Wednesday's Have You Heard

Celebrate diversity: Lesbian, gay, bisexual and transgender well-being will be the focus of session 5062, "Policy Impacting LGBT Health," which starts at 8:30 a.m. in room 149A of the convention center. (Think of your early-morning attendance as a tribute to D.C.'s marriage equality!)

Fit kids: Come hear from experts in the field at session 5090, "School-based Fitness Testing for Large-scale Surveillance of Student Fitness Levels and Childhood Obesity," at 8:30 a.m. in meeting room 14 of the Renaissance Hotel. I know it's early, but think of the kids!

Fighting the good fight: Centers for Disease Control and Prevention Director Thomas Frieden will be on hand for Wednesday's session 5096, "Winnable Battles," which starts at 10:30 a.m. in room 146C of the convention center.

Hola!: Feel that ocean breeze? Then maybe you're already at special session 5101, "APHA Goes to Cuba: Lessons Learned from the Island Nation," which runs from 10:30 a.m. to noon in room 151AB of the convention center.

First peoples: Learn more about health issues affecting the country's native communities in session 5159, "Native Health Issues and their Importance in the Public Health System: A Panel Discussion," which starts at 12:30 p.m. in meeting room 14 of the Renaissance Hotel.

Lessons from the past: Believe me, we're tired too. But definitely not too tired to make it to this year's Closing General Session from 2:30 to 4 p.m. in room 146AB of the convention center. This year's session will focus on "The case for workplace health and safety: 100 years after the Triangle Fire" and will feature addresses from APHA President Linda Rae Murray; David Michaels, U.S. assistant secretary of labor; Leo Gerard, international president of the United Steelworkers; and Darryl Alexander, director of the Health and Safety Program at the American Federation of Teachers. Take a gander at this guest blog post about why you can't miss this session.

Guest post: Don't miss this year's Closing Session

by Liz Borkowski
Even if you fear your brain won’t hold another shred of public health information by midday Wednesday, don’t miss the Closing General Session, where the timely topic will be “The case for workplace health and safety: 100 years after the Triangle Fire.”

On March 25, 1911, a fire raced through the Triangle Waist Company factory in lower Manhattan. A collapsed fire escape and locked doors prevented many of the garment workers from reaching safety, and 146 workers were killed. Many of them were young women who’d recently emigrated to the United States and were a crucial source of support for their families. Many jumped to their deaths as they tried to escape the flames.

“On that spring afternoon, the sound of frantic screams and wailing fire truck bells awakened the conscience of America,” U.S. Secretary of Labor Hilda Solis said in a speech on the 100th anniversary of the Triangle disaster. “The fire opened our eyes to the tragic consequences of wretched working conditions.”

Galvanized by the disaster, advocates demanded — and won — laws requiring better working conditions. Frances Perkins, who witnessed the horrific scene from a nearby park, became secretary of labor under President Franklin D. Roosevelt and played a key role in the National Labor Relations Act and Fair Labor Standards Act.

One hundred years later, rates of occupational fatalities and injuries have dropped dramatically. The Centers for Disease Control and Prevention considers improvements in workplace safety to be one of the top 10 U.S. public health achievements of the 20th century. The earliest systematic survey of workplace fatalities covered Allegheny County, Pa., where in 1907, 526 workers were killed in that county alone. The National Safety Council estimated the 1912 toll of occupational fatalities nationwide to be between 18,000 and 21,000. Contrast that to 2009, when 4,551 workers were killed on the job, according to the Bureau of Labor Statistics.

This drop in worker deaths is an important achievement, but the latest numbers also remind us that we still have a long way to go. We’ve also seen some horrific 21st-century workplace disasters as well: 29 workers killed at the Upper Big Branch Mine in West Virginia; 11 in the BP/Deepwater Horizon disaster in the Gulf of Mexico; and seven in the explosion at the Tesoro refinery in Washington state.

And then there are the smaller, but no less significant, tragedies in which workers are suffocated in trench collapses, crushed by heavy equipment, electrocuted, burned…the list goes on and on. If you’ve got a few minutes (and if you’re like me, some tissues nearby), I encourage you to visit the Weekly Toll blog to get a clearer picture of the lives we lose to unsafe workplaces every week.

