December 2, 2020
President-elect Joseph Biden
1401 Constitution Ave., NW Suite 38038
Washington, DC 20230
Dear President-Elect Biden:
The American College of Occupational and Environmental Medicine extends its congratulations on your recent election and expresses our hopes for success as your new administration assumes the leadership of our country.
Occupational and Environmental Medicine (OEM) is the medical specialty that identifies, prevents, and mitigates adverse effects of hazardous agents and conditions in the workplace and environment. ACOEM is a national medical society representing 4,000 occupational medicine physicians and other health care professionals devoted to promoting optimal health and safety of workers, workplaces, and environments.
ACOEM is dedicated to improving the care and well-being of workers through science and the sharing of knowledge.
ACOEM and its members are committed to the applications of sound science and rigorous research to improve the lives of the American people and all others around the world. We stand ready to provide assistance to your administration in its response to the COVID-19 pandemic.
We also are prepared to work with you to address important issues concerning Workplace Health and Safety and Environmental Stewardship. Both of those areas of concern, which fit squarely at the center of our professional experience and expertise, have been the focus of ACOEM activities for more than fifty years.
First, we ask that you encourage OSHA and EPA to maximize their reliance upon the best available scientific evidence. Most particularly, we urge you to withdraw EPA’s proposed rulemaking: Strengthening Transparency in Regulatory Science. This proposal is inconsistent with the proper conduct of scientific inquiry, and we do not believe that additional burdensome peer-review steps are likely to strengthen confidence in the evidence base for new environmental regulations.1
Next, we recommend that you direct OSHA to vigorously enforce existing standards and regulations. This includes not only enforcement of newer OSHA Standards, such as those for Silica and Beryllium, but also the more general enforcement of OSHA Standards and principles that have long served to provide safer workplaces for American workers.
In order to reclaim our role as a global leader in health, we urge you to reaffirm US involvement with and funding for the World Health Organization.
In addition to more rigorous enforcement, ACOEM urges a more proactive approach to workplace health and safety. Following are examples of some specific legislative and regulatory actions that need your support.
- Support implementation of an OSHA Emergency Temporary Standard for workers in health care and other workplaces with a high risk of COVID-19 exposure, such as was proposed in H.R. 6559, the COVID–19 Every Worker Protection Act of 2020.2 We support the implementation of a similar standard by the Mine Safety and Health Administration.3
- Support development of an OSHA workplace violence prevention plan to protect employees from violent incidents in the workplace, such as S. 851, Workplace Violence Prevention for Health Care and Social Service Workers Act.4 We note that such a rulemaking has been pending at OSHA for several years, without action
- Support greater protection of workers from the adverse effects of heat, both indoors and outdoors, such as contained in the Asuncion Valdivia Heat Illness and Fatality Prevention Act of 2019 (HR 3668).5
- Support prohibition of the manufacture, processing, and distribution in commerce of asbestos and asbestos containing mixtures and articles, such as contained in the Alan Reinstein Ban Asbestos Now Act of 2019 (HR 1603).6
In addition to our concerns above about the proposed scientific transparency rule, we also advise that EPA be more proactive with regards to specific toxicants and classes of toxicants. Following are three examples to illustrate this concern.
- Support the tightening of EPA’s annual primary PM2.5 NAAQS, following the earlier recommendations of EPA staff.7 As a final rule may be issued before January 20, we urge EPA to reconsider and reopen the final rule.
- Support the establishment of a national drinking water standard for the several specific PFAS compounds with sufficient scientific evidence of adverse effects, and funding for research on the potential adverse effects of the many other PFAS compounds accumulating in our environment.8
- Urge EPA to use its authority under the Toxic Substances Control Act (TSCA) to address whether exposures to certain chemicals, such as asbestos9 and methylene chloride 10, present unreasonable risks to workers.
We appreciate the magnitude of the challenge facing your Administration. The items listed above illustrate some specific concerns of ACOEM and its members.
The COVID-19 pandemic has Illustrated the need for more occupational medicine professionals to keep our workers and workplaces safe and healthy. Unlike most residency training programs which receive their funding through CMS or Medicare, occupational medicine residencies rarely receive CMS or Medicare funding. This is similar to pediatric residencies who also do not receive Medicare funding but receive funding through the Health Resources and Services Administration (HRSA). We request increased financial support for occupational medicine residency funding through HRSA or the National Institute of Occupational Health and Safety (NIOSH).
Ultimately, we express our hopes for your future success. We extend to you our willingness to contribute, relying on our members’ enthusiasm and expertise, to assist you and your administration. Please do not hesitate to ask our help.
Beth A. Baker, MD, MPH, FACOEM
cc: Ann Rosenthal
Doug Parker Patrice Simms