A suspected correlation between a certain lung disease and the inhalation of carcinogens recently received added traction thanks to findings released by two Canadian researchers. Their conclusions, following ten years of study, including two to three years of case studies, links a lung disease known as sarcoidosis to breathing in silicates, silica, and metal dust. The National Institutes of Health defines it as an inflammatory disease characterized by the development and growth of tiny lumps of cells called
granulomas. If these cluster together in an organ, permanent scaring or thickening of the organ tissue may result, sometimes causing debilitating sickness and even death in extreme cases.
The researchers also found that first responders to the World Trade Center attack on September 11, 2001, had an increased incidence of a pulmonary disease similar to sarcoidosis. For example, NYC fire fighters’ cases in the 12 months in its aftermath rose from 12.9 cases per 100,000 firefighters from 1985 to 1998 to 86 cases per 100,000. The collapse of the two towers had released a huge quantity of airborne particles that many had inhaled, prompting the researchers to theorize that a cause-effect
relationship may exist between the event and subsequent spike in this disease among the responders.
This most recent report is not unique because similar opinions have been offered by others performing clinical research in this field, among them the Mayo Clinic. Regarding sarcoidosis, the Clinic states that some research suggests that infectious agents, chemicals, dust, and a potential abnormal reaction to the body’s own proteins (self-proteins) could be responsible for the formation of granulomas in people who are genetically predisposed.
Sarcoidosis, however, should not be confused with silicosis, the latter being an incurable disease that may even be deadly. According to OSHA, respirable crystalline silica also causes lung cancer, other potentially debilitating respiratory diseases such as chronic obstructive pulmonary disease, and kidney disease. In most cases, these diseases occur after years of exposure to respirable crystalline silica found in stone, artificial stone, and sand. When workers cut, grind, or drill these materials, or use industrial sand, they can be exposed to minute silica dust particles which then may be inhaled deeply into the lungs.
Sarcoidosis’ causes have been suspected but not known, but this new information from the Canadian study that appears to link the disease to respirable dust created by certain industrial and construction
processes should concern employers whose operations include any of the following activities:

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 Sand blasting
 Sawing concrete or brick
 Drilling or sanding concrete
 Grinding mortar
 Manufacturing stone countertops, concrete blocks, or bricks
 Cutting or crushing stone
Although sarcoidosis until recently has not been thought to be caused by inhaling carcinogens, and has not been considered preventable, it is possible that some of the same respiratory preservation standards currently used to counteract silicosis may help to stave off sarcoidosis too. A clearer picture and better understanding of this disease is beginning to emerge now that eventually may result in a new industrial hygiene process that will protect workers from it. In the meantime, employers should
continue with the OSHA mandated silicosis controls that have been in effect since 2008 which may have a collateral benefit that protects workers from sarcoidosis as well.


Employers Have Options When Cited by OSHA
An OSHA Compliance Officer’s visit to a work site, warehouse, or factory floor that results in a citation being issued should not be taken lightly by employers nor should it be considered a hopeless situation. Employers have the right to an administrative review of the order, a process which is
common to many similar enforcement actions at all levels of government. Basically, the employer must be afforded an opportunity to be heard and is the first step to be taken before a potential judicial review. In fact, courts typically require that administrative remedies be exhausted before a
judicial scrutiny may begin.
Specified with each violation listed on the citation is the penalty amount which will vary but may be as high as $136,653 for each “Repeat” or “Willful” offense or as low as $13,653 for “Serious” or “Other
Than Serious” offenses. The total fine could be substantial. The agency uses the high price tag as a deterrent to warn employers that not complying with its requirement that they provide a safe and healthful work environment can be expensive.
Regardless of the penalty amount, regulated parties should review the available options such as paying the fine or to challenge one or more of the violations, the fine amounts, or the inspection methodology itself. To make an objection, one must submit a written Notice of Contest to the local
area OSHA office within 15 working days of the citation’s date (Saturdays, Sundays, and Federal holidays are excluded). A reliable delivery service that provides a receipt is critical since once the 15 days elapse, the administrative review period expires.

Cont.
The next question many employers may have is, “Where do I find the Notice of Contest form?”
Surprisingly, no such form exists. Each company is expected to create its own notification which at minimum must contain the following elements:

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 “Notice of Contest” heading
 Company name
 Citation Issuance Date
 Inspection Number
 Then include a simple narrative such as Dear Area Director, This a Notice of Contest of the above citation(s) and all sub-parts, inclusive of all penalties for the citation.
 Finally, add employer signature. Be certain to clearly identify what is being disputed. This includes the violations, and the citation itself, the penalties, the classifications, the time frame allotted for compliance, and any other aspects of the inspection process that should be reviewed.
Another alternative which exists for those employers who do not want to pursue the Notice of Contest option is to ask for a conference with the OSHA authorities at their office. This meeting will open lines of communication and may build goodwill which could help achieve a reduction in penalty amounts, a modification of the violations themselves, or even a resolution of the entire citation. Choosing this route also suspends the 15-day deadline until such time that employer decides that the negotiations have not been successful and that submitting a Notice of Contest will be necessary.
Receiving an OSHA citation understandably may trigger trepidation among employers but being aware of the available options to manage and potentially mitigate their impact should help reduce the overall level of anxiety. Consulting with an attorney who is experienced dealing with OSHA and occupational safety related matters should be considered too when that citation from OSHA arrives in the mail. The key point is that employers should be aware of the available options and take a measured approach to
resolving the matter administratively whenever possible.

Please direct any questions or concerns to:
The Safety Division at Hamond Safety Management
Anthony Vacchio, [email protected] 516-762-4224