"Nearly half of the workers suffering silicosis in the UCLA and UCSF study said their workplaces were using water to control dust. Roughly a quarter said they always had respiratory protection. Fazio said studies have found that in many shops, dust is so thick in the air that respirators cannot filter out a sufficient amount.
Metzger argued that the kind of sophisticated and costly measures that would be needed to reliably protect workers cutting engineered stone are not economically plausible in an industry where immigrant workers typically labor in small shops and are often paid in cash. Engineered stone "is too dangerous to be used safely," he said. "If there’s any industrial product that should be banned, this is the product.""
All this thanks to synthetic stone - important note for countertops owners, if you want to make sure you don't support the product
>dust is so thick in the air that respirators cannot filter out a sufficient amount
This is not a technology problem, this is an 1880s "Safety devices are too expensive problem" along with paid under the table workers problem. All kinds of other industries manufacture 'dangerous' products with regulations that protect the workers. Housing and agriculture are both industries that do not and fight ever further for anti-regulations to protect the workers even less.
Removing the availability of cheap labor by providing more worker rights, and less/no criminalization of undocumented immigrants alongside an h1b reform would do wonders for the general health of this society.
Nobody is against cheap workers paying taxes. They’re against undocumented workers getting paid under the table and unfairly competing with documented workers that have to pay taxes and thus are more expensive. Gotta solve the documentation problem one way or another.
Once illegal immigrants gain citizenship and essentially basic civil rights (being a criminal federally isn't really freedom no matter if your state is sort of cool about it or not) they will no longer be willing to work in these conditions. They don't report or sue now due to their status, people fear deportation and it's often used as a threat by business owners and housewives employing cleaners and nannies.
Observing public discourse regarding illegal immigration offers great insight into how the Overtone window works and how it can be pushed in any direction by elite-owned media. What is essentially illegal is now being called undocumented. It blows my mind. I had to go over a lot of hoops to be allowed to move to and work in Switzerland. It's the right of the host to set the rules and enforce them. If you don't intend to respect that and still come you're doing something illegal.
And I've been an expat in multiple countries for the majority of my life. Undocumented just means you broke the law to get in. This is illegall. Let's call a spade a spade.
Because being “undocumented” isn’t actually “illegal”.
Heck undocumented is a bad term too on its own but for other reasons.
Being in the US without a right to be in it, is a civil matter. Not criminal. It hasn’t been a criminal matter, and there are actually proponents of making it a criminal matter because then these folks would get actual representation in court.
Second, even if being in the US without the right to be in it becomes a criminal matter, you are still innocent until proven guilty. There are thousands of people who may not be able to produce evidence that they have a right to live in the US.
What Switzerland does has no place in this discussion either.
Anyway now that you know illegal is a factually wrong term, are you going to stop using it?
The word “illegal” applies to both civil and criminal matters. The presumption of innocence doesn’t apply to civil matters. More importantly, labels generally refer to actual facts. You can talk in general about “speeders” or “shoplifters” though obviously the police would have to prove any individual person accused of those things was in fact doing so.
> What Switzerland does has no place in this discussion either.
Why?
I'm from EU; most countries here will require you to go through some legal process to become eligible to live and work there if you're from outside of EU. This is absolutely normal and expected.
Your argumentation is not only wrong, it would be impossible to maintain peace if crossing the border without any authorization was allowed. Can you imagine the number of Russian spies and saboteurs Poland would have to deal with if the borders were just open to everybody? It would be lunacy to allow that.
> Anyway now that you know illegal is a factually wrong term, are you going to stop using it?
It's not factually wrong. In most places in the world it's literally illegal to cross the border without a visa or other permit. You will get detained and expelled for doing that; and for a good reason.
That you might not like it and prefer to call it some other term doesn't change anything.
Russian spies are literally already within the American political system.
We weren’t able to stop spies during the height of the Cold War. We won’t now. Emotional arguments that point at a random unsubstantiated threat doesn’t actually help this discussion.
Switzerland isn’t relevant in this discussion because we’re talking about the US. They’re not nearly in the same situation or league to be compared.
And again, illegal is really mainly for criminal matters. Not civil. You can keep using whatever word you want but calling it a conspiracy that “big media” is doing is just plain wrong.
It's amazing how you avoid all the points I'm making. I've been in discussions like this too many times. There's no value in dragging it any more at this point. Thank you for your comments, but I'd rather put my energy into more constructive discourse.
Paradoxically there is probably no other developed country where finding work as an un undocumented illegal immigrant is easier than in the US. While immigration laws there are very strict by western standards.
How are you going to have “more worker rights” when your workforce is desperate, poorly educated immigrants who come from countries with no labor or workplace safety protections? Counter cutting is a custom business—these aren’t mega corps you can easily regulate. Did you know that this was even a problem until you read this article? Do you think do gooders can be everywhere to observe this sort of thing and bring it to the authorities? Do you think legislators are going to care about this issue when it only affects undocumented immigrants who can’t vote? (Or are you suggesting that people should be able to vote the minute they come over the border?)
There is a deep and fundamental link between having a native born workforce that is educated in this country and socialized to expect certain minimum standards, and the ability to legislate and enforce increased worker protections.
They already have legal protections for this. The problem is the workforce is poorly educated immigrants who, who are fleeing desperate circumstances and have different expectations compared to native born Americans. They’re much less likely to strike to demand better conditions when they’re just grateful things are better than in back home.
I'd like to know as well. When my parents remodeled their kitchen they got some kind of simulated granite aggregate made of recycled material that I believe was fully heatproof and held up very well over the years. But did somebody get silicosis in the process?
They might have, you have no way of knowing whether the factory in which they were made used PPE or not. If they were cheap, probably not, if they were expensive, maybe, or maybe the manufacturer was just pocketing more profit.
Most of these aren’t made in a “factory.” Because countertops are heavy and pretty much all custom sized and shaped, they’re being made in small scale local businesses.
Or why pick any straws unless you have a medical condition that prevents you from just drinking.
We typically order water to drink in restaurants and when it gets to the table, the servers almost always toss some straws on the table. If we say we don’t want them or if we mention when ordering that we don’t want straws, we get looks like we must be some weirdos. Why automatically push straws for everyone?
Only time I want straws is when the drink is too thick to drink by tipping the glass. Like chocolate with quite alot of cream as decoration or some smoothies. Soda with too much ice crush ... just have too much ice.
I find it quite strange for adults to drink with straws. It is a child thing in my world.
This is basically cultural. In my home country straws are basically something small kids use. There are just a few beverages where a straw really adds some value, like some alcoholic drinks with plenty of floating stuff and milk-shakes.
If anything, straws make some stuff TOO easy, like drinking loads of soda while driving, and this is not good for you.
I think that a lot of problems could be solved by people just consuming less of some stuffs, instead of trying to find a technical solution to the present problems of consuming some of that stuff.
It seems that the synthetic stone is not the cause, but highlighting the problem: poor enforcement of safety standards and inadequate PPE provided to workers.
Just because there's more silica doesn't mean that it's suddenly unsafe whereas cutting granite is safe. Even drywall or cutting concrete you're supposed to wear PPE.
It never leaves your lungs though. In the last 20 years we went from "dust masks are for wimps" to "wow not wearing PPE is terrible". One small silver lining of covid is that even relatively oblivious home owners even wear PPE for small projects now. Smoking OR inhaling large amounts of dust might not kill you, but both are bound to make you miserable later in life. There is already a steep drop off in lung cancer deaths, peaking in the early 1990s. Right now we're down to about 1930s level despite having nearly triple the population.
You can buy a cheap yet very comfortable 5000 or 7000 series respirator from 3M for about $20 and the "pink pancake" P100 filters are another $12. If you're a hobbyist those ought to last you a year, maybe even 5 depending on what you're cutting. I do metalwork as a hobby and I can definitely feel it in my lungs (and taste it) the next day if the garage door is shut and I forgot to wear the respirator.
Cutting cement boards with a diamond blade is pretty god-awful for your lungs. On the order of few years.
Effects depend on the particle geometry.
But as a general rule of thumb: if it's biologically inert and tough enough to stick around for awhile... it'll just stay in your lungs. E.g. fiberglass, cement, rock, paint.
I wear a respirator a LOT more these days than I did when I was younger.
A friend is in the countertop business in Florida. We just transitioned his shop to primarily rely on refurbed FANUC robotics performing the heavy lifting and cutting ops to prevent these health hazards (as he’s the one doing the cutting). Work areas are operated in lazy negative pressure with work atmosphere filtered prior to exhaust out of the building.
Regulation is the only way to prevent labor from being treated as disposable by these businesses, regardless of the status of these workers.
The materials are a second order effect. Undoubtedly breathing granite, soapstone or whatever dust isn't good for you either. Maybe it just takes longer to kill you.
Isn't soapstone closely related to asbestos? I'd expect it to produce the same type of powder that makes asbestos so dangerous (and on top of silicosis it can give you mesothelioma)
I think the issue is that people are opting for "engineered stone" over wooden laminate which doesn't have the same issue.
So whether it is engineered or natural stone the problem is that stone cutting has dust that needs to be dealt with. But the emerging issue is that with the rising popularity of engineered stone, a higher percentage of countertops overall are hazardous to cut.
Anything that contains silica... which includes concrete, practically anything stone based. This has nothing to do with this material being particularly dangerous above and beyond what is expected with any material cutting. You should not be cutting anything at the industrial scale without proper PPE.
Definitely an OSHA requirement, but there's no guarantee that 1) management supports the necessary supplies, checks, reminders, actions, etc or 2) workers want to wear the respirators/masks in general. On top of that, inspectors may be instructed (depending on inspection management, training, etc) that the water based dust suppression is good enough. Even if they want to see masks, management and workers may only implement them during inspections. Adherence to rules is necessary for rules to do anything anywere, ever.
Even though there are whistle-blower protection laws, they aren't good enough. No-one should fear risking their job when they stand up for their own health.
Management on the other hand should enforce masks as a means to avoid liability.
What should happen is if someone sees it they call 911 and the cops show up. Followed by the county permit inspector. And then the owner gets arrested and the job site shut down for 6-12 months. Seriously that's what happened at friends workplace when an electrician got fried working on a live 440 volt panel. Don't see why a counter top shop should be treated any different.
A key insight into things like this is that many regulations are like speed limits: loosely enforced. Sometimes because it is too hard to inspect every shop handling dangerous materials.
In cases like these you have to ban the dangerous material, or essentially kill the market for the products that use it.
BTW, I'm not sure how solid granite, soapstone, marble, etc. would be any better. Maybe my 30 year old totally fake Corian is back in style. But for the microplastics from scrubbing it?
The silica content varies significantly based on the stone being cut. Engineered stone is apparently like 90%+ silica, with the rest being binders. Granite is apparently ~10-45% silica, while marble has a negligible amount.