These workplace disasters injure as well as kill, but we don’t even have a satisfactory count of how many people are injured or made ill on the job. From health care workers with back injuries to farm workers poisoned by pesticides, thousands are suffering because their workplaces, while generally safer than those of 1911, aren’t as safe and healthy as they should be.

At tomorrow's Closing General Session, we’ll hear from four great speakers:

• Linda Rae Murray, president of APHA and chief medical officer of Illinois' Cook County Department of Public Health;

• David Michaels, U.S. assistant secretary of labor for occupational safety and health;

• Leo Girard, international president of the United Steelworkers; and

• Darryl Alexander, director of health and safety for the American Federation of Teachers.

I expect they’ll tell us more about how workplace health and safety has improved and how much it still needs improving. And I’m sure we’ll learn about what the public health community needs to do to make sure the spirit of reform that caught fire after the Triangle disaster burns even brighter.

The Closing General Session runs from 2:30 to 4 p.m. on Wednesday, Nov. 2.

Liz Borkowski is a research associate at the George Washington University School of Public Health and Health Services and a member of APHA’s Occupational Health Section. She runs the public health blog The Pump Handle.

In the above photo, a construction worker in 1943 is about to affix a wooden plank using a hammer and nails. Notice that he's not wearing any of the protective gear, such as protective eyewear and a hard hat, that he would be required to wear today. Photo courtesy the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health

Career highlights

APHA Annual Meeting attendees took advantage of one-on-one career coaching sessions at the Everything APHA booth inside the Public Health Expo. Visit APHA's CareerMart for more on public health job opportunities.

Photos by Jim Ezell/courtesy EZ Event Photography

Public health on the silver screen

Since 1970, the country has seen a downward trend in black lung disease, also known as coal worker’s pneumoconiosis, which is caused by breathing coal dust over a period of time.

But in the last 10 years, we’ve seen the number of cases double. In the film, “Faces of Black Lung,” Annual Meeting attendees heard the stories of coal miners who shared how their lives have changed since being diagnosed.

“I never thought about taking care of myself," said one patient, as he sucked on his oxygen tube for air. "Never thought about X-rays. I just thought about my family.”

Now he can’t say two words without gasping, his labored breathing a symptom of the disease.

Black lung patients were among several voices heard in personal narratives shown on the big screen at a Tuesday afternoon session of the 8th Annual APHA Film Festival. In addition to the coal miners’ stories, today’s session featured films about breast cancer patients, blood cancer survivors, prisoners at risk for HIV, teens concerned with the health of their environments, parents discussing teen driver safety, hospital employees sharing their reasons for getting a flu shot, and Wisconsin health workers explaining how they handled the H1N1 pandemic.

Seven-minute clips of each film were selected for their diversity in addressing a variety of public health concerns.

Two high school students from Brownsville, Texas, narrated the film “Health and Environment Action Network,” which illustrates how the Hispanic community can prevent environmental illness and disease. The film is part of a national and local movement to improve air and water quality. Produced by the Brownsville Community Health Center, the film shows public health experts concerned about air quality working in Brownsville and other border towns.

“We see a lot of truck traffic here,” said one resident. “People should keep their young children indoors in the early morning when traffic is heavy.”

A rough cut of the film “Designing Healthy Communities” showed how an unhealthy physical environment can shorten our lifespan by as much as five years. For example, living in a city like Riverside, Calif., can increase the risk of lung disease by 30 percent, experts warned.

In “No Warning Shots,” which was produced by the Center for Health Justice, health workers are shown visiting prison populations in California to discuss the risks and realities of HIV and AIDS. The video is shown to new prisoners in the state.

The Wisconsin Division of Public Health produced “Facing a Pandemic: Wisconsin’s Response to 2009 H1N1 Influenza,” a documentary that takes the viewer on a step-by-step journey of how the state handled a public health emergency and won.

The Leukemia & Lymphoma Society produced “Paths to Recovery: Stories from Two Blood Cancer Survivors” to show the daily struggles of patients.

“It never goes away entirely, even when it’s in remission,” said one patient. “There’s still no cure.”

Don't miss tomorrow's film festival showing, session 5160, at 12:30 p.m.

— L.R.

