ACOEM Comments on OSHA Respirable Crystalline Silica Standard for Construction.

October 15, 2019
U.S. Department of Labor
Occupational Safety and Health Administration
OSHA Docket Office, Room N–3653
200 Constitution Avenue, N.W.
Washington, DC 20210
RE: Occupational Exposure to Respirable Crystalline Silica—Specified Exposure Control Methods; Docket No. OSHA–2010–0034
To Whom It May Concern:
The following comments are submitted by the American College of Occupational and Environmental Medicine (ACOEM) in response to the Request for Information (RFI) on the effectiveness of engineering and work practice control methods not currently included for the tasks and equipment listed on Table 1 of the Respirable Crystalline Silica standard for construction.
ACOEM is the premier national medical association representing more than 4,000 occupational and environmental medicine physicians and other related health professionals who champion the health of workers, the safety of workplaces, and the quality of the environment. We strongly support OSHA’s expanded health standards on respirable crystalline silica. Our members are involved in carrying out requirements of the standards through both consultation with employers and provision of medical surveillance.
Workers exposed to silica are safer due to the standard’s lower permissible exposure limit and emphasis on hierarchy of controls. The medical surveillance requirements of the standard allows workers to become aware of silica-related health problems and have control over their own health. Silica-related diseases are being uncovered since the standard was enacted, as evidenced by the recent Morbidity and Mortality Weekly Report (MMWR) of silicosis cases in countertop manufacturing workers reported by several states’ departments of public health (Rose, 2019).
ACOEM is specifically responding to questions 29 and 30 of the RFI. Question 29 asks whether there are circumstances in General Industry (GI) or Maritime where the flexibility of the Construction standard’s Table 1 would benefit employers, while maintaining protections for workers. ACOEM is concerned that permitting “flexibility” for GI and Maritime employers will result in less exposure monitoring and medical surveillance for workers. The MMWR report describes 18 cases of silicosis, most of them severe, including two fatalities. OSHA’s GI/Maritime standard will protect future countertop workers from a similar fate.
Question 30 asks about the possible economic effects of broadening the circumstances under which general industry and maritime employers could comply with the silica standard for construction. The MMWR article illustrates the severe lung disease that can occur with silica exposure. Some of these workers may need lung transplants, costing hundreds of thousands of dollars. The direct and indirect costs of weakening worker protections is significant.
As OSHA has noted, the working environment in GI and Maritime is different than in construction in most cases. Workers performing tasks similar to those in construction are likely to be performing these tasks for longer and/or more repetitive periods of time, resulting in higher cumulative silica exposure and higher risk of silica-related illnesses. For this reason, OSHA requires that employers in general industry and maritime are allowed to follow the construction standard if the tasks are indistinguishable from those in Table 1 and are not performed regularly (paragraph (a)(3)). We urge OSHA to keep this requirement in place.
ACOEM believes that the GI/Maritime silica standard provides good protections for workers, including a hierarchy-of-controls approach to prevent silica exposure, exposure monitoring, and medical surveillance. Both the Construction and GI/Maritime standards are a great step forward in protecting silica-exposed workers and should not be weakened.
Thank you for your consideration of this request. Please contact me or Patrick O’Connor, ACOEM’s Director of Government Affairs, at 703/351-6222, if you have any questions.


Stephen A. Frangos, MD, MPH, FACOEM
Rose C, Heinzerling A, Patel K, et. al. Severe Silicosis in Engineered Stone Fabrication Workers — California, Colorado, Texas, and Washington, 2017–2019. Morbidity and Mortality Weekly Report, September 27, 2019; 69; (38):813-818.