The pamphlet said that in one study, a marble shop performing dry grinding (no wetting, nor other engineering controls) had airborne silica levels of 39-45 ug/m3, while a granite shop which also did not use engineering controls say 89-460ug/m3.
Have you ever wore a respirator? Not a mask (which all already uncomfortable to wear all day), but the full respirator which is what is needed for this dust. I've done it for an hour when working with chemicals (different filter from dust, but otherwise the same) and I was glad to get it off.it is hard to blame someone for not wanting to wear them all day. They still should.
If you need to wear a respirator all day i'm told the most comfortable is an air supply and dragging a hose behind you.
I have a wood shop, I wear a respirator constantly unless I've got the doors open and the fans on and I'm not going to be doing more than a one-off cut that afternoon. A properly fitted 3M 6800-series full-face respirator is pretty comfortable even for long periods and while wearing glasses. A 6200-series half-mask is even more comfortable, though a little awkward with glasses.
The only problem is that a 6800-series costs $200, plus probably $30 a month in P100 cartridges given the level of particulates in the air, and that's more than these companies think their workers' lives are worth.
Wearing a respirator mask is substantially more pleasant when you're just farting around your hobby shop (and only when the temperature is pleasant or cool), than it is when you're actually working at a productivity level expected of laborers, with heavy stone, in an industrial workshop, no matter the temperature and humidity.
Try spending an hour in your shop constantly lugging heavy tools and wood around wearing that respirator on a humid 80 degree day, then you can be smug and waggle your finger at laborers for not protecting themselves.
FWIW, I'm not a professional, but I've worn a full-face respirator while spending entire days working in extremely hot crawlspaces, demo'ing and removing heavy antique cast iron drain pipe, running a wet saw for large-format tile, etc.
I'm just one datapoint, but my assumption would be that if it's truly too much of a burden, their employer should be buying better respirators and/or filters.
I mentioned the wood shop because I have expended considerably more energy in that shop and also in researching how to do so safely, but I've owned a property management company and personally I've done two house remodels where I did most of the demolition (and most things that weren't framing or plumbing) myself. I don't like to do it, but I am no stranger to spending hours at a stretch working in a half-mask, over my head, in Some Weather, in crawlspaces, attics, and basements.
Yes, I'm extremely fortunate that I can pay for help when needed, but I do quite a lot of my own work. So, if you're going to invent a guy to be mad at, maybe you should pick a softer target.
I've got a 3M full-face respirator as well, and I agree. I've worn it with P100 filters for 8+ hours (minus breaks to drink water) doing hard work in uncomfortable conditions many times, and never found the respirator to be a burden.
They're a little pricey up front, but I figured it was cheap overall compared to the long-term costs of using something less effective. Having eye protection integrated as well is ideal, since it never fogs up.
I got one of their FF400 face shield respirators to do lead paint removal and spent dozens of hours in unconditioned spaces with a tyvek suit. They are extremely well designed and never fog because the inhaled air passes first through the face mask area and then through one-way valves into the mouth/nose section and is exhausted downward at the front of the mouth/nose area.
I used it during the beginning of COVID to protect myself up until I was vaccinated and went for about 18 months before getting infected. Definitely got some odd looks at Costco.
Maybe you are meaning for medical staff? Yeah there's a fully unfiltered exhaust stream blowing downwards.
I too am a proponent of proper half face respirators (7500 here), and they are quite comfortable compared to the various disposable solutions, but I'd still acknowledge that wearing one does carry some discomfort. Not enough to make me want to get silicosis instead, but also not so little that I can confidently say I'm happy wearing it for 8 hours.
What's your solution for the full face with glasses? The spectacle kit looks like it's a frame that you need to get custom lenses put into. The few times I've worn mine (FF-400) I've just suffered the extra ear pressure, but it's not great. It's also a size too small because it was what was in stock at the start of Covid when nobody knew wtf was going to happen, but I don't see that increasing one size would change much. I plan to eventually trying to form a custom thing to hold a regular pair of glasses.
And have you really found the P100 cartridges need to be discarded every few weeks? The only things I've found say that particulate filters only need to be discarded when they become difficult to breathe through, and I've never actually reached that point.
how big do you have to be to get an actual OSHA inspection? I've worked in lost of small and medium shops of various kinds and the local fire department will show an interest sometimes, but I've never heard of anyone getting involved with OSHA for any reason.
They do, just like the ATF requires all sorts of record-keeping for gun sales and the EPA has rules about disposal of chemicals and the IRS has all sorts of tax regulations.
However, all three organizations have been subject to decades of budgetary cuts/freezes/criticism by republican lawmakers and thus have a fraction of the inspectors they should.
The way republicans have functioned for a few decades (after realizing that legislatively trying to kill the ATF, EPA, OSHA, etc is unpopular) is to hamstring the budget for those departments, tie up leadership appointments as much as possible, and then in hearings shout about how ineffective the agencies are.
It's like starving someone and then criticizing them for being lazy and inactive.
The same technique is used to attack social services. WIC, a food stamp program for mothers with infants and children, requires yearly "certification" which involves in-person interviews at offices that few and far between, often not public transit accessible, and so on. How is a mother who is so poor she needs WIC (and thus may not even have a car) supposed to afford to take a day off from work and travel to an office so someone can verify that her child still exists?
Compare that to other government programs that benefit the wealthy and corporations. Do people writing off luxury cars, entire homes, and bizjets have to show up at a regional IRS office (annually) to have their records audited, proving that the luxury property is actually being used for business purposes and they're entitled to a writeoff (or being given use of said property without paying taxes on it)?
I have had things cut for me and I find myself begging the workers to wear ear pro, eye pro, air pro, and they invariably smile, nod, and work without it. Even if I point out the protective gear sitting near the work area. I too was young once. Now I wear the kit.
This is both a collective action problem (people not using the right gear will be faster and cheaper than those with, meaning bad behavior outcompetes good) and an information asymmetry problem - workers are usually not fully aware of the problems they're creating for themselves.
Also people don't think they care. In high school one kid told me 'I don't want anyone to wipe my butt when i'm old, so I'm going to commit suicide at 50, therefore my smoking isn't going to harm me'. He is now approaching 50, I wonder if he still thinks that, but I haven't seen him since.
The company is to blame. It's law to wear protective gear in many legal jurisdictions, and that 100% means the company is liable, if it does not actively enforce, and create a "culture of safety".
Exactly. In general companies don't like OSHA hanging around. They'd rather run fast and lose even if it costs a finger or two. Enforcement of the law is how get compliance.
The point remain here: The workers are the ones choosing to not use the safety gear, in some cases.
I was the safety representative at a previous job. Management care a lot about safety and provided everything required, and high quality gear as well. Still people would cut corners and not use the equipment because it was faster not to. These where people paid by the hour, they have zero incentive to work faster. If people work on contact however, it's easy to create an environment where speed is priorities over safety.
Where I live the company is responsible for safety, so if a worker decides to not use the safety equipment the company is liable, not the worker, since they must enforce their usage and check that the workers comply, and if not take measures (that include firing the worker if it refuses to use them).
Of course they made so because otherwise it would be convenient to the company provide the safety equipment and not enforce their usage, this way getting work done faster (and thus have more profit).
You see, in many industries when an employee/contractor doesn't wear protective gear they are walked off site by security because the controlling agent of the property doesn't want OSHA fining them.
There are plenty of people to blame, and there is plenty that can be done. This dumb ass "No regulations needed, free market will take care of itself" is how the rich put the poor or ignorant into early, terrible graves.
Realistically, protective gear (actually protective gear, not thin dust masks) is expensive. The workers cant afford it, and the businesses want to save the money.
There's some small margin of workers who have access to protective gear but don't wear it, but in reality for most workers it's the job of the company to provide it and train workers to use it.
Car mechanics have a few cultural things that lead to everyone buying a preposterously expensive box of their own stuff. First is theft (stuff walks away a lot) and second is flat-rate differentiation. Having the right tools can make a flat-rated job take much less time and thus incentivizes the mechanic to have their own tools, and still would even if the garage provided them.
Not saying it's good or right, but there are incentives that push towards it.
I worked in day labor for less than two days. Day labor is, needless to say, low-skill and high-turnover. But there are still dangerous jobs to be done. My job involved directing a wet-vac to pick up water, inside a store, while the other guy was grinding or something that needed to be wet down.
I am a nerd and my glasses were falling off from the sweat. I think I was wearing a pair of work boots which may be required. But the guy giving me orders on-site was not my employer. These clients are well-aware that day laborers may not be back tomorrow. So why give us durable safety equipment that costs money? The day labor office is my employer, but they may not be accurately informed about the safety requirements of the client and the site. They may require us to purchase safety equipment at own expense, but if we don't know what the site requires, or how long we will be there, that's an up-front expense we are unwilling to part with.
Day laborers are one step up from the guys hanging out in Home Depot parking lots, whereby they are legal to work in these United States, but can't get a job anywhere else.
So it's a 3-way tug-of-war of vagueness and parsimony, and it always just ends up being nod-nod, wink-wink, do the best you can.
If function is your primary concern, then the only material to choose is the one professional kitchens use: stainless steel. It won't be as good looking depending on your tastes, but it will beat most stones on other properties
What is the cost though? Is rust a concern? And of course, looks are a concern, but I imagine quartz is relatively cheap because many, many people can afford it.
It's not very expensive, though I can't give you a price since I live in a rental apartment. As for rust: not a concern with stainless steel, our kitchen is almost 20 years old and the steel countertop and sink still look immaculate. A bit of steel wool or polishing paste are enough to make it look like new. If it wasn't for the look I bet most kitchens would come with stainless steel countertops
If I, a factory owner, offer optional safety equipment that slows workers down a bit, but I also demand such high productivity that corners have to be cut - whose fault is it when the inevitable happens?
What if I, a factory owner, provide optional basic safety equipment costing $30 per person, but the mask makes the goggles steam up and the boots aren't comfortable? There's better safety equipment available for $300 per person - is it my fault for not buying it?
What if I, a factory owner, happened to start my factory by hiring macho tough guys who don't like wearing a mask, and subsequent hires learn that behaviour from them?
Generally I to listen to the craftspeople I employ on issues of safety because keeping them safe is the whole point of safety. But they and I have a shared responsibility to make sure, if they say the machine is actually safer without the guard, that they're right about that.
In my experience, most of what happens is that workers don't want to wear the gear because it's hot/uncomfortable and they're working really long hours and get tired and sloppy by the end of it.
I actually worked in such a factory, so this is based on direct experience, and what I saw was people cut corners mostly because they were tired after long shifts, though lack of comfort was also a factor due to the heat.
The employer did try to make everyone wear the gear and had inspections and most people wore most of the stuff most of the time, we even won a safety award at one point for going so long without any OSHA-recordable injury. But we weren't perfect and one day I helped bandage a guy who was airlifted after slicing his arm open in a really bad way, something the kevlar wrist protectors should have stopped.
