CHAPTER 1
THE IMPORTANCE OF SAFETY AND HEALTH

1-1 INTRODUCTION

Modern Western society continues to place a high value on human life. That was not always the case. Even today, some societies place a limited value on human life.

In the United States, life expectancy overall for 2017 was 78.6 years, down slightly compared to two years earlier. For males, life expectancy is 76.1 years and 81.1 years for females and increasing slowly. Several other developed countries have slightly higher life expectancies and their rate of increase has exceeded that of the United States. Some underdeveloped countries have life expectancies around 50 years. The World Health Organization (WHO) reports that the average world life expectancy in 2019 was 73.4 years.

Over the last several centuries, engineering and medicine have all but eliminated some diseases that were major threats. Examples are smallpox, typhoid, cholera, bubonic plague, diphtheria, tuberculosis, and polio. Medicine contributed improved diagnosis, improved treatments, and use of antibiotics and vaccinations. Beginning in the late 1800s, the germ theory of medicine emerged to explain how diseases exist, get transferred, and become treatable. Engineering contributed sanitation systems to manage human and other wastes and to prevent the spread of diseases and illnesses. Engineers introduced water treatments to minimize disease transmission and to allow people to bath regularly and conveniently.

Today, we are on the threshold of biological medicine that helps with diagnosis and treatment of disease. A few drops of blood can test for nearly 1,000 medical conditions. With the mapping of the DNA molecule, physicians can test individual DNA and identify the potential for a patient to acquire certain diseases. Biologically grown substances, tissue, and even organs are leading to revolutionary treatments such as tissue and organ replacements that do not require other people to be donors.

Overall, these revolutions have extended human life.

The industrial revolution occurred between 1760 and 1840. Early in the industrial revolution, the life expectancy for the working class in Manchester, England, was 17 years. For the gentry living on manors, life expectancy was 35 years. Child labor was common and shortened the lives of the young.

The industrial revolution introduced many new hazards to workers. Early on the rate of injury and death at work was very high, often from machines and processes. For example, grinders in England who worked in dusty condition while grinding metal to form knives, scythes, forks, and other instruments became overcome with a disease called grinder's asthma. Today, the disease is known as silicosis. While pay was at a premium, their life expectancy was much lower than people in the normal population. In 1865, the life expectancy ranged from 29 to 40 years, depending on the kind of work. In addition, any damage to the lungs increased the likelihood of also acquiring tuberculosis.

While the rates of injury, illness, and death from work with machines and processes have come down a lot, there is still much to be done. Some new equipment and technologies have added hazards, while others have reduced hazards. Consider gasoline for automobiles. Between about 1920 and 1980, lead was a gasoline additive. Engine exhaust produced lead into the air and lead poisoning increased in the overall population. When laws removed lead from gasoline, the rate of lead‐related disorders among the general population decreased considerably.

For many years, the Chemical Abstract Service (CAS), operated by the American Chemical Society, has maintained information on disclosed chemicals and other materials. The information appears in the CAS Registry.1 Each entry has a unique CAS Number. There are millions of entries with thousands more added each day.

A new chemical database is the SCIP database (substances of very high concern) operated by the European Chemicals Agency (ECHA). Each chemical receives a unique EC Number.2

There are more than 300,000 inventoried or regulated substances. We know little about the safety and health hazards of many of these regulated substances. A few have studies determining if they are hazardous. Chapter 24 addresses some issues related to chemicals and where to find health information about them.

The industrial revolution spawned a major safety movement. For many years, there was little control of workplaces and public safety and health issues. Initially, a few states took responsibility for certain dangers, and insurance companies promoted safety and health.

An example is that of boilers. Steam power became a primary source of energy and power for industries, shipping, and other applications. It became a primary source of heating in buildings. There were no design standards for some time, and boiler explosions were commonplace. Records suggest that as many as 50,000 people in the United States died from boiler explosions each year. One of the worst on record was the boiler explosions on the Mississippi River steamship, Sultana. Following the end of the Civil War and while carrying about 1,500 Union soldiers from imprisonment in the South back to their homes in northern United States, 3 of the 4 Suntana boilers exploded near Memphis on April 27, 1865, killing most people on board. The boat with a design capacity for 376 was carrying nearly 2,100 people.

Slowly states introduced laws and regulations for boiler design and manufacturing. The high rate of boiler explosions and introduction of laws and regulations led to the creation of the American Society of Mechanical Engineers (ASME) in 1880. The organization published the Boiler Testing Code of 1884, which eventually led to the first ASME Boiler and Pressure Vessel Code, published in 1915. Since then, this ASME Code has been the standard for design, manufacture, and operation of steam and related power sources (nuclear, for example) and equipment.

It was not until the early 1900s that safety and health became established. Much of the effort to implement safety improvements in industry came from industry leaders themselves. Some organizations emerged and one that remains in place is the National Safety Council (NSC). One that did not survive is the American Safety Museum, which sought to communicate hazards and their control through exhibits when other communication methods (phones, radio, television, and Internet) did not exist. Several publications emerged that focused on worker and public safety and health and offered valuable information. Many organizations fell by the wayside over time.

In the United States, there were many social issues to overcome when trying to advance safety and health. One was immigration. People did not speak the same language, and workplace supervisors often did not know the language of their workers. In addition, illiteracy was very common, both for native‐born people and immigrants. Written communication was not practical. The legal system for dealing with workplace injuries, illnesses, and death strongly favored the employers (see Chapter 6). It was not until 1911 that the first state passed a workers' compensation law. Others followed. Before such laws, workers injured on the job had to fend for themselves financially. Widows of those killed were even worse off with no breadwinner left in the household.

Around the turn of the century, housing for many was very poor and crowded, with no running water, no indoor plumbing, and little or no ventilation. Early in the 1900s, cities were beginning to install sanitary sewer systems, waste removal, and clean water supplies. The public had limited knowledge about the many safety and health hazards that they faced in their daily lives. There were few professionals focused on safety‐seeking to deal with such hazards.

An issue when dealing with safety and health matters is “What is the value of a human life today?” When defending proposed regulations and comparing the costs to implement a regulation against the benefits gained, federal agencies often estimate the value of human life. The Environmental Protection Agency has used $9.1 million (2010). The Food and Drug Administration estimated a human life at $7.9 million. The Transportation Department set human worth at $9.6 million (2016). In considering the Clean Air Act for 20 years from 1970 to 1990, estimates for the benefits ranged from $5.6 to $49.4 trillion while the costs to implement were $523 million.

For insurance claims from injury and illness, insurance companies often consider the useful, employable life remaining for the impacted person. A term is the value of statistical life (VSL) and quality‐adjusted life‐year (QALY). The annual dollar amounts used in claims analysis vary by insurance company, but a VSL of $50,000 is a commonly used value. Some employers and government agencies may want to compute the benefit of avoiding a fatality. A term used in such considerations is the value of preventing a fatality (VPF).

The financial amount used for any of these considerations varies by country. For example, in Australia, the VSL is $4.2 million ($AU). An equivalent in Sweden is about €3.7. In Russia, life values range from $40,000 to $2 million.

Governments, employers, and individuals spend significant money to avoid loss of human life and to prevent injuries and...