1
Introduction

Work is a fact of life for many children and adolescents in the United States. The U.S. Department of Labor estimates that almost one-half (4.26 million) of the 10 million teenagers between the ages of 15 and 17 work at some time during the year (U.S. Department of Labor, 1998). While some periods of work occur during the summer, surveys of high school students indicate that about 80 percent of them work during the school year at some time during their 4 years of high school (Bachman and Schulenberg, 1992; Light, 1995; Steinberg and Cauffman, 1995).

There are potential benefits associated with engaging in work during adolescence. Some amount of work in high school has been shown in some studies to be associated with increased self-esteem, independence, and higher levels of employment and income in the years following high school. The general view that good work experience is part of growing up and that work serves youth well is probably true. However, insufficient attention has been directed to what constitutes good work experiences.

There are dangers associated with working (see Box 1-1). For example, more than 70 youngsters under the age of 18 die each year in work-related incidents (Castillo et al., 1994; Derstine, 1996), hundreds are hospitalized with work-related injuries and illnesses, and tens of thousands seek treatment in hospital emergency rooms for



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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States 1 Introduction Work is a fact of life for many children and adolescents in the United States. The U.S. Department of Labor estimates that almost one-half (4.26 million) of the 10 million teenagers between the ages of 15 and 17 work at some time during the year (U.S. Department of Labor, 1998). While some periods of work occur during the summer, surveys of high school students indicate that about 80 percent of them work during the school year at some time during their 4 years of high school (Bachman and Schulenberg, 1992; Light, 1995; Steinberg and Cauffman, 1995). There are potential benefits associated with engaging in work during adolescence. Some amount of work in high school has been shown in some studies to be associated with increased self-esteem, independence, and higher levels of employment and income in the years following high school. The general view that good work experience is part of growing up and that work serves youth well is probably true. However, insufficient attention has been directed to what constitutes good work experiences. There are dangers associated with working (see Box 1-1). For example, more than 70 youngsters under the age of 18 die each year in work-related incidents (Castillo et al., 1994; Derstine, 1996), hundreds are hospitalized with work-related injuries and illnesses, and tens of thousands seek treatment in hospital emergency rooms for

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States BOX 1-1: CHILDREN INJURED AND KILLED AT WORK A 15-year-old boy died in a bakery accident in Pennsylvania. He was killed while cleaning a horizontal dough mixing machine, although he was hired supposedly only to bag rolls. He had been employed in violation of the state's child labor laws. He didn't have working papers, he stayed on the job after permitted hours, and he was paid in cash, under the table (Meltzer, 1994). A 16-year-old crew cook in a fast-food restaurant was pushing a container of hot grease from the kitchen to the outside for filtration. When he reached to open the door, his foot slipped, the lid fell off, and hot grease spilled over much of his body. He sustained second-and third-degree burns to his ankles, arms, chest, and face and was hospitalized for two weeks. Scarring occurred on all the burned areas (Heinzman et al., 1993:715). A 12-year-old girl was killed when a car struck her while she was riding her bicycle delivering newspapers. The incident occurred just after 4 p.m. on an undivided two-lane road, where speeding is reportedly a problem. She was wearing a reflective white vest and white jacket, but not a bicycle helmet. Federal child labor laws, which limit hours and conditions of youth employment, do not apply to news carriers, who are considered independent contractors (Massachusetts Department of Public Health, May 1995). A 14-year-old high school boy was killed when the tractor he was driving overturned on an icy county road and pinned him (Wisconsin State Journal, January 6, 1998:3B). injuries incurred on the job (Layne et al., 1994). Furthermore, working long hours while attending school has been associated with other undesirable outcomes, such as an increased risk of alcohol, tobacco, or drug use (Bachman and Schulenberg, 1993; Mortimer et al., 1996; Resnick et al., 1997; Steinberg and Cauffman, 1995; Steinberg et al., 1993) For many years the United States has judged it important to protect youth against bad work experiences by restricting both the types of work permitted and the hours that young people of different ages can work. By bringing together the best information about the

