Sometimes a book will change your life. In the case of David Michaels, administrator for the U.S. Occupational Safety and Health Administration (OSHA), that book was Causal Thinking in the Health Sciences. Reading it after he had graduated from college, Dr. Michaels decided he wanted to study the subject of that book—epidemiology. The next step was obvious: apply to Columbia's Mailman School of Public Health, where the book's author, Mervyn Susser taught.
Soon enough he was studying with Professor Susser; his wife, Professor Zena Stein; and medical sociologist Jack Elinson—three "giants in the field of public health," as Dr. Michaels puts it. After receiving an MPH in epidemiology, he switched to Sociomedical Sciences for his doctoral studies to incorporate qualitative research in his studies. His dissertation, titled "What Becomes of the Brokenhearted" (after an old Motown hit song), looked at cardiovascular health among newspaper linotype workers made obsolete by computer technology. He graduated with a PhD in 1987.
On June 7, Dr. Michaels returns to Columbia. He is being honored with the Mailman School's Allan Rosenfield Alumni Award for Excellence for his outstanding contributions to public health. Reflecting on his graduate studies, Dr. Michaels says, "The reason we're in public health is to understand the world so we can transform it and make the world a better place. Columbia is where I got the tools to do that."
For Dr. Michaels, transforming the world began without delay. Even as he completed his degrees at Columbia, he worked fulltime at Montefiore Medical Center in the Bronx. In 1986, he founded an Epidemiology Unit at Rikers Island—the first such unit in a jail in the United States. As Dr. Michaels explains, Rikers was one of the most important medical contacts for many of the most underserved in New York, since jails are obligated to provide healthcare. There, he studied issues like drug abuse, mental health, and the emerging issue of screening for TB among HIV-positive inmates immune to the standard skin test.
His research into HIV/AIDS continued after joining the faculty at the City University of New York Medical School at City College, where he developed a mathematical model for estimating the number of children orphaned by the disease. "There were kids whose mothers were dying, and many had no one to take care of them," he says. "There were no programs for these kids." The study was published in The Journal of the American Medical Association and was used by the Centers for Disease Control and Prevention to allocate funding for the Ryan White Program, which provides services to those without sufficient health care coverage or financial resources for coping with HIV disease.
It wasn't long before the federal government tapped Dr. Michaels' skills, wisdom, and passion on a fulltime basis. In 1998, President Bill Clinton nominated him as the Energy Department's Assistant Secretary of Environment, Safety, and Health. There, he orchestrated an historic compensation program for nuclear weapons workers exposed to hazardous materials. "It was a challenge," says Dr. Michaels, explaining that the prevailing Cold War mentality resisted taking any responsibility, and some of the materials couldn't be identified because of secrecy. "We had to come up with a system that recognized these realities," he says. The program passed with bipartisan support. To date, it has paid more than $8 billion to affected workers and their families.
After leaving the Department of Energy, Dr. Michaels joined the faculty of George Washington University's School of Public Health and Health Services. There he directed the Project on Scientific Knowledge and Public Policy, which examines the use and misuse of science in public policy and advocates for transparent decision-making. One important example, he says, is having government require the same standards as peer-reviewed journals when it comes to disclosure of funding for research used to make regulatory policy. In 2008, he published the book Doubt Is Their Product, which described how chemical companies and others were adopting the tactics of the tobacco industry to smear science and weaken regulation. Another target of his criticism was OSHA, which, he said, needed an overhaul.
In 2009, President Obama offered him the chance to do just that. As head of OSHA, Dr. Michaels has worked to broaden the administration's role from ensuring businesses are merely compliant to specific standards to supporting of a holistic culture of workplace safety. "That involves giving workers a larger role in improving safety conditions in the workplace." Unsurprisingly, science too has also been a key driver behind Dr. Michaels’ strategy. "We have to be a data-driven agency," he says, pointing to research studies, including randomized clinical trials that validate its work. "We have a responsibility to workers, employers and tax payers to show that we're doing a good job."
The scope of OSHA's work is huge; the agency's jurisdiction includes seven million workplaces and 130 million workers. On any given day, as Dr. Michaels puts it, he and his staff are working on health issues ranging from nail guns to nail salon workers—the latter, he explains, who are exposed to solvents and other chemicals. Right now, OSHA is rolling out Heat Safety Summer to prevent heat injury among those working outdoors. The bilingual campaign employs simple guidelines for protecting workers from heat (Water. Rest. Shade.) that were first used by OSHA to protect cleanup workers in the aftermath of the Gulf Coast oil spill. Some at the time questioned whether these measures were necessary, but OSHA is credited with preventing any deaths or serious illnesses from happening as part of the cleanup effort.
The Gulf Coast cleanup is just one of a long line of OSHA successes. Dr. Michaels likes to say that when they opened their doors in 1971, 38 workers every day were being killed on the job. Today that number is down to 13—even though the workforce has nearly doubled. And OSHA's achievements, Dr. Michaels emphasizes, haven't come at the expense of businesses. This idea has been backed by President Obama, who said, "I reject the idea that we need to ask people to choose between their jobs and their safety."
That notion is also supported by research: a new study in Science finds that random OSHA inspections reduce injuries by almost 10% and reduce worker's compensation costs by more than 25%. "OSHA doesn't kill jobs; OSHA stops jobs from killing workers," says Dr. Michaels.
June 7, 2012