Safety expert weighs implications as job market shifts ‘from stability to precariousness’

Dr. John Howard

Dr. John Howard

The nature of work is changing dramatically, and it’s creating new challenges – and pitfalls – for regulators charged with protecting workers’ health and safety.

The highest-ranking official at the National Institute for Occupational Safety and Health called on academics gathered Wednesday at the University of Minnesota to dig deep into the implications of emerging economic trends like robotics and agency-based, temporary employment, as well as the potential use of “big data” to make workplaces safer.

“The government built all of our social-protection laws based on an old paradigm,” Dr. John Howard told about 75 professionals gathered at the Midwest Center for Occupational Health and Safety’s annual symposium. With a greater share of the U.S. workforce moving “from stability to precariousness,” he added, “the normal employer-employee relationship has eroded.”

Howard, who also serves as administrator of the World Trade Center Health Program, covered a wide range of issues and referenced a trove of published research in his 45-minute address.

No one knows exactly how many U.S. workers are employed in temporary jobs or other “non-traditional” arrangements, Howard said. But it’s definitely on the rise.

Research shows the 21st-century job market is characterized by uncertainty and ambiguity. Workers increasingly settle for short-term “gigs” rather than career-path jobs. Many find themselves at the mercy of sophisticated, “Just-in-Time” scheduling software that makes their shifts irregular and paychecks unpredictable. Layers of subcontractors and agencies often create murky managerial relationships.

In many ways, the emerging labor market looks increasingly like the construction industry, where tradespeople bounce from jobsite to jobsite and from employer to employer. That means regulators, Howard said, ought to cast a wider net for wage theft, misclassification of workers as “independent contractors” and other violations that plague construction work.

But worker-protection laws written in the mid-20th century aren’t always applicable in the modern age, when any coffee shop with wifi can serve as an office and Google Hangouts can take the place of a conference room. “We really have another definition of a workplace, and it’s a challenging one,” Howard said.

Meanwhile, global trade and automation continue to alter the type of work most Americans do.

It’s generally accepted, Howard said, that 47 percent of existing job categories will be subject to automation in the next two decades. And experts expect about 80 percent of the workforce soon will be employed in service-oriented work – jobs, Howard said, that usually require no more than a high-school degree.

“It may not be possible now to increase productivity through education,” Howard said, acknowledging that such an assertion flies in the face of predictions offered two decades ago by proponents of NAFTA and other free-trade agreements. “Economists are finding out that the benefits of trade don’t necessarily justify its cost,” he added.

Technology is also creating opportunities and challenges when it comes to protecting workers’ health and safety on the job.

Researchers in the field of occupational health are only beginning to understand the potential of new sensory technology that provides a constant stream of data from the jobsite to safety monitors – everything from air quality to the heart rates of workers on a factor floor. The “big struggle,” Howard said, is mining that data for indicators that accidents or other adverse events might be on the horizon.

Finding those indicators could amount to a major breakthrough in worker safety – and a much-needed one as well. Research suggests the changing nature of work – the shift “from stability to precariousness,” as Howard put it – comes with some serious health and safety risks for working people.

Studies suggest temporary workers have shorter life spans than those in career-path positions. Unpredictable work schedules may also be taking a toll on workers’ mental health. And when a patchwork collection of temp agencies and subcontractors provides labor for a single workplace, site-specific safety training is often inconsistent – and sometimes nonexistent.

“Workers have a more distant relationship with the people they work with, the people who can help navigate potential hazards,” Howard said, noting that temporary workers are less likely to report potential hazards – or try using collective action to improve their working conditions.

“They work for a temp agency,” Howard said. “They feel lucky just to have a job.”

Union launches campaign urging patients to ‘insist on a registered nurse’

There’s no substitute for the professional judgment and personalized care nurses provide to their patients. That’s the message behind radio and online ads airing across the country, including in Minnesota, that advise the public to “insist on a registered nurse.”

National Nurses United, the nation’s largest union of nurses (the Minnesota Nurses Association is a member organization), is underwriting the ad campaign in response to sweeping changes underway in the nation’s health care delivery system.

Those changes, according to nurses, pose potential threats to patient safety.

“An unchecked proliferation of unproven medical technology and sharp erosion of care standards are rapidly spreading through the health care system, far outside the media spotlight but frighteningly apparent to nurses and patients,” the NNU said in a statement announcing the campaign.

Among the emerging trends that have nurses concerned is an expansion of “digitalized care,” in which computers diagnose patients and dictate their treatment based on generic population trends – and not the health status or care needs of the individual.

Computerized electronic health records systems, too, pose a threat to patient safety. The Office of the Inspector General for the Health and Human Services Department has reported widespread flaws in these systems, and when they fail, doctors and nurses are left in the dark, without access to medical histories or medical orders.

Computer programs should never supplant the professional assessment and judgment of experienced nurses and doctors, according to NNU Co-President Jean Ross, a member of the Minnesota Nurses Association.

“The American health care system already lags behind other industrialized nations in a wide array of essential health barometers from infant mortality to life expectancy. These changing trends in health care threaten to make it worse,” said NNU Co-President Jean Ross, RN. “Behind every statistic is a patient, and their family, who are exposed to unnecessary suffering and risk as a result of the focus on profits rather than what is best for individual patient need.

“What we are advising every patient, every American to do is stand up and be heard. When it matters most, insist on a registered nurse.”

NNU’s ad campaign features radio spots, online videos and social media outreach. To watch the new videos and hear the radio ads visit www.insistonanRN.org.