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States health and safety dangers of work to youth, as well as the benefits of work, rational social decisions can be made. The intent of this study is not to discourage young people from work experiences, but, rather, to improve the understanding of how and when work may be harmful so that wise decisions are made by individuals, families, and society as a whole. Attention to the potential for injuries and illnesses, as well as to potential positive and negative psychosocial effects among children and adolescents who work, has been growing since the late 1980s. More and more is known about the developmental needs and vulnerabilities of children and adolescents. At the same time, concern has mounted over the poor educational attainment of American youngsters, their lack of preparation for the job market, and their involvement in a variety of delinquent behaviors. Work is often suggested as an antidote to what ails the nation's young people. Parents of working youth often say that employment promotes a sense of responsibility, time-management skills, and positive work values (Aronson et al., 1996; Phillips and Sandstrom, 1990). Politically, the United States is in the midst of a strong antiregulatory period that has generated calls for reducing current regulations that deal with child labor. In the face of these competing social tensions, this study objectively looks at what is known about the work done by children and adolescents and the consequences of that work for their physical, emotional, and social health; their well-being; and their educational attainment. The term child labor conjures images of Dickensian sweatshops in early industrial America or in underdeveloped countries today. In this report, the term is used as it is used in the Fair Labor Standards Act and subsequent regulations: Child refers to any individual under 18 years of age. Because it is common to identify the word child only with prepubescent individuals, however, this report frequently refers to child and adolescent labor to underscore the fact that the report is about teenagers as well as younger children. For the purposes of this report, the terms teens, teenagers, youth, and adolescents are used interchangeably to refer to individuals from the ages of 13 through 17. The terms youngsters, young workers, and young people refer to all children under the age of 18. This report covers labor (rather broadly defined) about which there is a reasonable amount of data and information. By labor, or

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States work, the report refers to activities that contribute to the production of a marketable product, good, or service, whether that activity is done for pay or not. This definition of work includes tasks performed in family businesses and on family farms, even when those enterprises are not covered under current U.S. child labor laws. The study does not cover children who are not working: Children may be injured, and even killed, as visitors or bystanders in workplaces, but unless the children are actually engaged in work, incidents that befall them simply by virtue of their proximity to a workplace are not covered. This is not to say that structural factors in the work-place, such as the provision of child care, might not decrease such incidents. Also excluded from this report's definition of work or labor are nonmarket tasks done solely within the family, such as household chores, mowing the lawn, or babysitting for a sibling. This type of informal work within the family is seldom characterized as employment, and so, little information has been collected on it. Children and adolescents engaged in illegal activities—such as pornography, prostitution, or illegal drug sales—receive very little coverage in this report. Although young people are employed in such activities, their illegality makes gathering information about them difficult; hence, little is known about the extent to which children are involved. The overall estimates of hazards in the workplace reported in this volume are likely to be underestimates because of this exclusion. With respect to the consequences of child labor, the committee understands the term health in a broad sense, encompassing not only physical health and well-being, but also social, psychological, and educational health and well-being. Thus, this report examines not only physical injuries or illnesses that result from working, but also the effects, both positive and negative, that various types and amounts of work may have on such things as educational attainment, self-esteem, independence, and interaction with peers. HISTORICAL CONTEXT Various social and economic forces have led to changes in the amount of time spent by children and adolescents in school and at work in the United States. For much of the nation's history, school and work were mutually exclusive activities. In the late 1700s, it was not unusual for children as young as 7 or 8 to be placed outside

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States the home to earn income for their families. Schooling was sporadic for most children and adolescents, who spent the better part of the year in agricultural work or apprenticed to craftsmen and only attended school during nonwork seasons (Kett, 1977). The importance of children's contributions to the family economy is reflected in our traditional long summer vacations, which were originally intended to free school children to work on their families' farms. During industrialization in the early nineteenth century, the importance of children's contributions to family income continued. The rise of workers' associations to protect adult jobs coincided with other mid-century social forces that promoted the idea of adolescence as a special period in life that should be dedicated to education and protection from the adult world. From these movements arose calls for universal free and compulsory education and an end to child labor. Economic conditions, however, forced many families to continue to depend on income from the work of their children (Greenberger and Steinberg, 1986). The first half of the twentieth century saw the decline of children's full-time participation in the U.S. labor force. Reduced demand for poorly paid, unskilled laborers, coupled with compulsory education laws, led many youngsters to spend more years in school. The passage of the Fair Labor Standards Act of 1938 (FLSA) included restrictions on child labor intended to protect "young workers from employment that might interfere with their educational opportunities or be detrimental to their health and well-being." For the first time, federal limitations were placed on the types of nonagricultural work permitted for children and adolescents under the age of 18. Hours of nonagricultural work were also limited for those under the age of 16. These legal restrictions played a part in the movement of American adolescents from workers to students. In 1900, fewer than 10 percent of 18-year-olds graduated from high school; of those between the ages of 14 and 19, 70 percent of males and 35 percent of females worked full time. By 1940, 50.8 percent of American 18-year-olds finished high school; of those between the ages of 14 and 19, only 40 percent of males and 25 percent of females worked full time (Kett, 1977; Greenberger and Steinberg, 1986). The second half of the twentieth century has seen more young people remain in school. In 1990, only 9 percent of 16-and 17-year-olds were not attending school (1990 U.S. census data). By the

