Hazards: Technology and Fairness (1986)

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SCIENTISTS, ENGINEERS, AND THE BURDENS OF OCCUPATIONAL EXPOSURE: 61 THE CASE OF THE LEAD STANDARD original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the retained, and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. with occupational health and safety, the issue of lead poisoning had a contemporary importance that was amplified by its historic significance. With the enactment of legislation establishing the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Act in 1970, it was inevitable that efforts would be made to use Washington's new regulatory authority to protect workers exposed to lead. In the bitter almost decade-long struggle that surrounded efforts to promulgate a national lead standard, it became clear that the goal, held by some, of safety and health regulation based on scientific findings that were free of the bias of political and social interests was a chimera. At every stage of the process, from the time of the first NIOSH reports on lead exposure until OSHA's promulgation of the final standard for occupational exposure to lead, the centrality of politics was evident. This was not an aberration but an inevitable consequence of the fact that the process of risk assessment and that of standard setting both involved not only the threshold matters of whether given exposures posed a potential hazard for workers but also questions of how the burdens of risk were to be borne. Such determinations are inherently political because, whatever their empirical bases, they require a confrontation over matters of equity and distributive justice. BACKGROUND OF THE OSHA LEAD STANDARD Before enactment of the OSHA lead standard, exposure of workers to lead in the workplace was guided by a series of both public and quasi-public safety standards that were more often exceeded than adhered to. In the 1930s and 1940s, the prevailing standard was 150 micrograms of lead per cubic meter of air (150µg/m3 air). Based on the implications of a Public Health Service survey of the health of battery workers in 1928, this standard was far below the once- accepted 500 µg/m3 air. The standard of 150 µg/m3 of air was raised to 200 µ/ m3 in 1957 on the advice of the American Council of Government Industrial Hygienists. Although the prevailing standard was shifted downward to 150 µg/ m 3 some years later, it again rose when OSHA adopted its first standard for lead exposure in 1971 and incorporated the recommendation of the American National Standards Institute of a 200 µg/m3 level (OSHA, 1975). Despite this constantly shifting standard, the practice of American industry remained such that large numbers of workers continued to be exposed to levels of lead in excess of prevailing "scientifically" grounded recommendations. Thus in 1977 before adoption of the OSHA lead standard, more than 61 percent of workers in the primary and secondary lead smelting industry were exposed to lead concentrations exceeding 200 µg/m3 in air. This was 

SCIENTISTS, ENGINEERS, AND THE BURDENS OF OCCUPATIONAL EXPOSURE: 62 THE CASE OF THE LEAD STANDARD original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the retained, and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. also true for more than 20 percent of those who worked in storage battery plants (Hattis et al., 1982). It was against this background that NIOSH in 1973 issued its first report on the risk posed to workers by lead exposure. In its criteria document, NIOSH (1972) sought to provide those concerned with the future course of regulation with data that reflected the prevailing scientific consensus. NIOSH thus presented, without any attempt at critical analysis, a broad body of research findings, much of which was derived from studies conducted under industry sponsorship. This research and the NIOSH conclusions upon which it was grounded incorporated traditional clinical notions of how the pathological was to be defined. By narrowly drawing the boundaries of its concern, a significant array of physiological changes in lead workers was placed beyond the range of regulatory concern. Based on this clinical standard, the criteria document asserted that workers whose blood levels remained at or below 80 µg/100 g of blood would be unharmed by their exposure. Although the margin of safety provided by such a blood level could not be established, NIOSH had determined that there would be "few if any cases" of lead poisoning below blood levels of 90 µg/100 g (NIOSH, 1972, p. V-4). To maintain a blood level of 80 µg, NIOSH proposed that no worker be exposed to an air lead level of more than 150 µg/m3 (NIOSH, 1972, p. V-5). By rejecting the 1971 OSHA standard for lead in air as insufficiently protective, NIOSH would have required a return to a standard of safe exposure that had long existed. Such a standard, however, would have required a modification of prevailing industrial practice, which, as noted, often resulted in lead exposures of more than 200 µg/m3 of air. The reaction by representatives of industry and labor to the NIOSH findings prefigured the more bitter confrontation that was to occur when OSHA sought to promulgate a standard of lead safety for workers. At a 1974 conference convened by the Lead Industries Association (LIA) to discuss the NIOSH report, industry representatives and their scientific allies found much to recommend the institute's efforts. The 80 µg blood level had long been put forth as providing an adequate margin of safety by George Kehoe, the preeminent figure in lead toxicity research, who was viewed by industry as sympathetic to its interests. Concern was voiced, however, over the proposed reduction in permissible levels of lead in air. Not only was a scientific basis for the more stringent standard lacking, but the very basis for suggesting that exposure to lead in air could serve as an appropriate occupational health standard was brought into question (Proceedings, 1975, p. 95). The most critical note during the LIA conference was struck by Sheldon Samuels of the AFL-CIO's Industrial Union department. He charged NIOSH with participating in a "vile numbers game" (Proceedings, 1975, p. 

