A call from 40 public health scientists for an end to the continuing humanitarian and environmental catastrophe in Gaza.

An under-recognised aspect of the current humanitarian catastrophe in Gaza is the impact of the war on the environment and the associated risks for human health. This commentary contextualises these impacts against the background of human suffering produced by the overwhelming violence associated with the use of military force against the general population of Gaza. In calling for an immediate cessation to the violence, the authors draw attention to the urgent need to rebuild the health care system and restore the physical and human infrastructure that makes a liveable environment possible and promotes human health and well-being, especially for the most vulnerable in the population. Environmental remediation should therefore form one of the most important parts of international efforts to assist reconstruction, through which we hope Palestinians and Israelis will achieve lasting peace, health, and sustainable development, all as part of accepted international human rights obligations.

Hazard and Injury Experiences of Latino Day Laborers in Houston, Texas.

Latino day laborers in the United States provide skilled labor to businesses and homeowners through informal work arrangements. We conducted exploratory qualitative research with Latino day laborers in Houston, Texas, to investigate their perceptions of safety risks and circumstances related to work-related injuries. We conducted focus groups with 34 participants and used risk mapping and body mapping activities to elicit greater engagement by the Latino day laborers in the conversations. Participants described physical, occupational, and psychosocial hazards that affected their risk for workplace injuries. They indicated a significant risk for injury was employers failing to provide proper tools or equipment for the job being done. The themes that emerged from the analysis were lack of control over employment conditions and the risk of performing unsafe work in order to meet financial needs. This formative qualitative research informed a pilot test and subsequent clinical trial of injury risk reduction strategies for Latino day laborers. Interventions to protect day laborers from work-related injuries should be informed by recognizing the employment and social dilemmas they confront.

Development and refinement of a corner-based injury prevention programme for Latino day labourers.

Objective: Latino day labourers (LDLs) in the USA are at increased risk for non-fatal and fatal occupational injuries, which are compounded by stressors that include wage theft, job insecurity and discrimination. This paper describes the development and refinement of Vales+Tú (You are Worthy of More), an injury prevention programme currently being evaluated as part of a cluster randomised trial in which health promotion is taken directly to the 'corners' (e.g. street corners, home improvement store parking lots, and public parks) where workers gather to seek employment. Design: Vales+Tú comprises two corner-based intervention approaches, group problem-solving (small group discussions) and brief motivational interviewing (one-on-one dialogue), that aim to activate LDL agency to control their safety and that of their peers. Setting: Corners in Houston, Texas, where LDLs seek employment. Method: Intervention Mapping informed the refinement of Vales+Tú for the current trial. We provide a narrative review of the development process based on needs assessment and formative development activities (surveys, focus group discussions and pilot tests). Results: In addition to documenting the need for LDL injury prevention, with 20.2%-41.6% of Houston-based LDLs surveyed between 2013-2014 and 2019 reporting a severe work-related injury in the past year, we describe key facets of the Vales+Tú corner-based intervention approaches - including their theoretical basis and LDL-centred activities, as well as enhancements made informed by formative evaluation. Conclusion: The community-engaged development process of Vales+Tú resulted in two practical intervention approaches that can be adopted by worker centres and other organisations to promote LDL worker safety.

Effects of social, economic, and labor policies on occupational health disparities.

BACKGROUND: This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States. METHODS: We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities. RESULTS: Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker's compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities. CONCLUSIONS: There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.

An impact evaluation of a federal mine safety training regulation on injury rates among US stone, sand, and gravel mine workers: an interrupted time-series analysis.

OBJECTIVES: We evaluated the impact of a safety training regulation, implemented by the US Department of Labor's Mine Safety and Health Administration (MSHA) in 1999, on injury rates at stone, sand, and gravel mining operations. METHODS: We applied a time-series design and analyses with quarterly counts of nonfatal injuries and employment hours from 7998 surface aggregate mines from 1995 through 2006. Covariates included standard industrial classification codes, ownership, and injury severity. RESULTS: Overall crude rates of injuries declined over the 12-year period. Reductions in incident rates for medical treatment only, restricted duty, and lost-time injuries were consistent with temporal trends and provided no evidence of an intervention effect attributable to the MSHA regulation. Rates of permanently disabling injuries (PDIs) declined markedly. Regression analyses documented a statistically significant reduction in the risk rate in the postintervention time period (risk rate = 0.591; 95% confidence interval = 0.529, 0.661). CONCLUSIONS: Although a causal relationship between the regulatory intervention and the decline in the rate of PDIs is plausible, inconsistency in the results with the other injury-severity categories preclude attributing the observed outcome to the MSHA regulation. Further analyses of these data are needed.

Selected science: an industry campaign to undermine an OSHA hexavalent chromium standard.

While exposure to hexavalent chromium (Cr(VI)) has been associated with increased lung cancer risk for more than 50 years, the chemical is not currently regulated by the U.S. Occupational Safety and Health Administration (OSHA) on the basis of its carcinogenicity. The agency was petitioned in 1993 and sued in 1997 and 2002 to lower the workplace Cr(VI) exposure limit, resulting in a court order to issue a final standard by February 2006. Faced with the threat of stronger regulation, the chromium industry initiated an effort to challenge the scientific evidence supporting a more protective standard. This effort included the use of "product defense" consultants to conduct post hoc analyses of a publicly-funded study to challenge results viewed unfavorably by the industry. The industry also commissioned a study of the mortality experience of workers at four low-exposure chromium plants, but did not make the results available to OSHA in a timely manner, despite multiple agency requests for precisely these sorts of data. The commissioned study found a statistically significant elevation in lung cancer risk among Cr(VI)-exposed workers at levels far below the current standard. This finding changed when the multi-plant cohort was divided into two statistically underpowered components and then published separately. The findings of the first paper published have been used by the chromium industry to attempt to slow OSHA's standard setting process. The second paper was withheld from OSHA until it was accepted for publication in a scientific journal, after the rulemaking record had closed. Studies funded by private sponsors that seek to influence public regulatory proceedings should be subject to the same access and reporting provisions as those applied to publicly funded science. Parties in regulatory proceedings should be required to disclose whether the studies were performed by researchers who had the right to present their findings without the sponsor's consent or influence, and to certify that all relevant data have been submitted to the public record, whether published or not.

Weight of the evidence or wait for the evidence? Protecting underground miners from diesel particulate matter.

A coalition of mine operators has used a variety of tactics to obstruct scientific inquiry and impede public health action designed to protect underground miners from diesel particulate matter. These workers are exposed to the highest level of diesel particulate matter compared with any other occupational group. This case study profiles a decade-long saga of the Methane Awareness Resource Group Diesel Coalition to impede epidemiological studies on diesel exhaust undertaken by the National Institute for Occupational Safety and Health and the National Cancer Institute, and to derail a health standard promulgated by the Mine Safety and Health Administration. The case study highlights the coalition's mastery of legislative, judicial, and executive branch operations and the reaction of policymakers.

Manufacturing uncertainty: contested science and the protection of the public's health and environment.

Opponents of public health and environmental regulations often try to "manufacture uncertainty" by questioning the validity of scientific evidence on which the regulations are based. Though most identified with the tobacco industry, this strategy has also been used by producers of other hazardous products. Its proponents use the label "junk science" to ridicule research that threatens powerful interests. This strategy of manufacturing uncertainty is antithetical to the public health principle that decisions be made using the best evidence available. The public health system must ensure that scientific evidence is evaluated in a manner that assures the public's health and environment will be adequately protected.