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States 1970s, a substantial number of high school students combined school with part-time employment, as they continue to do today (Ruhm, 1997). As noted above, surveys of high school students have found that about 80 percent are employed at some point while attending school. Moreover, in contrast with the past, the earnings of few of today's student workers appear to contribute to the support of their families (Greenberger and Steinberg, 1986; Johnston et al., 1982; U.S. Department of Education, 1996; Yeatts, 1994). School and Work The relationship between school and work is fluid, and the two institutions interact in a number of ways. School has traditionally been seen as preparation for employment, teaching both skills and attitudes that will, among other benefits, make young people better workers. Working can also teach young people skills and attitudes, show the value of lessons learned in school, and provide an additional learning environment. Most work requires some basic academic skills—knowing the multiplication tables and how to read, for example—that few youngsters would master simply by being in work settings. It is far more efficient to teach both academic knowledge and some general work skills, such as keyboarding, in classrooms than on the job. However, people also learn from hands-on activity and by performing concrete tasks. Relating academic subjects more closely to employment contributes to the foundation for many subjects and can open some subjects to a wider range of students. For example, Hull (1993) compared the performance of college-bound students in traditional physics classes to that of vocational education students following a curriculum that taught principles of physics through technology. The vocational students not only made up the deficit in knowledge of physics that they had demonstrated at the beginning of the course, but after 1 year they had surpassed the students in college preparatory classes. Vocational education emerged as a way of teaching young people knowledge and skills for employment in specific fields. However, as jobs have changed at an accelerating rate and as more jobs have required a deeper understanding of fundamental processes—of why as well as how—a new emphasis on enhancing academic learning has emerged among vocational educators (Parnell, 1985). Beginning

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States in the late 1980s, the school-to-work movement expanded in response to the perception of a growing gap between what adolescents were learning in school and what businesses expected of new workers. At the same time, studies of high school students have found that they see little connection between school and life outside of school, are bored in school, and consequently are not putting much effort into school (Steinberg et al., 1996). What they are required to learn in school seems unconnected with the real world. Jobs that require no academic skills reinforce this skepticism: Store clerks are never asked to solve geometry problems. But exposure to more demanding adult jobs may motivate young people to return to the classroom: They may be more willing to learn geometry when they know it is needed to survey a plot of land or design a building. The workplace can also be an alternative learning environment where young people can learn facts and principles that they did not grasp when presented in textbooks and lectures. This potential benefit of work experience has not been established empirically, but accounts of workers with minimal education successfully coping with complex phenomena suggest that it does exist (Scribner, 1984). From the school side, classroom reflection about work experiences can also open broad issues traditionally addressed in social studies and literature courses. Such issues might include the functions of profit in a free-enterprise economy, the distribution of power in a democratic society, and the multitude of perspectives and perceptions different people bring to the same situation. When used in this manner, work experience contributes to education in the broadest sense. Occupational Safety and Health The relationship between certain diseases and occupational exposures has been recognized by physicians for at least 400 years (Rom, 1992). With the advent of industrialization, work was performed in many new and different work environments, and the nature of occupational health and safety risks experienced by workers became more complex. In response to workplace injuries and illnesses, England created a centralized system of factory inspections in 1878; Germany followed at the beginning of the twentieth century. Although Massachusetts had created the first factory inspectorate in the United States in 1867, most other states did not follow this path.

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States After 1900, the increasing numbers of work-related injuries experienced in modern factories resulted in the passage of state workers' compensation acts (essentially no-fault insurance systems) to pay injured workers limited disability and health benefits. Although these programs filled an acute need by providing some support for the injuries workers experienced at work, they were primarily designed to protect companies from tort liability that had begun to be assessed when injured workers took their cases to the civil courts. The first national legislation to protect the health of U.S. workers was the Walsh-Healey Public Contracts Act of 1936, which required federal contractors to comply with health and safety standards; at the same time, the Social Security Act funded the establishment of industrial hygiene programs in many states. Concern over a ''spreading epidemic of occupational injuries and disease" (Bingham, 1992:1325) led to the passage, in 1969, of the Coal Mine Health and Safety Act (MSHA) and, in 1970, of the Occupational Safety and Health Act (OSH Act), giving the federal government broad responsibility for worker health and safety. The 1970 OSH Act established an employer's general duty to provide a healthy and safe work environment and "...to furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or likely to cause death or serious physical harm...." Today, debate is most frequently centered on defining "recognized" hazard and "serious physical harm," with employers generally arguing for narrow interpretations and workers arguing for broad ones. Companies appear to focus most of their attention on control or prevention of injury risks since the negative impacts of injuries are easily and directly measured in terms of production delays and the costs of workers' compensation. Much less attention is devoted to preventing chronic diseases, such as occupational cancer, since the latency of these diseases results in little direct evidence of costs at the time the risks are incurred. During the 1970s and 1980s, many larger companies developed medical or nursing units to provide health-related services to workers, and only a few developed comprehensive occupational health and safety programs targeting prevention. The recent trend toward "lean" companies has resulted in a reduction or elimination of many such programs.

