiene—Government policy—United States. 4. Industrial safety—Government policy—United States. I. Board on Children, Youth, and Families (U.S.). Committee on the Health and Safety Implications of Child Labor. HD6250.U3 P73 1998 331.3′1′0973—dc21 98-40159 Additional copies of this report are available from National Academy Press, 2101 Constitution Avenue, N.W., Washington, D.C. 20418. Call 800-624-6242 or 202-334-3313 (in the Washington Metropolitan Area). This report is also available on line at http://www.nap.edu. Printed in the United States of America. Copyright 1998 by the National Academy of Sciences. All rights reserved.

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States COMMITTEE ON THE HEALTH AND SAFETY IMPLICATIONS OF CHILD LABOR DAVID H. WEGMAN (Chair), Department of Work Environment, University of Massachusetts, Lowell JAMES V. BRUCKNER, Department of Pharmacology and Toxicology, University of Georgia MICHAEL I. COHEN, Albert Einstein College of Medicine and Montefiore Medical Center LETITIA K. DAVIS, Department of Public Health, Commonwealth of Massachusetts PETER DORMAN, Evergreen State College SANFORD M. DORNBUSCH, Stanford Center on Adolescence, Stanford University STEPHEN F. HAMILTON, Department of Human Development, Cornell University BARBARA C. LEE, National Farm Medicine Center, Marshfield, Wisconsin JEYLAN T. MORTIMER, Life Course Center, University of Minnesota LINDA RAE MURRAY, Division of Occupational Medicine, Cook County Hospital, Chicago, Illinois SUSAN H. POLLACK, Kentucky Injury Prevention and Research Center, Lexington, Kentucky MICHAEL A. SILVERSTEIN, Department of Labor and Industries, Olympia, Washington DORIS P. SLESINGER, Department of Rural Sociology, University of Wisconsin LAURENCE STEINBERG, Department of Psychology, Temple University ANTHONY J. SURUDA, Rocky Mountain Center for Occupational and Environmental Health, University of Utah ELLEN G. WIDESS, Lead Safe California, San Francisco, California NANCY A. CROWELL, Study Director CINDY PRINCE, Senior Project Assistant (through September 1997)

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States BOARD ON CHILDREN, YOUTH, AND FAMILIES JACK P. SHONKOFF (Chair), Heller Graduate School, Brandeis University DAVID V.B. BRITT, Children's Television Workshop, New York City LARRY BUMPASS, Center for Demography and Ecology, University of Wisconsin SHEILA BURKE, John F. Kennedy School of Government, Harvard University DAVID CARD, Department of Economics, University of California, Berkeley KEVIN GRUMBACH, Department of Family and Community Medicine, University of California, San Francisco MAXINE HAYES, Assistant Secretary of Community and Family Health, Department of Health, Olympia, Washington MARGARET HEAGARTY, Harlem Hospital Center, Columbia University ALETHA C. HUSTON, Department of Human Ecology, University of Texas, Austin RENEE R. JENKINS, Department of Pediatrics and Child Health, Howard University Hospital SHEILA KAMERMAN, School of Social Work, Columbia University SANDERS KORENMAN, School of Public Affairs, Baruch College HON. CINDY S. LEDERMAN, 11th Judicial Circuit, Juvenile Division, Dade County, Florida SARA MCLANAHAN, Office of Population Research, Princeton University VONNIE MCLOYD, Department of Psychology, University of Michigan PAUL NEWACHECK, Institute of Health Policy Studies and Department of Pediatrics, University of California, San Francisco DEBORAH STIPEK, Graduate School of Education, University of California, Los Angeles PAUL WISE, Department of Pediatrics, Boston Medical Center EVAN CHARNEY (Liaison), Council, Institute of Medicine RUTH T. GROSS (Liaison), Board on Health Promotion and Disease Prevention, Institute of Medicine ELEANOR E. MACCOBY (Liaison), Commission on Behavioral and Social Sciences and Education MICHELE KIPKE, Director ANNE BRIDGMAN, Program Officer for Communications DRUSILLA BARNES, Administrative Associate

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States Contents     PREFACE   ix     EXECUTIVE SUMMARY   1 1   INTRODUCTION   17     Historical Context   20     Why U.S. Children and Adolescents Work   25     International Context   26     This Study and Report   28 2   SCOPE AND PATTERNS OF WORK BY CHILDREN AND ADOLESCENTS   31     Data on Work   32     Intensity of Work   39     Where Young People Work   46     Work-Related Issues for Special Populations   49     Conclusions   52 3   HEALTH AND SAFETY AT WORK   53     Nonfatal Work-Related Injuries   56     Fatal Injuries   77     Exposures to Potential Health Hazards   83     Do Children and Adolescents Have Unique Risks at Work?   85     Sources of Surveillance Data   97     Conclusions   108