The fallout

A nuclear disaster in a plant near Chicago would force the evacuation of 7 million people and could deliver fatal doses of radiation to 20,000 people, said a speaker at an APHA session on "In the Wake of Fukushima: Is Nuclear Energy Healthy for Communities?" this afternoon.

Furthermore, said Andrew Kanter, president-elect of Physicians for Social Responsibility, the nuclear fallout plume would be so large that many local emergency responders would not be permitted to go near the scene to help because of the danger.

The dangers of nuclear power are well-known, particularly after the Fukushima disaster in Japan earlier this year, said speakers during the scientific session. They argued that America should seek other methods of alternative energy.

While the Three-Mile Island near-meltdown in 1986 had “put a major crimp in the expansion of nuclear power in America,” those seeking alternative energy sources have backed it as a cleaner alternative, said Robert Gould, president of the San Francisco-Bay Area chapter of Physicians for Social Responsibility.

The session highlighted the risks of a nuclear disaster and noted that in addition to the Chernobyl, Three-Mile Island and Fukushima crises, there have been other near-misses that could put the public’s health at risk.

Kanter noted that the vast majority of the fallout from the Fukushima disaster went over the ocean rather than toward Japan’s most populous cities. Despite that, radiation hotspots were found in Tokyo and elsewhere.

Dangers he listed during his talk included possible releases from active plants, releases resulting from the unsafe storage of nuclear waste and the many potential dangers of a terrorist attack at a nuclear energy plant.

He highlighted another scenario, in which the Indian Point nuclear reactor near New York City has a meltdown. That scenario would cause 3,500-44,000 immediate deaths, 100,000-500,000 long-term deaths from cancer and other diseases, and $1.1 trillion-$2.1 trillion in economic damage.

In her presentation, Jacqueline Patterson, environment and climate director of the NAACP, said nuclear power plants are disproportionately located near low-income communities. Furthermore, she said, uranium mining disproportionately affects American Indian and indigenous communities.

All three speakers pointed to a greater need for research into alternative fuel sources and an examination of the true potential fallout of a serious nuclear incident on American soil.

— C.T.

A little birdie told me so: Tweet of the day

Today's tweet of the day comes from Twitterer trulyjoannies and goes out to all you fellow Twitterers using the hashtag #apha11: tweetup sounds so fun! i hope to attend the conference and tweetup with you folks someday!!

We hope so too!

'We're ready to take the lead'

Thoughts on this year's Opening Session from past APHA President Virginia Caine. For more soundbites from meeting attendees, visit APHA's YouTube channel.

Picture this

What image does climate change conjure in your mind?

According to Maria Blair with the American Cancer Society and one of the speakers at this morning's session on “Climate Change and Health: The Global Challenge,” this is a key question that must be answered to help contextualize the issue and mobilize action.

Kim Knowlton, senior scientist with the Natural Resources Defense Council and chair of APHA’s Climate Change Workgroup within the Environment Section, discussed the need for short-term action to offset current and future health risks. She pointed to data that found 2011 to be a year in which all-time high temperatures were broken across the United States.

“Adaptive measures are already happening in cities around the world,” Knowlton told attendees. “Climate change is the health issue that unifies so many pressing health issues of the day.”

After a survey of experts identified significant limits among European health agencies in dealing with climate-related impacts on infectious disease, session presenter Jan Semenza, along with the European Centre for Disease Prevention and Control, helped develop an adaptation tool and software program that health officials can use. The tool allows decision-makers to project risks and map regions or areas that might be at greatest risk for a host of different pathogens based on a variety of potential climate change factors.

Although health departments, nonprofit organizations and a number of federal agencies are working toward preventing climate-related health risks, there remains a disconnect among many policy-makers and the general public about the effects of climate change on the public’s health.

Session presenter Maria Blair challenged the public health community to think about whether “we are framing the problem and engaging people in the right way on this issue.”

“I don’t know about you, but I haven’t heard people reflect lately on that awful climate change-induced snowstorm we had the other day or recent climate change-causing heat waves or drought,” Blair said.

We need to mainstream the “complex issue of climate change to be successful and help provide the right tools for those making choices at the local level,” she noted.

Building resilience doesn’t happen overnight and climate change is not a problem that a single institution can solve. Slowly but surely, however, it seems we’re moving the levers to get there.

— M.S.