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States WHY U.S. CHILDREN AND ADOLESCENTS WORK Historically, children and adolescents left school (and sometimes home) to enter the work force at relatively early ages in order to help support their families and to be trained for the jobs they would hold as adults. In the latter half of the twentieth century, the vast majority of young people in the United States remain full-time students until age 18, and the jobs typically held by adolescents provide little or no systematic preparation for later careers. Yet, most adolescents in this country work while going to school, and many of their parents, and adults in general, believe that working exerts a positive influence on adolescents (Aronson et al., 1996; Greenberger and Steinberg, 1986; Phillips and Sandstrom, 1990). I am working basically so I would have my own money. High school student, Youth panel for the committee Little research has been done on why children and adolescents seek paying jobs, but the primary reason seems to be money. Whether the money young people earn goes toward helping pay family bills or toward their own needs, income, rather than the work experience, itself, seems the main motivating factor. Greenberger and Steinberg (1986) report that 74 percent of the employed high school students in their sample say money is the primary reason for having a job: About half of them say that the money is for necessities and half say it is for "extras." In a large national survey of high school seniors, a majority of the employed students said that they spent between half and all of their income on their own personal needs and activities (Johnston et al., 1982). More than 80 percent of high school seniors say that "none or only a little" of their earnings go toward family expenses (U.S. Department of Education, 1996). Similar responses were found in 1981, 1991, and 1992. Yeatts (1994) reports that 69 percent of working high school seniors spend some of their earnings for car expenses, 97 percent use their earnings to "buy things,'' and 44 percent save some for college. Having money of their own not only allows adolescents to purchase items for their own use, but it may also give them a sense of independence.

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States My father said you're always asking me for money, so why don't you get you a little job so you can make your own? High school student, Youth panel for the committee Parents encourage adolescents to get jobs, because doing so will enable them to buy the things they want or because work is seen as an inherent good. A common belief in the United States is that holding a job builds character and teaches a young person what real life is like. Interviews with parents support this idea; parents expect that jobs will teach their adolescents to be dependable, punctual, and responsible (Greenberger and Steinberg, 1986). Working adolescents also describe themselves as more punctual, responsible, and dependable than those who are not employed (Greenberger, 1984). I first started a job because my parents thought it would teach me responsibility. High school student, Youth panel for the committee INTERNATIONAL CONTEXT The discussion of child labor in America is taking place at a time of intense debate over the legitimacy of child labor throughout the global economy. It is interesting to note that the issues that have emerged in the United States differ substantially from those addressed by the International Labour Organization (ILO). In the United States, the primary concerns have been the availability of work for low-income teenagers, the health and safety of the work environments of children and adolescents, and the compatibility of that work with young people's educational needs. On the international front, in contrast, it is the legitimacy of child labor itself that is debated. The most recent ILO convention on child labor (No. 138) was adopted in 1973 and ratified by 55 countries (excluding the United States); its stated objective is "the effective abolition of child

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States labour." To this end, it mandates a minimum age of 15, to be relaxed only in exceptional cases, and a minimum age of 18 in hazardous jobs. The only exceptions envisioned for developed countries are employment in conjunction with vocational education programs and "light work" that impinges minimally on youngsters' physical, social, and educational development. The convention does not make a case for the benefits of child labor, nor does it view improvements in health and safety as preconditions for extending these benefits to more young people. Despite the large differences in emphasis, however, it can be argued that U.S. objectives are consistent with Convention No. 138 if there is stricter adherence to the "light work" model—healthy work that does not interfere with education and development. A major difference between the United States and other industrialized countries appears to be the lack of a coordinated system for helping young people make the transition from student to worker. In countries such as Germany, for example, young people enter apprenticeships that are closely linked to their education and that lead to specific adult jobs. German apprenticeship is formally structured, with a contract that specifies the rights and obligations of the employer and the apprentice and a curriculum that specifies the opportunities for learning that the firm will provide and the knowledge and skills that the apprentice must acquire. Apprentices' learning is tested by a national examination and documented by their employers; on completion, the young workers have credentials that are recognized by all employers. Austria, Denmark, and Switzerland have comparable systems. In contrast, the jobs held by most U.S. children and adolescents, as noted above, are usually disconnected from school curricula and are usually not seen as career stepping stones. It appears that the proportion of adolescents working in the United States is relatively high compared with other developed countries; see Table 1-1. Caution must be exercised in comparing data among countries, however. What groups are included in the labor force and how terms such as "employed" and "unemployed" are defined differ by country. Methods of data collection, classification, and tabulation differ. Countries also use different reference periods for determining who is employed: Some countries ask about employment on the specific day of the census, and others ask about

