One of many COSH groups around the country, Mass COSH is a coalition of workers; unions; community groups; and health, safety, and environmental activists that organizes and advocates for safe jobs and healthy communities throughout eastern and central Massachusetts. For 30 years, Mass COSH has worked with the Massachusetts labor movement, recruiting a diverse multilingual staff to organize, advocate, lobby, and provide assistance to local unions, individuals, and groups.46 Mass COSH has recently focused on immigrant, low-wage workers and their communities, involving workers and unions in changing the workplace. Active projects have included an Environmental Justice for Cleaning Workers Initiative. Mass COSH has also consistently recruited and relied on volunteer technical experts, including physicians, industrial hygienists, epidemiologists, and policy experts.47

Since 1993, the Occupational Health Surveillance Program (OHSP) of MDPH together with the Health Departments of California, Michigan, and New Jersey have received funding from the National Institute for Occupational Safety and Health to conduct surveillance of WRA, identifying industries, occupations, and exposures associated with WRA.37 A focus on sentinel surveillance provided an opportunity to understand the importance of individual WRA cases and solicit their stories of exposure and disease. Cleaning product emerged as a significant WRA cause in all four states.38 As a result, OHSP staff developed expertise on the health effects of exposure to cleaning product .

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Workplace assessment with janitors in a transportation center
Approximately 140 members of the SEIU Local 615 worked for a private contractor, cleaning a large passenger transportation center with 24-hour access. During the past several years, they had raised many issues of workplace hazards with their supervisors. When they couldn’t get them corrected, the workers approached their union representatives with the issues. For example, broken wheels on cleaning carts required workers to use extra force to push them up ramps, into bathrooms, and around the facility. Discarded materials in bathrooms included broken glass, syringes, and unmarked liquids with potential physical, biological, and chemical hazards. Concern about cleanliness in public bathrooms promoted increased use of more concentrated disinfectants, especially during night shifts, which caused acute irritant symptoms. Understaffing resulted in job overload, extra tasks, speed-up, and fatigue.

In response to these concerns, SEIU Local 615 and MassCOSH developed a four-page Spanish-language survey in March 2005 to seek feedback about specific symptoms, hazards, and equipment, as well as provision of health and safety training. The survey provided check-off lists of health problems that respondents associated with chemical use, health problems they associated with overwork, and other workplace hazards (e.g., exposure to dust, body fluids, bacteria, sexual harassment, and violence). It included a drawing of a human figure and allowed respondents to pinpoint the location of pain attributed to their work. Respondents were also asked to indicate whether they had received training in eight different topics related to health and safety.