So I would say that employers do try, to the limit they can, but all accidents happen during gaps. And the employees tend to have their own interests in comfort or cutting corners that sometimes conflict with their safety. More limited shifts and attention to comfort might help, but it's not always clear how to provide that.
You can still have things like the guy who got crushed by his forklift after rushing to dump a hopper of trash by doing something really dangerous while unloading it because he wanted to hurry and finish so he could go to his family for Christmas vacation. And it's not easy to stop that kind of thing, even if you do a lot of warnings and inspections to yell at people who don't do things right and pay attention to close calls.
It's common, when counting "days without an accident" and handing out awards and bonuses, to only reset the count for accidents of a certain severity.
After all, if you get a minor injury and you know getting treatment will cost your colleagues a $200 bonus, you might keep quiet about it and tough it out to the end of your shift.
To achieve a good culture of safety, you need to make the rewards for safety strong enough to resist the rewards for cutting corners - but you also need to make sure a guy can get a band-aid from the first aid kit or tell his boss about a trip hazard with no disincentives.
I don't think there was anything serious that didn't get reported. We never had to use anything beyond a single band-aid for non-recordable injuries that I know of and unless you want the office staff reporting every paper cut to OSHA, I don't think they were being unreasonable there.
If anything I'd worry more about the temperature of the floor or the number of hours worked, but it's hard when some people had second jobs or what have you.
I know a bit about the welding industry and and it’s a lack of education, macho attitude, bad habit “I know by smell/touch/sound that it’s going well” and of course management not making it mandatory.
Working with respirator is not the fun part of the day, for sure. And mask/gloves slows you down. But well being able to breathe and see at the end the day without the worst sunburn of your live helps ;)
According to this podcast, Cass Sunstein, co-author of Nudge, used his economist-oriented federal government department to delay and block legislated regulation related to protection for silicosis during the Obama administration. https://podcasts.apple.com/us/podcast/if-books-could-kill/id...
Jeez - Sunstein has such great work in legal scholarship, but I guess power corrupts?
Even more surprising to me was Sunstein and his wife Samantha Power attending Henry Kissinger's birthday party after Power previously published a book basically pinning 150,000 deaths in Cambodia directly on him. They knew this guy is basically a war criminal and still went to celebrate his birthday.
The US has no war criminals, because no court in the world would dare to prosecute Americans for war crimes, the ICC tried once, didn't end well for them. So relax, Kissinger is one of the good guys.
One strange thing the older among us are pretty sure to notice is how in average the tech industry worker moved from a quasi-hippie political point of view towards boot-licking default.
In the old slashdot times, such a comment would probably have +5 insightful badge attached, here in HN in 2023, it is downvoted to hell.
I was interested, but also didn't want to scrub through a podcast. Summary:
Cass Sunstein was the administer of the White House Office of Information and Regulatory Affairs. The OIRA is given the remit to review drafted rules (ie regulations) that various federal agencies want to enact. The OIRA is supposed to perform an external cost-benefit analysis of the proposed regulations. OIRA is suppose to turn around rulings in 90 days.
While Cass Sunstein was administrator (2009 to 2012), various pieces of regulation were submitted for review, and ended up being reviewed for ~3+ years. Examples include:
* Requiring rear-view cameras (submitted for review in 2011, regulation finally passed in 2014 with a 2018 deadline for compliance)
* The silicosis workplace safety regulations (as mentioned - submitted in 2011, finally passed review in 2013)
* Coal ash handling regulations (from the EPA) delayed from 2009 to 2014
For the specific case of silicosis specifically, it doesn't appear that the OIRA ended up blocking the regulation, though it certainly slowed it down.
It is worth noting that these delays continued after Sunstein left office, and there's certainly evidence of OIRA significantly delaying review processes prior to Suntein's term as administrator.
Thank you for collecting this. A couple years to draft & study some proposed regulation doesn't seem that heinous to me. It would make sense to not hastily publish a regulation that will last decades without really considering it and its effects well. They can be a source of lawsuits, and I would assume, you want it to be effective which can take some study.
The refusal of politicians to mandate motorcycle helmets for car drivers and pedestrians needlessly increases the number of humans dying as well.
Since the article is referring to "83 cases among countertop workers identified across the state [of California] since 2019", it's almost certain helmets would save more lives than anything you do about engineered stone. So what's the excuse there?
There are already regulations requiring ppe and ventilation that aren't followed, they are already dying despite regulations.
I'm not saying that we need more delays. I'm also not saying that there isn't room for more regulation here, but just slapping any poorly considered regulation down may not solve the problem.
These are regulations that have already been studied extensively at the agency level. OIRA’s cost-benefit analysis is a second layer of review on top of that.
It’d be interesting to see a cost-benefit analysis of OIRA’s cost-benefit analysis. All the delays aren’t free.
~5 years ago I had a quartz countertop installed. For the final install, the workers were out in the front yard making some final cuts. My 10yo son comes out to see what's going on, looks at the giant cloud of dust, says "Silicosis ain't no joke" and goes back inside.
Not long ago, we had our countertop replaced (from quartz to granite). They ended up having to make a cut in it while it was sitting in our kitchen. Our home was in a cloud of dust for several hours, and when the dust finally settled a day later, every surface imaginable was covered in dust.
I’m pretty sure none of them wore masks when doing this. I honestly didn’t think to wear a mask either (since they weren’t and never really even warned us how bad it would be), but fortunately we were behind closed doors most of the time the particles were in the air.
Fortunately it was a granite countertop and not quartz. But I still can’t imagine that stuff is good to breathe on a recurring basis, and it still amazes me that they were fairly casual about the whole thing.
My guess is the industry just isn’t educating workers about the risks.
> Fortunately it was a granite countertop and not quartz.
Granites are primarily composed of feldspar and quartz, which are both primarily composed of silica. Silica is the thing that causes silicosis, and when that granite was cut it was clouds of silica dust that covered your home.
You were no more safe in that granite dust than you would have been in quartz dust.
Not sure I agree/understand, but it seems like if I’m inhaling 2x the poison over the same amount of time, that has exactly 2x the impact/risk on your health.
This isn’t the same as something like a virus, where it’s more binary.
To be clear, I’m not arguing to prove I’m right (because I’m certainly not an expert and am open to being wrong), I’m trying to understand more about how particle inhalation can have varying risks (or not) based on density.
TFA article says the stuff gets in your lungs and stays there. Are you trying to figure out whether you should wear protection for x% silica containing materials? Seems like a fool's errand.
Not at all, I actually wear a mask when just sweeping the garage. :) I certainly think there should be regulation requiring masks in industries like this — and I will definitely wear a mask the next time I’m around any sort of countertop dust.
I’m mostly just curious about the science, and whether/why it is more binary than I’m understanding, vs. just taking some random HN strangers’ words.
Silica particles won't disolve in water, it's like breathing broken glass, and that's the main problem not limited to silica, but breathing ANY particle that harms your organs.
Lots of things don’t dissolve in water but are still effectively contained by water. That said, I wonder what happens to the water being used for this purpose. If it isn’t treated/disposed of somehow, I could see it evaporating and allowing the dust to become airborne again. If this is in a permanent shop environment, it might explain the apparent lack of effectiveness of this solution.
When I do sand blasting a have a little box I do it in. With windows. I wonder why they don't have such an arrangement for the bench cutting. No matter the health hazard, it doesn't sound economical to cover a whole kitchen in dust for a two feet cut.
I bet there is a product that could be used, however I'm sure the installers think it's "just one more thing to carry around" when the faucet hole cut only takes a few minutes.
Sure, but is only more work to carry around the cover-thing, if you don't have to clean up the mess.
I quick search on Amazon for "Stone Cutting Dust Cover" gave plenty of cheap looking clear plastics covers with a hole for a vacuum cleaner. I bet there are pro variants available of those.
surprised they cut it dry. i just had to add 2 holes to my granite countertop. used a “well” guide that also has water in it. it’s meant to keep the cutting edge cool but also there was no dust to speak of
Don't worry about it. You were exposed to a very small amount a single time. It's the repeated exposure day after day that kills people. Saying that, yeah it's not nice. But the single exposure to dust isn't going to hurt you.
Not surprised. Back in my artist days, the studio I rented was in a building with a countertop business on the first floor. The extent of their safety measures were blowing the dust out into the back alley. Most workers rarely, if ever wore masks, and the inside of the shop was absolutely covered in dust. The dust would make it up to me on the second floor, everything in my studio would accumulate a thin layer just a week or so after cleaning.
Wasn’t great but the rent was cheap, until it wasn’t
> everything in my studio would accumulate a thin layer just a week or so after cleaning
I wish I ONLY had to clean the surfaces once a week.
In my country and city unfortunately -- even though I dont live near a major road or construction site -- dust is everywhere. Within 24 hours or less of wiping clean, you can see a visible layer of dust on any horizontal surface in home.
What I find interesting when comparing the US the Canada on topics like these is that in Canada, there is self-interest in demanding workers be protected. Like beyond the fact that it's a good thing you do.
Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher.
There's incentives for our government to protect workers from risks that will cost a fortune to fix.
In America, there's only the "because it's the right thing to do" reason, which is never enough for anyone to actually do anything.
Medicare for the elderly, but we also have Medicaid for people in poverty (< $15k/yr income for a single person w/o a family) which covers most basic medical/dental/ vision needs and is taxpayer funded.
Someone taken out of the workforce may qualify for that if they don’t already qualify for disability insurance or similar payments (although I’m not 100% clear if those are funded via private disability insurance or public programs)
First, Medicare pays a lot more to healthcare providers than Medicaid. Medicare pays more for more medications than Medicaid, and has fewer prior authorization requirements for those medicines. Fewer providers will accept Medicaid, and people using Medicaid will receive less or worse healthcare than those in Medicare.
Second, Medicaid is administered by each state, and there is a lot of variability on how easy the state makes it so people can actually get healthcare. Lots of states straight up refuse money simply to punish people of a certain socioeconomic class because it happens to win votes.
Bottom line, Medicaid is so leaders can claim they are helping poor people get healthcare AND keep taxes low. Medicare is for actually delivering healthcare to people because that contingent makes up a huge proportion of votes.
And yes, even Medicare is not delivering all healthcare, as it has multiple tiers to deliver differing amounts of healthcare to different socioeconomic classes.
The most obvious point: if they were equivalent programs, we would just include people under the poverty line with Medicare. Instead, we have a completely different program, managed by different people with different goals. Down to its very core, Medicaid is a political football.
Exactly, I guess my comment could have been much shorter.
I love how there is even an Additional Medicare Tax. The political lines in the US are very much old v young, but some of the young, especially politically active ones, vote with the old since they are among the wealthy young, and the rest do not participate enough, or do not have sufficient knowledge about how resources are being meted out and how they will be affected now and in the future.