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States 4   WORK'S EFFECTS ON CHILDREN AND ADOLESCENTS   110     Adolescent Development and the Role of Work   110     The Nature of Work by Young People   112     Consequences of Working   113     Minority and Disadvantaged Youth   134     Conclusions   138 5   AGRICULTURE   141     Unique Features of Agriculture   146     Injuries to Children and Adolescents in Agriculture   152     Hazards Faced by Children in Agriculture   153     Regulation of Agriculture   157     Barriers to Regulation of Agriculture   159     Conclusions   160 6   LAWS, REGULATIONS, AND TRAINING   162     Laws and Regulations Pertaining to Child Labor   163     Workers' Compensation   177     Enforcement of Child Labor Laws and Regulations   180     Training and Other Efforts to Educate Young Workers   184     Conclusions   191 7   CONCLUSIONS AND RECOMMENDATIONS   212     Surveillance Systems   214     Data   217     Education   220     Protective Measures   225     Other Research   235     REFERENCES   237     APPENDICES         A Sources of Information   267     B Descriptions of Longitudinal Studies   269     Biographical Sketches of Committee Members and Staff   291     Index   299     Other Reports from the Board on Children, Youth, and Families   317

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States Preface The common statement that "Children are our future" reflects the priority long placed on the health and welfare of children in American society. More than 75 years ago, President Theodore Roosevelt established the U.S. Children's Bureau in the Department of Labor, placing it there because the problem of child labor was so salient at that time. Our nation has taken pride in how we provide for our children through a variety of social policies, such as the right to a high school education and protection from hazardous working conditions. In general, many of the components of our social policy designed to promote growth and development of children have been operating with apparent effectiveness for many years, but recent evidence suggests that a review of the current status of these policies is in order. The most public evidence of this need is the increasing number of reports in news media that highlight dangerous, illegal, or exploitative use of children as workers. Although these news reports have often featured work settings outside the United States, there have been some U.S. stories that raise troubling questions about the effectiveness of existing policies to protect the nation's children. There is clearly a new awareness and sensitivity to the fact that mistreatment of children, in whatever form or place, must be discovered and dealt with quickly and decisively.

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States At the same time, it should be recognized that the problems that have caught the attention of the news media represent only a small part of youth employment in the United States. Youth employment, in fact, has become the norm in our society. Thus, it is important to recognize that youth employment includes a broad mix of positive and negative features. And it is critical that parents, teachers, policy makers, and youths themselves consider carefully the consequences of employment on children and adolescents who are still growing intellectually, socially, physically, and emotionally. If we restrict our concern to illegal child labor or to the mistreatment of working children in other countries, we risk denying the large majority of working youth in this country adequate consideration of their needs and protection of their health. These concerns led the National Institute for Occupational Safety and Health (NIOSH) to ask the Board on Children, Youth, and Families to undertake a study on the health and safety implications of child labor, which has been done by this committee. The study was supported by NIOSH, the Robert Wood Johnson Foundation, the U.S. Environmental Protection Agency, the National School-to-Work Office, the Wage and Hours Division of the U.S. Department of Labor, and the Maternal and Child Health Bureau of the U.S. Department of Health and Human Services. The committee included 16 members selected to represent a broad range of expertise that included adolescent social and biological development, public agency programs and practice, law, economics, sociology, psychology, occupational medicine, and rural health programs. Such an unusually broad range of backgrounds for the committee members was necessary to bring the proper attention to the complex issue of child labor. It was, therefore, immensely rewarding that, throughout the committee's deliberations, there was an eagerness on the part of all members to learn from one another. This proved essential in order that the intricacy and complexity of the committee's charge could be met and that the recommendations could reflect the needs of children, with proper respect for properly guided growth as they evolve their appropriate independent place as adults. It should be noted that approximately half of the committee members are receiving or have received funding from NIOSH in support of their own research work. About midway through the

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States project, I took a sabbatical from the university for work at NIOSH, but on a completely unrelated topic, health and safety issues of aging workers. Throughout our deliberations, we sought a common understanding of the value of work to personal and social growth of youth as well as to learning from the ''real world." We also examined the importance of work during adolescence to training for a lifetime of work and to what extent it is possible and effective to integrate and cross-fertilize classroom learning with practical experience. We synthesized the limited information about unintended health risks at work, about means and effectiveness for training of youth about health risks, and about what should be considered appropriate work tasks and jobs for young workers. Finally, we attempted to determine what was known about the effects of work on educational attainment. Throughout, our intention was to identify ways to maximize the benefits of work for young people while targeting for elimination the adverse consequences that could be identified. The charge given the committee was intentionally broad so that both the positive and negative effects of work for youth would be given adequate consideration. The committee met four times over 10 months, with very active deliberations both during and between meetings. The committee's efforts were enhanced by the input from many researchers, agency personnel, and representatives of interested groups who provided input during the committee's deliberations. The committee also consulted informally with other experts as issues arose and commissioned a paper on child labor regulations and analyses of some data from the Current Population Survey. Through this process, the committee sought to synthesize the relevant research, characterize the adverse consequences and extent of work for youth, assess the current status of regulation and information available from public data systems, and develop appropriate recommendations to guide development of a modern public policy on youth employment. These individuals are acknowledged by name and affiliation in Appendix A. Several agency personnel deserve special mention for their helpfulness and availability to the committee and staff throughout the project. At the very beginning, Linda Rosenstock, director of NIOSH, played a key role in the formulation of the study charge,

