By Michael Silverstein

Thirty-five years after the passage of the Occupational Safety and Health Act, the promise of worker protection remains substantially unfulfilled. Over the past several months, I have been traveling across the country and talking with people experienced in worker health and safety to gather ideas about what we can do to protect workers better. The more I hear, the more I am certain that we can’t achieve this by simply trying harder to do more of the same.

The draft paper “Getting Home Safe and Sound? OSHA at Thirty-Five” summarizes what I’ve learned and suggests three main areas for change: stronger and more creative implementation of the OSHAct; statutory improvements to the OSHAct; and a variety of measures outside the OSHA framework.  I hope that this paper will touch off productive discussion and catalyze action to improve worker health and safety. Before completing the paper, though, I’d like to open it up to online readers for comment.

The draft paper is posted online at, and I encourage anyone interested in the topic to download it, read it, and join the discussion about it on this blog. You can leave a comment in the comment section below, or email it to thepumphandle [at] gmail [dot] com. (If your comments are specific editing suggestions, please send them via email rather than leaving a comment.) Also, if you’d like to write a separate blog post on a topic related to the paper, please email us with your proposed topic.

A bit more about the paper: It lists numerous possible improvements proposed by many individuals and organizations over the years.  However, even with the best list of reforms in hand and the best people in key leadership positions, success will be beyond reach without significant change in the political landscape so that worker protection becomes a much higher and more visible national priority.   The paper suggests several measures to help achieve this change: reframing the language of worker protection to link it with broad resonant themes of health and human rights; assembling coalitions around issues of shared importance to labor and environmental groups, community organizations and public health professionals; building an institutional infrastructure; and strengthening our scientific base.  

The paper’s conclusion forgoes a long shopping list in favor of a much more limited set of principles, priorities and plans.  This is rooted in the belief that accomplishing change requires sharp focus by multiple parties on a common set of objectives so that energies can be concentrated and coordinated instead of diffused.  While the entire paper is a draft and its list of principles, priorities and plans is a working proposal, I believe that improvements should be along the lines of achieving a more compelling and better articulated short list rather than expanding into a more inclusive longer one. 

This paper is relatively silent on several important subjects.  It is focused on OSHA, with little attention given to the Mine Safety and Health Administration, the National Institute for Occupational Safety and Health, systems for worker protection in countries other than the U.S., and a critical consideration of avenues for worker protection outside the OSHA umbrella such as workers’ compensation or tort litigation.  This is partly a matter of time and resources and partly a conscious decision to avoid an encyclopedic approach that might be interesting but overwhelming.   

While I accept responsibility for the content of this draft, I need to acknowledge that many of the best ideas came through lengthy discussions and meetings with numerous friends and colleagues.  I have not appended a list of all those who have been part of the preliminary discussions but intend to do this with the final version. 

So, please share your suggestions for improving the paper and thoughts on next steps. You can leave a comment below* or email thepumphandle [at] gmail [dot] com. If this comment thread gets too full, or if the discussion seems to be splitting off in multiple different directions, we’ll add new posts to continue the discussion.

Michael Silverstein, MD, MPH is a Clinical Professor of Environmental and Occupational Health at the University of Washington School of Public Health. He has served as Assistant Director for Industrial Safety and Health with the Washington State Department of Labor & Industries (1997 – 2005); Director of Policy for the US Occupational Safety & Health Administration (1993 – 1995); and Assistant Director for the Occupational Health and Safety Department of the United Automobile Workers Union in Detroit, Michigan (1976 – 1990). Dr. Silverstein received his MD from Stanford Medical School, MPH from the University of Michigan, and AB from Harvard College. He is board certified as a specialist in occupational health and has also practiced family medicine.

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Update: Discussion continues here.