Since the examples are in CA, there is Medi-Cal for those who are too poor to buy subsidized insurance and it’s not age-related unlike Medicare. It’s an expanded form of Medicaid. I’d bet CA taxpayers do shoulder the costs if the victims know to apply.
Incidentally this is also why everyone working in a nation has to receive these benefits (and any others guaranteed to citizens), otherwise you get migrant workers who suck up this, quite literally in this case, but don't receive healthcare.
Only illegal migrants aren't covered, legal ones are. If you make it available to everyone regardless of their legality to be on the soil you open up a whole bunch of other issues
You can either provide social benefits to your country's poor or you can have open borders. If you try to do both at once, you're providing social benefits to the world's poor, and the amount of benefits you can provide from a given tax base falls through the floor.
Your ancestors genocided the whole continent, if anything that argument is against what you advocate. We're not in the 1700s, people can travel more easily, information travels instantly, what worked 300 years ago doesn't necessarily works now.
I'm all for helping people but you cannot import the world's misery and expect it to be smooth, first because it doesn't solve anything, second because it just doesn't work from a simple demographic point of view.
Canada largely avoids this problem by not allowing a subset of illegal people to exist in the country. Canadians are polite, but working in canada without some sort of legal status is far harder than in the US. They have lots of immigrants, but vanishingly few illegal ones in comparison to the US.
> Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher.
The taxes part is the same; only the healthcare half is different.
Not agreeing/disagreeing with this you but I wonder how you feel about obesity tax ? Low physical fitness tax ? There's plenty of evidence that exercise and diet significantly impact health (especially on population level) - like you said there's an incentive to keep those people healthy contributors instead of chronic burdens on the system. Sounds like a logical extension but doesn't seem popular/implemented widely.
I feel great about slapping a tax on the profits of companies that sell highly processed, sugary, addictive foods so that the market selects for healthier alternatives.
Maybe subsidies for selling fresh fruit and veg also.
I guess you could tax their victims instead though... they don't have a lobby so theyre probably easier to take advantage of.
When you live in poverty and have no prospects for the future. Some mass produced cake from the supermarket might be the only thing keeping you together. As soon as the work of the laptop class is automated by next generation agentic LLM's, you will probably understand.
> As soon as the work of the laptop class is automated by next generation agentic LLM's, you will probably understand
Coming any second now, right behind robotaxis, with the only difference being that robotaxis will probably actually happen within the lifetimes of the current “laptop class”.
We aren't talking about cake though. We are talking about inexpensive highly processed foods made predominantly from ingredients that are subsidized specifically because of their caloric density. I.e. corn.
High caloric density is what you want if you need to be able to feed your country in war, so we subsidize these foods.
No one wants to eat just plain corn though, so companies process it into other foods that are then sold cheaply because they are receiving these large subsidies.
People end up consuming large quantities of these foods because they are cheap, and our brain reward centers a pre-wired to love lots of cheap easy calories.
Knowing all of this, it makes perfect sense to tax the living crap out of highly processed foods that are made from subsidized ingredients. You're just taking back the subsidy you put there in the first place, and shaping consumer behavior for the greater good (which is a common use case for taxation).
> Knowing all of this, it makes perfect sense to tax the living crap out of highly processed foods that are made from subsidized ingredients.
The consequence of this would be that the subsidized food gets exported to a country that doesn't tax it, at which point you're subsidizing some other country's food.
The US is also a large net exporter of food, implying there is more than enough domestic production for wartime needs. Also, the US hasn't been in that kind of a war in almost a hundred years and MAD makes it unlikely that it ever would be again. The obvious conclusion is to eliminate the subsidies.
>The consequence of this would be that the subsidized food gets exported to a country that doesn't tax it, at which point you're subsidizing some other country's food.
If theyre smart they won't take this shit either.
Nice of you to let Americans sacrifice their health on $othercountry's behalf though.
>What do you suppose the chances are of 100% of other countries imposing a similar tax
Quite high. Agricultural dumping is typically frowned upon even more than regular dumping. Half of the reason for the WTO's existence was to get countries to stop being so trigger happy about doing this.
You think the chances are "quite high" of all other countries doing this? There are several countries that inherently have to import food because they don't have enough arable land to feed their population.
Yeah, and they already buy plenty of shit food from America. They aren't going to buy more oreos to these countries just because America can't sell them to America any more.
But of course they are, because the price of that food would go down. If it's still being produced because it's still being subsidized but Americans stop buying it because it's punitively taxed, where do you think it goes?
Taxing junk food seems pretty challenging politically, considering that businesses hate it as you're taxing their junk food, conservative voters hate it as government nanny state, liberal academics hate it as a regressive tax and a thing that lessens support for actually removing the subsidies, and anyone paying the tax hates it as a tax they have to pay.
At least for removing the subsidies you only have to fight the businesses.
We are Calvinists down here, so bad people were always predestined to be bad and they deserve to be punished. Corporations making money must have be good because they are succeeding, so why would we hurt them?
I will never be punished for being over- or underweight since I am good. The universe would have to be broken for me to be taxed.
What about all the other harmful activities? Recent studies about alcohol usage shows that even small amounts can be much more harmful than previous estimates. In addition to the health issues, we also need to consider all the accidents and violence that is connected to drunkeness.
Alcohol is not only heavily taxed in Canada, but most provinces also have a monopoly on selling spirits. That's right, the gov is selling the booze, pocketing both the tax and the profits.
This is based on the assumption that sugar causes obesity - I don't think there's any strong evidence for that, or that low carb diets work better for fat loss than low fat, from what I've seen both have same effect (calories equated) and both have equally terrible long term adherence/outcomes. Sugar seems like a nice villain but it's more likely that you'd have to tax any high calorie food that tastes good.
Fair enough, guess my problem would be that since these things would be implemented by politicians it would end up being driven by fads/popular opinion, and without strong evidence (of which there's very little) you'd essentially be conducting population level experiments even if you wanted to be scientific (eg. food pyramid to the extreme)
Last I checked, Canada doesn't share a border with Mexico and some portion of these Latino "day workers" are illegal immigrants. Day workers are often paid under the table and when I have read other stories about them, they tend to include medical horror stories like "So, this guy cut 3 of his fingers off and they didn't even take him to the ER. They just returned him to the place where they had picked him up."
This is not exactly the best use case for arguing about Canada versus US healthcare policies.
> It's simply not politically feasable to say, "Without immigrants, our economy is f'ed."
And yet, that's what politicians in Germany are saying: "Denn Deutschland braucht sie dringend: Durch die seit Jahrzehnten sinkende Geburtenrate gibt es auch weniger Arbeitskräfte. Diese Lücke konnte lange über Zuwanderung aus dem EU-Ausland gefüllt werden. Doch inzwischen reicht das nicht mehr aus." (https://www.spdfraktion.de/themen/neustart-migrationspolitik, the social-democrat representatives in Parliament)
"Because Germany needs them urgently: Due to the declining birth rate for decades, there are also fewer workers. For a long time, this gap could be filled by immigration from other EU countries. But this is no longer enough."
> its how they partially make up for a declining birthrate.
To the detriment of their origin countries who suffer from losing their best and brightest. How "Northern countries exploit the South again" is a (rather quiet) talking point that I believe will become louder in the future.
Canada doesn't have a border with Mexico, but it does have its share of undocumented and under-protected workers.
> While there are no accurate figures representing the number or composition of undocumented migrant population in Canada, estimates range between 20,000 and 500,000 persons
> Research suggests most undocumented individuals live in large urban centres and typically work in seasonal and informal sectors, such as construction, agriculture, caregiving and housekeeping.
> Undocumented migrants are a vulnerable group due to their lack of immigration status, as was seen during the COVID-19 pandemic. They have limited access to health care, social services or employment protections.
Until this year, asylum-seekers could transit through the United States into Canada under the Safe Third Country Agreement, by crossing the border at an irregular crossing like Roxham Road.
On a per-capita basis that's not hugely different, but one of the reasons may be that Canada provides a somewhat easier path, relative to the United States, to becoming a legal immigrant rather than remaining undocumented.
Relative to Canada the United States is even more difficult to legally immigrate to, consider that the US system has been constantly adding ever increasing hurdles to legal immigration for ages.
Canadas temporary foreign worker program means you don't need to illegally hire day workers, you just keep the wages low enough that nobody will take the job and then tell the government you need to bring in foreign workers - not for professional or technical work, not for picking in the fields, but for working at McDonald's and tim Hortons.
They also allow international students at diploma mills to work 40 hrs a week, above the table.
>What I find interesting when comparing the US the Canada on topics like these is that in Canada, there is self-interest in demanding workers be protected. Like beyond the fact that it's a good thing you do.
Is there any evidence of this? That the Canadian Gov cares more about workers than the US Gov?
>Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher.
What evidence do you have that this is the case?
>In America, there's only the "because it's the right thing to do" reason, which is never enough for anyone to actually do anything.
Is this your opinion or is this the reality. I don't know if you have ever walked by a construction site in Toronto to see guys cutting cement or stone. None of them have masks. Sometimes they will have a wet saw when cutting cement on the street but that is to reduce dust for traffic and pedestrians and not so much for their health. The Canadian Postal Union fought the Federal Gov for years to provide an environment where paper dust was considered a health hazard and workers need to be protected. Many postal workers suffered from COPD because paper dust was too fine for the Lungs to filter. What about farmers and dust? I'm sure they suffer just as much as American farmers.
I've come to realize Canadians suffer from an inferiority complex and have to constantly try and make comparisons to make themselves feel better, it's a strange phenomena.
Perhaps unexpectedly, people dying are usually _cheaper_ for a healthcare system than healthy people. This has been studied a lot with smokers, basically people in old age cost far more than young people and thus a true cost-minimizing system would not be how you expect. Of course, we aren't trying to minimize cost so the premise is flawed.
From a cost perspective it’s best that people die suddenly. If I live a fairly healthy life into my 80s and die of a heart attack, I might not necessarily have cost my insurer that much, as opposed to if I suffer from a chronic illness for 10, 20, 30 years.
Cancer is now usually not a sudden death sentence - treatment is good enough now that most cancers caught early can be treated and patients often go through multiple remissions before it or a complication from treatment finally gets them.
Insurers very much do not want their customers getting cancer, because it is invariable an extraordinarily expensive condition to treat and treatment can go on for years.
> Cancer is now usually not a sudden death sentence - treatment is good enough now that most cancers caught early can be treated and patients often go through multiple remissions before it or a complication from treatment finally gets them.
Small clarification - early detection is most often curative and cheap.
The really expensive part is that several advanced stage cancers (even IV with widely disseminated metastatic disease) now survive for many years on treatments costing low to mid 6 figures/year.
It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law.
> Small clarification - early detection is most often curative and cheap.
> It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law.
The evidence in favor of mass screening programs in the hope of early detection is actually weak to non-existent [1].
