Promoting Policies to Improve Workers’ Health and Safety


At the American Public Health Association (APHA) annual meeting in Boston, Professorial Lecturer Celeste Monforton and Research Associate Liz Borkowski saw the culmination of nearly a year’s work when APHA’s Governing Council voted to adopt their policy statement on paid sick and family leave. Now, APHA has officially expressed its support for expanding US workers’ access to earned sick days and paid medical and family leave.

“It’s shameful that the US is the only industrialized nation that doesn’t give workers access to paid sick time to recover from illness, or paid maternity leave following a baby’s birth,” says Monforton. “A lot of health advocates have been working on changing this, and we thought that APHA, the world’s largest and most diverse public health association, should be on the record supporting paid sick and family leave.”

Monforton and Borkowski, along with fellow APHA Occupational Health and Safety section member James Cone, drafted a policy statement for APHA’s consideration. It describes the many ways inadequate paid sick and family leave harms workers, their families, and communities; summarizes existing federal, state, and local laws that address paid and unpaid leave; and calls for improvements to these laws and policies. For several months prior to the Boston meeting, they collected feedback from colleagues in other APHA sections, as well as advocacy groups such as the Center for Law and Social Policy (CLASP), and revised the statement.

“Many workers face the threat of job loss if they take a day off work to recover from an illness or care for a sick child,” Borkowski explains. “And even workers who have access to unpaid sick or family leave often feel they can’t afford to miss a day or more’s pay. This means workers often come to work even when they have the flu or some other illness, and that increases the risk of diseases spreading in their communities.” A lack of paid parental leave can also make it challenging for parents to care for new children, and that can affect children’s development and future health.

Now that APHA has formally adopted a policy statement supporting steps to create earned sick and paid leave policies, perhaps federal lawmakers will finally take action on this crucial issue. “Earned sick days and paid family and medical leave are good for working families and for public health,” Monforton summarizes.

APHA’s governing council adopted the policy statement on November 5. The full statement is scheduled for release early next year.

How to Keep Workers Healthy and Safe

With funding from the Public Welfare Foundation, Monforton and Borkowski have been working for several years to study occupational injuries and diseases that affect many workers and their families. As part of that work they have recommended public policies that would prevent such diseases right from the start or protect workers from on-the-job injuries.

“There are a lot of occupational injuries and illnesses that we’ve known for decades – even centuries – how to prevent,” says Monforton, who prior to joining GW had spent a decade working for the U.S. Department of Labor, first with the Occupational Safety and Health Administration (OSHA) and then with the Mine Safety and Health Administration (MSHA). “You prevent black lung disease by reducing miners’ exposure to coal dust. You prevent massive explosions by limiting the buildup of combustible dust. You prevent falls in construction sites with safety harnesses.” The challenge, she explains, is in assuring that employers meet their legal responsibilities to implement the practices known to protect workers’ health and safety.

“A lot of our work involves analyzing what OSHA and MSHA are doing, and recommending ways they could strengthen workplace health and safety standards and enforcement,” Monforton explains. “For instance, OSHA just proposed a new regulation to reduce workers’ exposure to silica – dust that many construction workers breathe in--which can cause severe, even fatal, lung damage. We’re working with our colleagues at other organizations to submit comments to OSHA about how the rule will improve public health, and how it could be made even more protective for workers.”

Educating Advocates, the Public and Others

To help advocates, public officials, and others keep track of the many important developments in US workplace health and safety, Monforton and Borkowski started a Labor Day tradition of releasing a report that highlights the noteworthy publications and activities in the field over the previous year. The latest edition, The Year in U.S. Occupational Health & Safety: Fall 2012-Summer 2013, includes research published in peer-reviewed literature and reports by nonprofit organizations; actions by Congress and executive-branch agencies; state and municipal laws and regulatory activities affecting workers’ health; and activism by workers from along the food chain, from farmworkers to fast-food employees.

“We’re seeing a lot of work on occupational health and safety issues at the state and local levels, and insightful research in academia. The annual report is a great way to bring all that information together in one place,” says Borkowski.  “It can be helpful for local worker-health advocates to see that, say, Portland has passed a paid-sick-days law and Hawaii has adopted protections for domestic workers.”

In addition to that once-a-year retrospective, Borkowski and Monforton have been covering breaking worker health and safety topics (as well as other public health issues) for seven years at their public health blog The Pump Handle, which is part of the ScienceBlogs network. In their over 200 blog posts each year, they explain and weigh in on political and regulatory developments as they happen, highlight the continued toll of unsafe workplaces, and delve into the factors and impacts of specific workplace hazards.

From Local to National

Monforton and Borkowski also serve as resources to reporters and organizations addressing occupational health and safety issues, and they participate in efforts to improve worker health in their own cities. Borkowski is part of the District of Columbia’s Paid Sick Days for All campaign, which seeks to expand DC’s paid sick leave law to cover tipped restaurant workers. She and Monforton co-authored a local Washington Post op-ed on the public-health importance of paid sick days for restaurant workers, Your Meal Shouldn’t Come with a Side of the Flu, and Borkowski testified at a recent City Council hearing about the law.

Monforton, who was an Assistant Research Professor at GW until she moved to Texas in 2010 and is now a professorial lecturer at SPHHS, is collaborating with the Fe y Justicia worker center in Houston on several worker-health issues, including partnering with community health centers to educate workers about safety rights and resources and urging the Houston City Council to pass an ordinance prohibiting employers convicted of wage theft from receiving city contracts. She also serves on the community advisory board for a recently funded research project at the University of Texas School of Public Health, which is examining health and safety issues for Houston’s day laborers.

“A lot of the improvements we’re seeing to worker health and safety are at the state and local level,” says Borkowski, giving as examples Massachusetts’ 2012 law to protect temporary workers and Rhode Island’s recent adoption of a Temporary Caregiver Insurance program, which will use small paycheck contributions to replace a portion of workers’ salaries while they’re off work caring for loved ones. (California and New Jersey already have such “social insurance” systems for paid family leave.)

“Seeing one city or state’s experience with a worker-protection law can make it easier for other cities or states to pass similar laws in the future,” Borkowski explains. “After San Francisco passed its paid-sick-leave law in 2006, other cities were able to see that businesses were still thriving, and that workers were using their leave appropriately. Now six cities and the state of Connecticut have paid-leave laws.”

“Our hope is that the growing list of cities and states with paid-leave laws will convince federal lawmakers that it’s time for national legislation assuring workers the right to earn paid sick, medical, and family leave,” says Monforton. She notes that in Congress, Senator Kirsten Gillibrand and Representative Rosa DeLauro have announced plans to introduce the Family and Medical Insurance Leave (FAMILY) Act, which would make partially paid medical and family-caregiving leave available to all workers.

“Now that we have APHA officially on the record supporting expansion of paid sick and family leave for US workers, future paid-leave legislation will benefit from the support of the public health community,” Monforton says.