Book Review: Bureaucracy vs. Health — Death on the Job: Occupational Health and Safety Struggles in the United States

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Book Review: Bureaucracy vs. Health

by Ellen Bulf

Death on the Job: Occupational Health and Safety Struggles in the United States

by Daniel Berman
Monthly Review Press, 1979

‘Science for the People’ Vol. 12, No. 2, March-April 1980, p. 13


”What happens in the workplace cannot be separated from what happens in the rest of society.” 

OSHA, NIOSH, LSHI, SEOH, WIOES, PACOSH, CACOSH … The past decade has produced a sloshy-sounding alphabet soup of new organizations active in the medical, political, legislative, academic, and research aspects of occupational safety and health. 

Daniel Berman’s Death on the Job is not primarily a documentation of work hazards; rather, its aim is to summarize the current U.S. occupational safety and health (OSH) movement and put it in historical perspective. Berman, a long-time health activist and former director of the Medical Committee for Human Rights, has the experience and perspective to make hamburger out of that sacred cow, the industry-dominated OSH system. 

The book begins with a quick behind-the-scenes tour of the current OSH movement. We find U.S. Steel in 1910 trying to find a way out of the rising cost of lawsuits brought by injured workers and their survivors. Today’s workers’ compensation system contains the same essential features then pioneered by U.S. Steel: partial, rather than complete, replacement of lost earnings; insurance carried by private companies; surrender of the right to sue the company for damages; and the denial of the very existence of occupational disease. 

This leads Berman to a survey of the various agencies and organizations involved with the “compensation-safety apparatus,” which he defines as: 

That complex of mostly private, corporate-dominated organizations which are concerned with compensation, workplace inspection, standards-setting, research, and education in occupational health and safety. It is called the compensation-safety apparatus because it emphasizes compensation over prevention and safety over health. 

There is interesting and valuable material here on such organizations as the propagandistic National Safety Council, the Bureau of Labor Statistics (which bases its accident figures on employer self-reporting), the insurance companies (which profitted $45 billion in compensation premiums in 1974 alone), industry trade associations (which have an unseemly influence on federal OSH standard-setting), company medicine, and more.

The activism of the late ‘60s and ‘70s brought the first serious challenges to this system. The remainder of Berman’s book is devoted to extended coverage of today’s mushrooming occupational health movement. This includes a short section each on over a dozen unions and a discussion of various activist groups such as the Society for Environmental and Occupational Health. (Even Science for the People gets a friendly nod.) The long-neglected field of occupational illness is also brought into the limelight with discussions of the current state of knowledge regarding long-term exposure to hazardous materials including asbestos, radiation, and cotton dust.

Berman tops it all off with a welcome (and seldom encountered) plea for international cooperation in standard setting and enforcement, and some thoughts on the future. Some of the problems he discusses are rising unemployment, export of hazardous work, declining union membership, and contradictions between union bureaucracy and the rank-and-file. 

When you take too big a bite, some inevitably gets left unchewed. Particularly in the historical sections, Berman’s conclusions are often more clear than the facts upon which they rest; and, in spite of extensive footnoting, enough material goes unreferenced to create some frustrations. But be forewarned (if you haven’t guessed already): Death on the Job is not a lecture but a speech — that is, not a dispassionate discourse but a polemic, albeit a well-documented one. 

Death on the Job is a relatively short (196 pages) reference for workers, health professionals, and lay advocates, summarizing what everyone — industry, government, unions — is doing about occupational health and why. Berman’s original research and radical perspective combine to make this a valuable work for those of us who have trouble telling the players without a program in the rapidly developing OSH movement.