> In total, 2 111 958 individuals enrolled in randomized clinical trials comparing screening with no screening using 6 different tests were eligible. Median follow-up was 10 years for computed tomography, prostate-specific antigen testing, and colonoscopy; 13 years for mammography; and 15 years for sigmoidoscopy and FOBT. The only screening test with a significant lifetime gain was sigmoidoscopy (110 days; 95% CI, 0-274 days). There was no significant difference following mammography (0 days: 95% CI, −190 to 237 days), prostate cancer screening (37 days; 95% CI, −37 to 73 days), colonoscopy (37 days; 95% CI, −146 to 146 days), FOBT screening every year or every other year (0 days; 95% CI, −70.7 to 70.7 days), and lung cancer screening (107 days; 95% CI, −286 days to 430 days).
There are large institutions, both nonprofit and commercial, which stand to gain by convincing people that mass screening is useful and important. The available scientific evidence does not support their position.
You’re looking at the wrong metric and misinterpreting the stats, not only is overall survival not a good metric for cancer screening none of the studies are sufficiently powered for OS.
What you want to do is look at stage at presentation, treatment costs by stage, and screening costs. These were done for nearly every recommended screening program.
The available evidence behind currently recommended screening programs unequivocally shows improved cancer-specific survival and earlier stage at diagnosis.
I'm going to strongly push back on both (1) the notion that overall survival is the wrong metric and (2) that I'm misinterpreting something, given that I didn't really offer any interpretation at all. I just cited a paper.
> What you want to do is
No, what I want to do is assess whether broad screening programs actually make people live longer. Overall survival is the correct metric. Evidence in favor of the claim is lacking.
> none of the studies are sufficiently powered for OS.
"Sufficiently powered" is relative to what size of effect you want to detect--which you haven't specified, so I'm not sure how you can make the assertion that none of the studies are sufficiently powered.
> The available evidence behind currently recommended screening programs unequivocally shows improved cancer-specific survival and earlier stage at diagnosis.
These outcomes ignore negative effects of screening on people who don't have cancer, which is why I'm not interested in them. And yes, there are negative effects, and no, they are not negligible.
> No, what I want to do is assess whether broad screening programs actually make people live longer. Overall survival is the correct metric. Evidence in favor of the claim is lacking.
Correct according to whom? If you want to choose only one metric quality adjusted life years is likely the best one.
While OS may be your goal that's not the primary endpoint of screening programs.
Some examples of why OS is limited: breast lumpectomy vs mastectomy and systemic therapy or polypectomy vs neoadjuvant therapy and colonic resection are both associated with very high morbidity that is very important to patients. The vast majority of patients care about quality of life.
> "Sufficiently powered" is relative to what size of effect you want to detect--which you haven't specified, so I'm not sure how you can make the assertion that none of the studies are sufficiently powered.
We do not expect any one screening program to have a large change on overall survival because there are many ways to die, very few studies are powered to detect the small differences expected. The reference below does some modeling and discusses cancer-specific vs all-cause mortality for your perusal.
> These outcomes ignore negative effects of screening on people who don't have cancer, which is why I'm not interested in them.
See morbidity discussion around delayed diagnosis above.
> And yes, there are negative effects, and no, they are not negligible.
As you're choosing to limit the discussion to overall survival, do you have any data to support the claim that screening has more than a negligible negative effect?
There is a better argument to be made for other harms of screening like cost and stress but if we want to discuss these negative effects of screening we also have to step back from overall survival and discuss morbidity benefits.
ETA:
> 2) that I'm misinterpreting something, given that I didn't really offer any interpretation at all.
This is your interpretation, and is an incorrect one:
> The evidence in favor of mass screening programs in the hope of early detection is actually weak to non-existent [1].
The evidence you cite says nothing about early detection and treatment paradigms.
> Correct according to whom? If you want to choose only one metric quality adjusted life years is likely the best one
By all means, if you have studies showing that broad screening programs are beneficial in terms of overall (not cancer-case only) QALY then please share them. I'm guessing you don't.
> As you're choosing to limit the discussion to overall survival, do you have any data to support the claim that screening has more than a negligible negative effect?
Do you have any data to support the claim that screening has more than a negligible positive effect on overall survival? (No).
Stop trying to put the burden of proving a negative on me. If you want to advocate for spending ten of billions of dollars annually (not to mention time and stress) on broad screening programs you bear the burden of demonstrating that's useful.
If we can afford to spend the money on screening everyone certainly we can afford to spend less money to run a large randomized trial screening only some people, but advocates of the screening programs won't stand for it because they are convinced of their own righteousness and refuse to admit uncertainty about whether the screening programs are actually doing more good than harm.
> By all means, if you have studies showing that broad screening programs are beneficial in terms of overall (not cancer-case only) QALY then please share them. I'm guessing you don't.
I gave you one.
> Stop trying to put the burden of proving a negative on me.
You're making the claim there's more than a negligible negative effect not me.
> Do you have any data to support the claim that screening has more than a negligible positive effect on overall survival? (No).
Did I say there is a sizable positive effect on overall survival? I said it's irrelevant.
No you didn't, you gave me a simulation study that discussed what kind of sample size might be necessary to find statistically significant effects in all-cause mortality. There's not a single mention of QALY in there. Please stop misrepresenting things.
> You're making the claim there's more than a negligible negative effect not me.
The cost itself is a nonnegligible negative effect.
> Did I say there is a sizable positive effect on overall survival? I said it's irrelevant.
You're wrong.
It's borderline fraud, in my humble opinion, to go around suggesting that massive interventions should be evaluated based on their effects only on the people who benefit most, ignoring the negative effects on the other 98% of the population. Which is exactly what you did in your first reply to me:
> What you want to do is look at stage at presentation, treatment costs by stage, and screening costs. These were done for nearly every recommended screening program.
> The available evidence behind currently recommended screening programs unequivocally shows improved cancer-specific survival and earlier stage at diagnosis.
This approach to evaluating an intervention is intellectually dishonest and emotionally manipulative. Any evaluation that does not take into account the other 98% of the population--through overall survival or QALY or some other metric--is giving an extremely biased picture of what the intervention is actually doing to the population as a whole.
What are the downsides? You're speaking nebulously about negative effects on 98% of the population without mentioning them.
Several screening programs like breast have been rigorously evaluated from costs, benefits and harms. I know very well what the negative effects are, do you? You haven't mentioned anything specific or provided estimates of harms yet you're the one making the assertion.
> You're wrong.
So if we're all wrong, what's the argument and where's the evidence without resorting to no OS benefit ignoring that this is again not the point of screening.
> It's borderline fraud, in my humble opinion
Your humble opinion disagrees with the entire medical community, including the study you initially cited. So we're all fraudulently screening for what purpose? You know that physicians don't collect billings or work fee for service in academic medicine correct?
> Which is exactly what you did in your first reply to me:
Did I say that was the only reason to screen and ignore the harms? I used that as an example of why overall survival is not useful as an isolated statistic.
You're the one who wanted to limit the discussion to one measure, I was pointing out the flaws.
Smokers specifically are very much a net cost to society, because smoking kills slowly and in a very expensive manner.
In any case, anything that makes people die young, or more generally reduces people’s capacity to work (like many diseases of affluence) is incredibly expensive to society once you factor in indirect and opportunity costs.
Do you have a reference for this? This was a weak hunch for me before but I always assumed I was wrong based on e.g. insurance rates. If insurance prices it higher, it must be more expensive to cover?
Canada worked to discourage and regulate smoking more aggressively around 20-30 years ago, and in 20 years we’ve gone from around 1 in 4 people smoking to more like 1 in 10. It steadily trends down.
I'm curious about how you got that impression. In Canada, smoking is down from 26% in 2001[1] to 15% in 2019[2]. (Cannabis consumption is probably trending upward though). I have no reason to believe that this decline is particular to the US and Canada. Japan has been trending down from 33% in 2000 to 20% in 2020[3]. I expect this will have accelerated since the government made a strong anti-smoking push during the Tokyo Olympics. In fact, this seems to be a trend across the entire developed world, see this chart[4] showing that cigarette sales per adult per day peaked by the 1980s in every developed country surveyed, and all have been trending downward for decades. The US shows up as exceptional mainly in how extremely high its cigarette consumption habits were in the '60s and '70s.
Ah, it was just a much larger shift in the US, especially demographically. It went from 44% of adults (stats not gathered on younger folks, but anecdotally it was ‘cool’ and a lot of highschool age kids smoked) to 13.8% for adults (anecdotally many quite old) and only 8.8% for younger folks.
Traveling outside the US to Europe or Asia (eastern/southern Europe or China in particular) it’s very visible, where in the US outside of a few locations it’s almost invisible now and notably uncommon.
Especially for educated or higher income folks, too.
> Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher.
The US healthcare system uses private insurance, implying that more use of the healthcare system raises everyone's premiums. And people without insurance then go to emergency rooms which are in turn still passing the cost onto private insurers. So voters already have the same incentive in order to avoid their premiums going up.
That incentive is obfuscated, though. Every insurer exists as an invisible boundary where cost is not passed to others.
On top of that, insurance is optional. There is no guarantee a person will get affordable care. That's the entire point of the system! If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system.
> Every insurer exists as an invisible boundary where cost is not passed to others.
How does that affect issues like this where an increase in overall costs would reasonably be expected to apply to all insurers?
> On top of that, insurance is optional.
More than 90% of the population has health insurance, which is well over the majority required to bring about legislation.
> If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system.
That certainly isn't true. Serious problems with the US healthcare system include AMA lobbying to maintain a doctor shortage, various patent laws and FDA rules that limit competition and increase costs and a malicious lack of cost transparency. None of that would be improved merely by routing the premiums through the government.
We already have the government involved - OSHA. Why would having it more involved be better if its current involvement is not solving the problem? It's pretty to think that the government has some sort of self-interest and if it can save money in the long run by spending money in the short run, it will do that. But that's not how things work, is it?
A more plausible conclusion from observing the results of an entity's involvement in something is that if it is incompetent with the thing you gave it to do, don't give it more stuff to do.
> if it is incompetent with the thing you gave it to do, don't give it more stuff to do.
When my code doesn't work, I don't sunset the code, I fix it. Why would the best course of action be to stop trying instead of fixing the root of the problem?
If your code doesn't work, it could be anything from a minor typo to a bad abstraction based on bad assumptions that requires a full refactor to get correctness and / or minimum acceptable performance.
About 90% of that scale requires sunsetting at least some of your code and doing something differently.
Canadian data is relatively poor quality (mostly from the 90s) outside of Alberta (I expect QC and BC probably have the highest rates) but historically and estimates are that we have slightly higher incidence than the US.
> There’s incentives for our government to protect workers from risks that will cost a fortune to fix.
There are many examples where this is inaccurate but let’s keep it simple and delve a little deeper into the silicosis problem presented in this specific study.