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States and she continued her interest and support throughout. Dawn Castillo, of NIOSH's Division of Safety Research and Leader, Child Labor Working Team, gave unselfishly of her time and knowledge by attending meetings of the committee, answering countless email queries from committee members and staff, sharing bibliographies and background materials, and keeping the committee informed about the work of the NIOSH Child Labor Working Team. John Ruser, Bureau of Labor Statistics, U.S. Department of Labor, presented information at the committee's workshop, shared his work on the use of full-time employee equivalent measures, and was extremely patient in assisting staff with analyzing data from the Current Population Survey. William Fern and Art Kerschner, Wage and Hour Division, U.S. Department of Labor, helped the committee understand the intricacies of child labor law and its enforcement, and Kevin Keaney, Office of Pesticide Programs, U.S. Environmental Protection Agency, did the same for pesticide regulations and that agency's Worker Protection Standards. Special thanks are due to a panel of high school students in the Washington, D.C., area who were willing to devote an afternoon to meeting with the committee. The committee gained a great deal of insight into the adolescent work experience from the students' discussion about their interests in working, their experiences (both good and bad), their knowledge about work risks and benefits, and their desire to both work and learn. In reviewing the research, committee members often were reminded of comments made by these high school students, some of which are highlighted in the report. Appreciation is also extended to those individuals who served as internal reviewers of the report. Many thanks are due to Aletha Huston, University of Texas at Austin, who offered helpful comments on behalf of the Board on Children, Youth, and Families, and to Robert Fullilove, New York University, who provided helpful input on behalf of the Board on Health Promotion and Disease Prevention. This report has been reviewed by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Report Review Committee of the National Research Council. The purpose of this independent review is to provide candid and critical comments that will assist the authors and the NRC in making the published report as sound as possible and to

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The content of the review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals, who are neither officials nor employees of the NRC, for their participation in the review of this report: Darlene Adkins, National Consumer's League, Washington, D.C.; Eula Bingham, Department of Environmental Health, University of Cincinnati; Mark R. Cullen, Occupational and Environmental Medicine Program, Yale University School of Medicine; Kristine M. Gebbie, School of Nursing, Columbia University; Harry Holzer, Department of Economics, Michigan State University; Lyle V. Jones, L.L. Thurstone Psychometric Laboratory, University of North Carolina, Chapel Hill; Jonathan D. Klein, Division of Adolescent Medicine, University of Rochester Medical Center; Robert Lerman, Urban Institute, Washington, D.C.; Robert A. Moffitt, Department of Economics, Johns Hopkins University; and Christopher J. Ruhm, Bryan School of Business and Economics, University of North Carolina. Although these individuals have provided many constructive comments and suggestions, responsibility for the final content of this report rests solely with the authoring committee and the NRC. Chairing this committee has been a rewarding experience, the task made much easier by the friendly and supportive atmosphere of the meetings. During the life of the committee, I and the entire committee depended heavily on the high quality intellectual and administrative skills of National Research Council (NRC) staff, under the able direction of study director Nancy Crowell. Her energy for the task was evident from the first day and her background work, research, and regular interactions with all committee members has left its positive stamp throughout this report. She was ably assisted by project assistant, Cindy Prince, whose new baby was a wonderful reminder of the task at hand. Additional thanks are owed to Anne Meadows for carefully editing and improving the structure of sections of the report, to Christine McShane for coordinating the editing, and to Eugenia Grohman for final editing and overseeing the review and publishing processes. Much credit is due Deborah Phillips, former director of the Board on Children, Youth, and Families, and to Karen Hein, former executive officer of the Institute of Medicine, for their contributions to the initial conceptualization of

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States this project, as well as their support and encouragement throughout the study. Finally, thanks and acknowledgment are due to the members of the committee, all of whom gave generously of their time. Several members took primary responsibility for drafting chapters of this report. I thank Letitia Davis for her work on Chapters 2 and 3; Jeylan Mortimer for her work on Chapter 4; Doris Slesinger and Barbara Lee for their work on Chapter 5; Ellen Widess for her work on Chapter 6; and Stephen Hamilton for his contributions to Chapters 1 and 6. Mostly, I thank all my colleagues for an intellectually stimulating and challenging task; I am confident our conclusions and recommendations will help ensure more rewarding work experiences for the nation's children and adolescents. David H. Wegman, Chair Committee on the Health and Safety Implications of Child Labor

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States Protecting Youth at Work

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