SCIENTISTS, ENGINEERS, AND THE BURDENS OF OCCUPATIONAL EXPOSURE: 63 THE CASE OF THE LEAD STANDARD original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the retained, and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. 80). The scientific community, by assenting to the institute's determinations and by providing the empirical foundations for its conclusions, was ''engaged in a massive, destructive game of deception greater than this society, perhaps, has ever encountered" (Proceedings, 1975, p. 81). Samuels argued that scientists who asserted that the proposed NIOSH recommendations provided a margin of safety for lead workers were making "authoritarian social decisions and labeling them scientific" (Proceedings, 1975, p. 81). Not only were essentially social determinations thus being masked, but hidden assumptions about how the burden of risk ought to be borne were being incorporated into the NIOSH calculations. Samuels put forth what was for that moment in the public debate on lead toxicity and the protection of workers a radical proposition. Blood lead levels had to be reduced to 40 µg/100 g—half the standard adopted by those who focused on conventional definitions of the pathological consequences associated with lead exposure. Furthermore, to achieve the required blood lead levels, Samuels demanded that air lead exposure be reduced to 50 µg/m3 of air— 25 percent of the prevailing OSHA standard, and one-third of the standard being proposed by NIOSH (Proceedings , 1975, p. 81). For those who heard these proposals, it was clear that Samuels was calling for a massive expenditure in resources and thoroughgoing changes in production processes to ensure the health of workers. In discussing the clash between labor and industry's representatives, Irving Tabershaw, editor of the Journal of Occupational Medicine, within which the proceedings of the LIA conference were reproduced, expressed his hostility toward those who would radically challenge the professional and social consensus then dominant in the lead industry. "Most revealing perhaps is the emotional attitude of labor towards the scientists and professionals practicing industrial hygiene and occupational medicine. The accusation of industry's malfeasance is so broad, nonspecific and unsubstantiated that it defies an answer, but it is illustrative of the climate in which occupational health standards are being developed" (Proceedings, 1975, p. 75). It was within this politically charged climate, a climate characterized by the emergence of strong environmentalist and women's movements and increased senstitivity to risks in the workplace, that social and scientific perceptions of the risks of lead exposure began to change. Changes in the practice of industrial toxicology fueled and were fueled by increasing concern about the ever more subtle effects of lead exposure. As a consequence, no sooner had NIOSH issued its first criteria document on lead than the process of reevaluation began. Two years later, in August 1975, NIOSH issued a revised set of recommendations (OSHA, 1975, p. 45934). No longer was a blood lead level of 80 µg/100 g considered safe for workers; the 

SCIENTISTS, ENGINEERS, AND THE BURDENS OF OCCUPATIONAL EXPOSURE: 64 THE CASE OF THE LEAD STANDARD original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the retained, and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. level now was reduced to 60 µg/100 g (NIOSH, 1978, p. XII-3). Although it was unable to determine the appropriate air lead level that would produce such a margin of safety for workers, NIOSH did note that it ought to be below the initially proposed 150 µg/m3 of air (NIOSH, 1978, p. XII-3). There seemed, however, no justification for forcing it down as low as 50 µg, as had been proposed by Sheldon Samuels. The August 1975 NIOSH recommendation served as a basis for OSHA's preliminary 1975 proposal for a lead standard (OSHA, 1975). Issued as part of a flurry of regulatory initiatives designed to mute the growing dissatisfaction with OSHA's lackluster and sluggish performance, the 1975 proposal was to be characterized by representatives from industry and labor as well as professionals within government as inadequate in its formulation of the scientific and policy issues at stake. Despite these limitations, OSHA's preliminary proposal was noteworthy in several respects. It broke with the tradition of lead toxicology that had been dominated by George Kehoe, and indeed with much prevailing professional opinion, by asserting that clinically significant changes might well occur at blood lead levels below 80 µg/100 g (OSHA, 1975, p. 45935). In adopting this position, OSHA rejected the conventional toxicological focus on gross manifestations of lead pathology and sought to underscore the relevance of more subtle occurrences. "Lead may produce changes in biochemical and physiological parameters which occur at blood levels lower than those usually associated with overt clinical effects. The point at which sub-clinical changes become sufficiently serious to represent a threat to health is not clearly defined" (OSHA, 1975, pp. 45935–45936). Faced with such uncertainty, OSHA adopted a "conservative" posture. An appropriate margin of safety for lead workers required that attention be given to "subclinical" changes. The burden of uncertainty was to be shifted from exposed workers to those who would be forced to make the necessary modifications in the production process. Thus, rather than focusing on encephalopathy and "wrist drop," the conventional signs of advanced lead toxicity, the OSHA standard targeted neurological changes that involved the slowing of nerve conduction (OSHA, 1975, p. 45935). Rather than focusing on gross anemia, a traditional indication of lead poisoning, the OSHA standard expressed a concern about alterations in hemesynthesis and their impact on blood production (OSHA, 1975, p. 45936). Instead of a standard designed to prevent renal failure, OSHA's proposal was directed at avoiding reduced renal function (OSHA, 1975, p. 45937). Finally, rather than the ''race poison" so central to Alice Hamilton's concerns and to those fearful of the potential effects of lead on women in the workplace, OSHA addressed its attention to a spectrum of reproductive hazards, including failures of conception and reduced fertility (OSHA, 1975, p. 45935).