From the JAMA article:
Although a substantial number of the patients, including some of those who were uninsured or with restricted-scope Medi-Cal, likely had an undocumented immigration status, we did not directly collect information about whether individuals were undocumented immigrants.
Note that public health system in Canada is not “free”. Legal immigrants, documented workers, citizens and refugees have access to provincial or federal health insurance which pays for care.
Undocumented or illegal immigrants have neither (and also would not get WSIB which would be the payer for most silicosis cases) and actually have better coverage in California.
Additionally:
Ten patients (19%) were uninsured, 20 (38%) had restricted-scope Medi-Cal, 7 (13%) had Medi-Cal, 8 (15%) had private insurance, and 7 (13%) had workers’ compensation.
So 34/52 had some form of government provided or mandated insurance.
As an aside while restricted-scope Medi-Cal and uninsured rates are the surrogates for undocumented immigrants in this study, those over the age of 50 (or 19-25) are also eligible for full scope Medi-Cal but were not identified in this study. Medi-Cal will also be expanding in January 2024 to cover undocumented immigrants aged 26-49.
Even if we assume Canada’s silicosis incidence is lower, all of the above strongly suggests your public health system cost-savings incentive hypothesis is incorrect.
Perhaps you are unfamiliar with medical research but stating that available data is poor quality is an objective assessment. I provided a brief explanation in parentheses which you excluded for some reason.
I also provided a reference that is open access but here is the relevant section for you:
In Canada, there are no national data on the incidence or prevalence of silicosis. In the province of Alberta, where silicosis is a notifiable disease, health insurance data revealed 861 cases with at least one reported diagnosis of ‘silicosis’ during a period of 10 years from 2000. These results were based on raw data and not a secondary review of primary imaging and clinical information. Data from 2000 through 2009 showed that only 29 workers' compensation claims were accepted for silicosis in Alberta. Data from Quebec's compensation system revealed 351 compensated cases of silicosis between 1988 and 1998. Of note, workers who participated in regular surveillance had milder disease at the time of compensation.
The JAMA study is from 2019-2022. Data that is 20-30 years old is relatively poor quality.
Changes in medicine, workplace safety rules and occupational trends makes it hard to compare to silicosis rates in Canada to the US in order to assess the claims of the comment I replied to therefore I think the relative incidence described in this review article (from 2022) is inaccurate.
If you want to disregard my quality assessment, the discussion ends with the review article showing silicosis rates are 3x higher in Canada.
Can you elaborate on how any of this shows I have an axe to grind or that I’m biased?
Canadian here who believes our labour safety standards are generally better than the USA (based on anecdote and experience, not data).
Canadian data is poor quality. On any issue you might care to pick, the topic is better studied in the United States. I run into this all the time. For example, we make allocation decisions at a charity I volunteer at with, about what health problems unemployed LGBT people tend to have. We use data for American urban populations. The data doesn't exist for Canada, AFAIK. It's a smaller country! There's simply less research and statistic-taking done! It's a reasonable statement.
Besides -- commenting on the lack of good data usually implies the exact opposite of what you seem to think -- it is an admission by the poster that their argument is based on weak evidence.
> it is an admission by the poster that their argument is based on weak evidence.
Which is exactly why I limited my reply to a discussion about the California study and healthcare systems rather than reiterating the claims in the 2022 article I referenced which states silicosis incidence is 3x higher in Canada, based on 20-30 year old data.
Although I live in the US now I’m a dual citizen and practiced medicine in both countries, the only axe I have to grind with Canada is the harsh winters which are incompatible with my fragile desert descent body.
> Note that public health system in Canada is not “free”.
I'm enough of a pedant to annoy the fuck out of most anybody who knows me, but really? Look, there is no "free" health care anywhere, but it's a term that has (perhaps unfortunately) become widely used as a synonym for, depending on your sensibilities "no charge at the point of service" and/or "socialized health insurance and health care coverage".
And Canada is certainly one or both of those.
The metric "well, they don't provide it for undocumented persons" is a weird one, as is the use of California as a counter-example.
I think you may be “annoying the fuck” out of yourself here. Your reply is full of strawman arguments.
The comment I replied to asserts that the government incentive to reduce healthcare expenditures improves workplace safety, and consequently in the context of this article would have prevented silicosis/PMF in these patients.
I highly doubt most HN commenters are aware of whether undocumented migrants are covered in the Canadian system as they are in California, certainly the person I replied to was not, so I explain differences in coverage.
Consequently, the argument doesn’t hold water as the financial incentive for the government is stronger in California than in Canada as it relates to this study population.
> The metric "well, they don't provide it for undocumented persons" is a weird one, as is the use of California as a counter-example.
I'm not providing any counter examples, undocumented workers in California are the subjects in the article we are commenting on. Where in fact there happens to be socialized healthcare that you seem to think I'm arguing against.
It's not a gibe. I used scare quotes around free because it's obvious that a socialized system is funded by taxes, what's not obvious a bill is always generated during healthcare delivery in the Canadian system.
You yourself seem to not understand this distinction with your comment: "no charge at the point of service".
There is always a charge at the point of service and a bill is generated. The difference with the US is that the Canadian healthcare system, which also functions mostly privatized, uses a single payer model so the government is the only one legally permitted to pay for insured services. In other words, each province runs a large insurance company and there is a law that states that no one is allowed to charge any person or company other than the government insurance plan for anything the government has deemed reimbursable for any person covered by the plan.
(So you don't misinterpret my statements again: while government run hospitals, but not the physicians working in them, do get capitation payments they also bill for some services. What is billed vs paid through capitation varies by province. Services rendered to uninsured patients are never from capitation funds and are always charged directly to the patient).
If the services rendered or you are uninsured, like the patients in the article study, it functions the same as the US and you will personally receive a bill in the mail with similarly obscene rates much higher than what the government insurance company would have paid.
This distinction has everything to do with the article and GP's point which asserts that the Canadian government will bear some cost for the care of the patients in the California study which is flatly incorrect. If there was no charge at the point of service none of this would matter.
Then again my Dad who died of a lung disease said the government agency (Coast Guard) he worked for turned a blind eye to what he and his co-workers had to do. Dad would tell me even as the late 1990s his job was to take a powder, wet it, form it into big mats. They were filters for the boiler water. The powder used was or maybe just contained asbestos. He said the workers on the dock were covered in it he said the place looked like it had snowed.
Dad knew but he was stuck in the past of "It had to be done" mentality. And really as a high school drop out he really may not have understood the danger. For years he and my grandfather had a painting business with the paint at that time containing lead.
The problem is that you generally have to force people to keep their own safety. Else the el cheapo company shitting on any work safety will be cheaper and quicker, coz workers don't know any better, and thus more competitive, at worst killing the companies trying to do it properly.
> Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher.
That is true with or without publicly funded healthcare.
I have ME/CFS and the fact that we're expensive to the general public seems to be the only reason there is any public money spent on treatments and cures at all. However, Canada and others are finding that medically assisted suicide offers an even cheaper alternative solution. So instead of money spent on treatments and cures we get subtle and not so subtle encouragements to kill ourselves, and I expect the problem to keep getting worse. I.e. I don't think the actual emergent behaviour for shared healthcare costs is as altruistic as you appear to except.
Please don't take HN threads on generic nationalistic flamewar tangents. I'm sure you didn't intend it, but that's what this leads to, in the statistical case.
He was drawing a pretty reasonable comparison between economic incentives in the respective countries and how it has downstream affects for regulatory response. Don't make it something it isn't.
You make a good point, enough for me to realize that I misunderstood the comment. Still, the last sentence of the GP comment veered into nationalistic putdown.
Flamebait in a comment has to do with the most inflammatory thing it contains, not the most interesting thing. When a house is on fire, people don't admire the décor.
This seems largely similar to worker protections for welding... the proper protection is essentially heavy shop ventilation and full respirators (which, good ones cost something like $1500).
I suspect the problem is that welding related disease/problems show up quite quickly in most cases, and welding tends to be a higher paid industry. More room for margin on PPE and workers have higher demands.
Tangentially related, there's this copper mining museum in BC (1) in what used to be one of these corporate towns where you lived and died. They do a quick demo of the equipments they used back in the day, in a pre cut hole. Even with your hands on your hears it's painful, teeth chattering - and they don't even really hit the rock.
People working in there weren't wearing any sort of hearing protection and became deaf within months. And after introducing pressured air driven equipment, they were all dying in a few years from silicosis. Until someone added water spraying to precipitate the dust into mud (wherein their issue became to fiddle caked in mud all day long in the dark, which I guess is an improvement over certain death). Which happened years later.
Thinking about the kind of life they had terrorizes me. I don't get how, for the longest time, people were fine with that. I mean no judgement on the workers, they probably didn't have a choice - but the people sending them in probably saw them as kettle.
Makes you think about the sort of progress in worker protection that was made since then. But also this kind of story reveals how people are still ready to profiteer from such deadly practices, if given the opportunity.
Oh yeah absolutely, but being a shareholder in there? I mean it's always easy to judge people whose context you don't know, but I think you can draw a line and this is past it
We can still draw those lines today, but mostly ignore them. Such as the nets around Foxconn factories, slave labor used to create chocolate, lithium mining, etc. Not nearly as dramatic as what those copper mine workers went through, but still quite bad.
Today the leading cause of death is heart disease. In that era it was infectious disease. You could have a cushy job doing numbers work in a city and still die of tuberculosis from being in close quarters. People were fine with it because everything was terrible.
In the century between the 1850s and 1950s we went from not even having radio communications or the germ theory of disease to building nuclear submarines and fiber optic data networks.
Once we had penicillin and cities stopped dumping raw sewage into the water supply, people started to have better options and these kinds of businesses had to improve safety to attract workers.
If you had to choose between the job you have now and the ones they had then, how much more would they have to pay you to get you to choose the latter? More than it costs for the safety equipment, right? So they started installing it.
Then governments passed laws requiring it because politicians are adept at taking credit for good things that were about to happen regardless.
Historically, it feels like laws compelling the government to act for the rights of workers has a mixed record.
There's a stronger record of laws preventing a government from acting against workers and ones permitting workers to take matters into their own hands.
They were enforcing some laws and doing so selectively.
Striking workers were usually on the wrong side of the law though because they were using coercion and force to make every worker to participate in strikes (they could hardly work any other way without laws restricting “right to work”)
> they could hardly work any other way without laws restricting “right to work”
Well sure they could. The workers who agree with the strike go on strike and if that's enough of them to put pressure on the employers to meet their demands, their demands get met.
If it isn't, you've failed to convince your fellow workers that the light is worth the candle and if you don't want to work under the terms that they do, you can go work for someone else.
This is mainly a problem when there is no other someone else to work for, but now you're back to anti-trust rather than labor laws.
> that's enough of them to put pressure on the employers to meet their demands, their demands get met.