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States TABLE 1-1 International Comparison of Working Adolescents Country Age Group Active in Labor Force (%) a Argentina 14–19 34.4 Finland 15–19 27.1 France 16–19 6.8 Germany 15–19 32.6 Greece 15–19 16.6 Ireland 15–19 21.8 Japan 15–19 17.0 Mexico 15–19 45.0 Norway 16–19 37.9 Spain 16–19 25.1 United Kingdomb 13–17 43.0 United States 16–19 53.5 a Being active in the labor force includes both employed youth and those looking for work. b United Kingdom data from Heptinstall et al. (1997). SOURCE: Data from International Labour Office (1996). usual employment with no reference to time. For adolescents, the ages included also vary from country to country. THIS STUDY AND REPORT At the request of the National Institute for Occupational Safety and Health, the Board on Children, Youth, and Families of the National Research Council and the Institute of Medicine organized a study on the health and safety implications of child labor. The study was asked to: synthesize the relevant research on the positive and negative consequences of child labor in both agricultural and nonagricultural settings; characterize the conditions under which adverse consequences are most likely to occur, and the extent to which children and youth are exposed to these conditions, including pesticides and other toxins;

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States assess the current status of regulation, monitoring, surveillance, and data collection associated with child labor in the United States; and provide a set of recommendations regarding the collection of health and safety data related to child labor, the coordination of monitoring and surveillance activities to assure that adequate, reliable, and useful data are collected; the identification of conditions of child labor that appear to pose particular risks to the health, safety, education, and development of children and youth; and the identification of research needs and opportunities. To fulfill these requests, the study committee and staff gathered information in a number of ways. Relevant research studies were collected through targeted literature searches of Medline, Educational Resources Informational Center (ERIC), and UnCover, as well as through searches of the past 10 years' indexes of journals devoted to the health or development of children or adolescents and journals devoted to occupational health and safety. The committee met four times between February 1997 and December 1997 to discuss data availability and research findings, identify critical issues, analyze the data and issues, seek additional information on specific concerns, formulate conclusions and recommendations, and refine this report. At two of these meetings, invited guests spoke to the committee about various data and issues pertinent to child labor and about relevant research findings. Prior to one meeting, several committee members had the opportunity to interview a group of high school students concerning their attitudes towards and experience with work and workplace risks. A paper on child labor regulations was commissioned for the study, and experts on various relevant topics were consulted informally between meetings. In addition, Current Population Survey data for 1995 and 1996 available on the World Wide Web were analyzed. Chapter 2 discusses what is known about the extent to which children and adolescents are working in the United States, where they are working, and how much time they spend at work. Included is a discussion of the various sources of data and their respective strengths and weaknesses. Chapters 3 and 4 examine outcomes associated with work by children and adolescents. Chapter 3 concentrates on work-related fatalities, injuries, and illnesses and the sources of data that track

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Protecting Youth at Work: Health, Safety, and Development of Working Children and Adolescents in the United States them. Chapter 4 reviews what is known about the educational, psychological, and social effects of working on school-age youngsters. Chapter 5 discusses work in agriculture, which is treated differently from other industries under child labor laws and regulations. Issues specific to migrant workers, who are primarily agricultural workers, are also discussed. Chapter 6 reviews child labor laws and regulations in the United States and their implementation and enforcement. The chapter deals primarily with federal laws and regulations. A thorough review of state laws was beyond the scope of this report; some state laws are presented as examples of approaches to regulating child labor. This chapter also presents information on some educational and training programs that are aimed at improving health and safety for young people at work. A thorough review of the issues involved in school-to-work transition would require a report unto itself (see, for example, National Research Council, 1994); the committee confined its review primarily to health and safety issues involved in the recent school-to-work programs instituted under the 1994 School-to-Work Opportunities Act. Chapter 7 presents the committee's recommendations.