Or your employers can hire some thugs to disperse you and the other strikers. When you resist the governor will just use that as a justification to send in the national guard to “maintain law and order”. At least that’s how it often worked in the good old days..
> Well sure they could.
In an imaginary world maybe. In a society with no safety nets and and where any meaningful accumulation of savings is infeasible? Not so much.
> you can go work for someone else.
Under the same conditions. Labor has an inherently weaker bargaining position (due to certain pretty obvious factors) compared to business owners. Unless you have some external regulation or societal pressure and employers are behaving fully rationally (i.e. maximizing profits) that will always be the case for the majority of the workforce.
> Or your employers can hire some thugs to disperse you and the other strikers.
Now we're back to "everyone agrees that violence should be illegal."
> In a society with no safety nets and and where any meaningful accumulation of savings is infeasible? Not so much.
But then what difference does it make if you go on strike with 75% of the other workers or 100%? Either way the boss just waits two weeks until you all need to buy food.
Which still assumes that the employer is a monopoly. Otherwise you go on strike by taking some gig work in the meantime, which maybe sucks, maybe even sucks more than your current job, but it lets you make rent for as long as it takes for the employer to feel the need to meet your terms.
> Labor has an inherently weaker bargaining position (due to certain pretty obvious factors) compared to business owners. Unless you have some external regulation or societal pressure and employers are behaving fully rationally (i.e. maximizing profits) that will always be the case for the majority of the workforce.
There is no law requiring employers to pay anyone more than minimum wage and yet >98% of people make more than minimum wage. What explains this other than that employers have to compete with each other for labor?
Yeah, the operators of company towns were violent pricks who didn't much like it that workers increasingly had better options than to die in a mine. That didn't change the economics though. Neither did committing violence against them, which was not only already illegal even then but also wildly unpopular.
There's nothing better for workers than a competitive market. What's the boss going to do when the workers have the option to quit and get a better job somewhere else?
Get legislation passed like “right to work”, conspire with other business leaders to suppress worker wages/benefits, make striking illegal, etc etc etc.
"Right to work" is not going to stop anyone from quitting if some other job provides better working conditions.
The only reason you need to strike is if there isn't any other employer offering better terms that you can go work for instead. Otherwise you can just threaten to quit unless they meet your terms and actually do it if they don't.
Conspiracies only work if the market is concentrated enough; if there are ten thousand employers and it's easy to start a new one then you're not going to be able to hold together a secret illegal cartel.
None of those actually work in a competitive market.
The market can de-competitiveize itself through non-compete agreements, intellectual property laws, and other barriers to entry. The competitiveness occurs around the "ruleset", which shifts around according to the regulatory environment.
The government tends to default to supporting strikebreaking(and still generally does in any era, including this one) because industrialists, financiers and politicians share lines of mutual support: legal ownership of intangibles like a corporation acts as an alternative to feudal fiefdoms and warlords, in that it's less destructive and lets complex processes evolve.
Corporations are very effective at putting taxable assets on the books, which allows a more complex state bureaucracy, so politicians end up wanting the support of business for government power and expenditures. Financiers want their thumb on the scale, for the winners they picked to continue winning, rather than to run off and form a competitor. And the industrialists themselves, though they are often at the forefront of the most dramatic reorganizations, tend to get stuck in equilibriums where either they're the evil monopolist, or someone else is. Once you arrive at the equilibrium, the elite players lose their dynamism and are pressured to stay within the existing trends or lose their place.
Thus when the Pinkertons or their modern counterparts come in, the officials shrug and say "business as usual, business as usual". The system convulses when it becomes a riot and property is destroyed because that weakens the whole premise: less capital to deploy, fewer assets to tax, failure to return on investment. And people out of a job, but if they were rioting it may have been a crummy job. It creates a shock that can break the equilibrium and enable a different deployment of labor and capital in a new technological environment. That's essentially why the industrial era has so many short, distinct periods and upheavals within it; the sausage is being made, though it's ugly to witness.
> The market can de-competitiveize itself through non-compete agreements, intellectual property laws, and other barriers to entry. The competitiveness occurs around the "ruleset", which shifts around according to the regulatory environment.
What you're getting at is that market competition can be destroyed through regulatory capture. But now you're making the case for regulatory form and anti-trust rather than some kind of labor laws, which was kind of what I was getting at to begin with.
Trying to regulate an artificial monopoly is a fool's errand, not least because if they have the political influence to capture regulators and retain their monopoly then they can also interfere with the passage or enforcement of anything that benefits workers at their expense. So all efforts should be directed to breaking them into tiny, tiny pieces none of which have enough power to capture the government.
Free market competition rarely develops without regulation and/or government/public oversight.
With no external control businesses tend to form cartels and/or adopt practices and regulations that are more hostile towards both consumers and workers than what governments can come up to.
On average anyway. Of course there markets and goods which are somewhat immune to this and exceptionally incompetent governments which can do significantly more harm than good.
> With no external control businesses tend to form cartels and/or adopt practices and regulations that are more hostile towards both consumers and workers than what governments can come up to.
Cartels are generally a result of government regulation, because they require something to be creating a barrier to entry that prevents new entrants from breaking the cartel.
You can also have cartels enforced by e.g. acts of violence or vandalizing competitors who won't join the cartel, but who claims that non-consensual violence or property damage shouldn't be illegal?
If you encounter an uncompetitive market in practice then you clearly have some kind of a regulatory failure, but the answer in these cases is not to pass more laws to mitigate the consequences of insufficient competition, it's to address whatever is causing the market to be uncompetitive.
> Cartels are generally a result of government regulation,
They are often the result of companies bribing or otherwise coopting the government to enact those regulations.
> You can also have cartels enforced by e.g. acts of violence or vandalizing competitors
Or you could just abuse your dominant position by preventing your suppliers or retailers from doing business with your competitors, outright buying them, running them out of business by temporarily dumping your prices etc. these are all both more effective and more realistic options than outright violence.
> but the answer in these cases is not to pass more laws to mitigate the consequences of insufficient competition,
Having corrupt and incompetent governments leads to bad outcomes. That’s not particularly insightful nor does it automatically discredit any form of regulation.
> it's to address whatever is causing the market to be uncompetitive.
You’re certainly right. Sometimes this can be accomplished by reducing restrictions and sometimes by introducing additional laws. We should also take into account that unregulated markets are hardly ever competitive.
> They are often the result of companies bribing or otherwise coopting the government to enact those regulations.
Which is the thing that does this:
> automatically discredit any form of regulation.
The default assumption is that a proposed regulation benefits powerful interests, because powerful interests are the ones who can have regulations enacted.
That doesn't mean it's a violation of the laws of physics for a regulation to do something good, but if you open the US Code to a random page it's not what you'd expect to find, and if someone proposes a new rule they should be viewed with skepticism.
> Or you could just abuse your dominant position by preventing your suppliers or retailers from doing business with your competitors, outright buying them, running them out of business by temporarily dumping your prices etc. these are all both more effective and more realistic options than outright violence.
These also require the market to already be uncompetitive. If there are a thousand suppliers and retailers, you have to be able to strongarm them all or your competitor can just use any that you can't. If there aren't regulations creating a market barrier to entry then new competitors can form and you have to buy them out for more than they make in the market which in turn is more than their entry cost, but if you do this then it's profitable to keep creating new competitors to make you buy until you run out of money. You can sell at a loss but with low barriers to entry now customers or retailers can go into competition with you just to force you to keep doing that forever and lower their own costs.
Also notably such things have been anti-trust violations for a hundred years or so without requiring any new legislation (and this is still a useful check when some other regulations have caused a market to already be uncompetitive or have high barriers to entry).
> Sometimes this can be accomplished by reducing restrictions and sometimes by introducing additional laws.
But many of the laws proposed to address problems caused by a lack of competition are not even attempts to restore competition. They're commonly attempts to mitigate the damage caused by the lack of it. And these laws typically make it harder rather than easier to actually restore competition, because regulatory overhead favors large conglomerates with legal departments, reduces the flexibility that could allow new challengers to find a niche or is just literally drafted by the incumbents to create a regulatory moat.
> We should also take into account that unregulated markets are hardly ever competitive.
There is no such thing as unregulated markets. Governments at a minimum enforce contracts and property rights, and then must do so in a way that doesn't enable market consolidation, e.g. by not enforcing contracts for the formation of a cartel or allowing one entity to buy all of the land in a city.
But regulations should be directed to pricing major externalities and promoting competition rather than trying to micromanage a society made rotten by other rules that make markets uncompetitive.
That is also what happened to the luddites. Adopt technology or the police will arrest you with loaded guns and you go to prison or get hanged. This part is left out to make the Luddites look foolish and technological progress the hero of the story.
> Adopt technology or the police will arrest you with loaded guns and you go to prison or get hanged
That really not true. Nobody forced them to adopt anything (in a literal way). It’s just that automated factories could produce more faster while paying their workers much less since they didn’t require skilled craftsmen.
Also artisans generally used a guild/cartel model which artificially constricted supply which inflated their incomes.
> out to make the Luddites look foolish and technological progress the hero of the story.
I thought it was pretty obvious to everyone that they were breaking machines because they eliminated demand for high skilled/high pay labour?
> Then governments passed laws requiring it because politicians are adept at taking credit for good things that were about to happen regardless
With this attitude we’d still be driving with leaded gas, living in lead painting rooms with asbestos roofs and spraying ozone layer destroying aerosols amongst a bunch of other things.
The mechanism you described only really works with short term safety issues. If it takes years or decades for health problems to develop neither workers nor their employers tend to be particularly bothered about solving them.
> The mechanism you described only really works with short term safety issues.
The mechanism I described works for employment issues, because employees can choose not to take a job and more dangerous jobs carry a risk premium that both employers and employees have the incentive to reduce when reasonable safety measures are available.
With leaded gasoline and CFCs the victims have no option to refuse, and it's completely legitimate to prohibit harms and risks imposed on other people without their consent.
For some reason you’re making the assumption that most employees are as capable of estimating this premium as well as their employers and/or that it’s even possible to estimate this risk in advance?
If it's not possible to estimate the risk in advance then how is the legislature supposed to do it? If only the employers and not the employees know of the risk then who is going to advocate for a law? And in the latter case the employer would presumably have liability for knowingly exposing people to something harmful without informing them of the risk.
It is perfectly possible in a competitive market to have terrible work conditions. While the average conditions tend to improve over time, not all workers are in a good bargain position viz-a-viz employees. There are information assymetries, transaction costs for changing jobs, short-term biases, market failures and a lot of other issues in the real world.
This view also assumes that skills are perfectly replaceable, that there's no cost for requalifying for another profession, and that this is instantaneous or that people have some magical way to offset the opportunity costs of requalification while they train for another job.
The problem nowadays (and this is not exclusive to HN, although it is especially salient here) is that people like to fall between two ideological extremes: Either that the government is a inherently neutral and benign all powerful institution 100% of the time, or that free markets always exist, and are always pareto-efficient and that governments action is always some sort of rent-seeking parasite.
In the real world things are a lot more complicated. Not every thing can be solved with the heavy hand of government, neither the market itself is always able to reach the most humane solution. Politics is still needed, and we haven't reached the end of History.
> This view also assumes that skills are perfectly replaceable, that there's no cost for requalifying for another profession, and that this is instantaneous or that people have some magical way to offset the opportunity costs of requalification while they train for another job.
It does not assume any of these things. The cost of switching jobs is not required to be zero. What it does is provide a ceiling for what the existing employer can get away with.
They may be able to get away with paying you 5% below market or subjecting you to an inflexible schedule and it isn't worth changing jobs to one that doesn't do that, but if they try to make you use equipment that will kill you then you just walk right out the door.
Moreover, this is why a competitive market is important -- if you're qualified to be a steel worker but the steel industry is a monopoly, you can always learn to be an aircraft mechanic, but that takes time. Whereas if the steel industry has 10,000 companies in it, you go and work for one of the others using your existing skill set. Which reduces what employers can get away with.
> Makes you think about the sort of progress in worker protection that was made since then. But also this kind of story reveals how people are still ready to profiteer from such deadly practices, if given the opportunity.
It’s not just people “profiteering” though? The story mentions workers standing at Home Depot. These are ordinary homeowners hiring these shops to custom cut countertops for them. It’s not some mega-corp mass-manufacturing counter tops.
And now half the people who should be trying to put a stop to it are instead talking about how we need low skill, low education foreign workers that can easily be exploited to keep consumer prices low.
> Thinking about the kind of life they had terrorizes me. I don't get how, for the longest time, people were fine with that.
A non-trivial number of these mine workers were arrested on trumped up charges like "vagrancy" for not having a job or "trespassing" for walking along a railroad. They would often be sold to companies as convict lease (cheap) labor. Essentially slave labor long after the Civil War since the 13th Amendment has the slavery loophole where it's allowed as long as you're convicted of a crime.
This disproportionately affected freed slaves in the South but was an issue for everyone everywhere since it introduced a profit motive to manufactured charges and inflated sentences. The extent that it predominantly affected Black folks and poor white folks had a lot to do with public sentiment not doing anything about it for a very long time.
To a not-small-enough extent, the same conditions exist today where labor can be coerced for little to no pay among the prison population, many of whom have been threatened with obscenely long sentences being shortened by accepting plea deals even when innocent or with extenuating circumstances. For-profit prisons often make the situation worse by further incentivizing incarceration on a larger scale.
Wouldn't a wet-cut system where you flow water over the area the blade is hitting, pretty much cut dust in the air by 99% or more? Water is pretty cheap and available ...
Yes, and I’ve known plumbers who have to make cuts in stone countertops to install taps etc to create a ‘dam’ out of putty to flow water in to the cutting site while doing it.
The solutions exist, the problem is making people invest in them and stick to it.
yet another example of exploitation of people just trying to make a living. No regulations or minimal enforcement means companies/contractors do the job as cheaply as possible. Undercutting companies that actually care about the safety of their workers.
I just am astounded, horrified. The answer to abusive management is simply rebalance power. The answer to abusive markets is pay more (Edit: better supply chain ledgers)
Just horrified
re supply chains - the simple way to stop sales of any product is a shelf market like this: "The product X was manufactured by the small child who last month was mutilates by a factory accident. Nice picture. our product has the following verified supply chain. but it's more expensive. your choice of course"
I suspect that stone dust generally will be found to be similarly harmful to asbestos.
Asbestos is apparently worse because of the sharp edges of the particles, but if I put any angle grinder dust under the microscope I see plenty of sharp bits too.
I think the actually harmful thing is that the dust is 'fresh' rather than being the result of years of chemical weathering which tends to smooth off the sharpest pointiest bits at nanometer scale.
I already commented above but no, they aren't - silicosos is similar to one of the several possible diseases asbestos can give you, asbestosis, but mesothelioma is the real horror outcome from asbestos exposure which I don't believe silica has any kind of similar connected disease.
The effects of stone dust are pretty well understood - silicosis is deadly and similarly harmful as asbestosis, and both raise the risk of lung cancer, but I don't believe there is anything like mesothelioma related to quartz dust which is the real horror of asbestos.
Having been involved in commercial construction in the late 90s, OSHA had a lot of regulation and focus on masons - especially cutting concrete block. It’s surprising that 25 years later that understanding of the problem didn’t translate to the other trades.
The people who installed my counters used no safety equipment. They used consumer grade power tools while spraying them down with water and took no safety precautions. I was actually worried about what would happen if they injured themselves and if my insurance would get sued. They were all Asian and did not speak English it seemed like a super shady operation.
Even if the factory is operated safely these countertops often require adjustment on-site to fit properly… typically done dry with an angle grinder or similar.
> They just need to redo their whole schema, they need to reconfigure their process to customize the engineered stone before its solidified, not after.
That's not viable. They are cut only after the actual physical space has been built (carpentry mainly) because measurements have to be taken then since nothing is perfectly true/plumb/square. Today the turnaround is about a week for the material to be cut and then installed. Sending it off to the manufacturer to create to spec would not only add several weeks to the process but significant expense.
Stone (both natural and engineered) can be cut safely. These shops just haven't been. Proper respirators, ventilation, and wetting will create a safe space to work in.
Fixing this, either by the way I suggest, or the way you suggest (Proper respirators, ventilation, and wetting will create a safe space to work in.) both add cost.
I think that's the problem, we're unwilling collectively as a society to pay the cost.
A lot of tradespeople refuse or ignore PPE. It's mostly macho men, the kind who don't go to the doctor, and smoke and believe it won't cause them cancer. Another fact: scant few men who work outside wear sunscreen. There were multiple generations of these kind of people on my mom's side of the family, and they inevitably died prematurely of preventable conditions.
A modern example: I've seen gravestone engravers completely covered in stone dust while wearing only a thin handkerchief; no hearing, eye, or proper lung protection. Sure they should know the risks but you can't force people to not smoke tobacco or use proper PPE.
During the peak of covid, the NY Times made a video showing hospital workers loading dead bodies into the refrigerated trucks that served as expanded morgues for Brooklyn Hospital Center (by Fort Greene). Online skeptics pointed out that it must be crisis actors, for one of the workers was wearing his mask below his nose. Only thing I could think of was "have you never been to a jobsite?" I got called a pussy for wanting eye protection from the guy welding 15 feet from me.
Always look out for #1 because it is unlikely no one else will.
If that means steel-toed shoes, a jock cup, thick gloves, shooting glasses, amplifying mickey mouse muffs, sunscreen, bottled water, and a P100 respirator, so be it.
Safety regs are written in blood. And it only takes an instant or a culture of disregard to lead to later cancer, permanent disfigurement, or death. There are no old bold pilots or construction workers.
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[ 5.5 ms ] story [ 484 ms ] threadMetzger argued that the kind of sophisticated and costly measures that would be needed to reliably protect workers cutting engineered stone are not economically plausible in an industry where immigrant workers typically labor in small shops and are often paid in cash. Engineered stone "is too dangerous to be used safely," he said. "If there’s any industrial product that should be banned, this is the product.""
All this thanks to synthetic stone - important note for countertops owners, if you want to make sure you don't support the product
This is not a technology problem, this is an 1880s "Safety devices are too expensive problem" along with paid under the table workers problem. All kinds of other industries manufacture 'dangerous' products with regulations that protect the workers. Housing and agriculture are both industries that do not and fight ever further for anti-regulations to protect the workers even less.
And I've been an expat in multiple countries for the majority of my life. Undocumented just means you broke the law to get in. This is illegall. Let's call a spade a spade.
Heck undocumented is a bad term too on its own but for other reasons.
Being in the US without a right to be in it, is a civil matter. Not criminal. It hasn’t been a criminal matter, and there are actually proponents of making it a criminal matter because then these folks would get actual representation in court.
Second, even if being in the US without the right to be in it becomes a criminal matter, you are still innocent until proven guilty. There are thousands of people who may not be able to produce evidence that they have a right to live in the US.
What Switzerland does has no place in this discussion either.
Anyway now that you know illegal is a factually wrong term, are you going to stop using it?
Why?
I'm from EU; most countries here will require you to go through some legal process to become eligible to live and work there if you're from outside of EU. This is absolutely normal and expected.
Your argumentation is not only wrong, it would be impossible to maintain peace if crossing the border without any authorization was allowed. Can you imagine the number of Russian spies and saboteurs Poland would have to deal with if the borders were just open to everybody? It would be lunacy to allow that.
> Anyway now that you know illegal is a factually wrong term, are you going to stop using it?
It's not factually wrong. In most places in the world it's literally illegal to cross the border without a visa or other permit. You will get detained and expelled for doing that; and for a good reason.
That you might not like it and prefer to call it some other term doesn't change anything.
We weren’t able to stop spies during the height of the Cold War. We won’t now. Emotional arguments that point at a random unsubstantiated threat doesn’t actually help this discussion.
Switzerland isn’t relevant in this discussion because we’re talking about the US. They’re not nearly in the same situation or league to be compared.
And again, illegal is really mainly for criminal matters. Not civil. You can keep using whatever word you want but calling it a conspiracy that “big media” is doing is just plain wrong.
There is a deep and fundamental link between having a native born workforce that is educated in this country and socialized to expect certain minimum standards, and the ability to legislate and enforce increased worker protections.
Also you pass laws that support striking workers with UI. There are effective ways to increase the strength of the working class.
Anti trust action is another huge one.
They already have legal protections for this. The problem is the workforce is poorly educated immigrants who, who are fleeing desperate circumstances and have different expectations compared to native born Americans. They’re much less likely to strike to demand better conditions when they’re just grateful things are better than in back home.
https://en.wikipedia.org/wiki/Supplied-air_respirator
The bulk of the dust hanging in the air could be removed with adequate ventilation fans, which seems pretty basic.
https://www.shophacks.com/tablesawdustcollection.html#/
https://academic.oup.com/occmed/article/63/5/317/1451439
What kind of countertops should be avoided? Would have been nice if the article suggested some solutions as well
We typically order water to drink in restaurants and when it gets to the table, the servers almost always toss some straws on the table. If we say we don’t want them or if we mention when ordering that we don’t want straws, we get looks like we must be some weirdos. Why automatically push straws for everyone?
I find it quite strange for adults to drink with straws. It is a child thing in my world.
If anything, straws make some stuff TOO easy, like drinking loads of soda while driving, and this is not good for you.
I think that a lot of problems could be solved by people just consuming less of some stuffs, instead of trying to find a technical solution to the present problems of consuming some of that stuff.
Also having a lot of ice complicates things especially if it starts floating near the top.
Just because there's more silica doesn't mean that it's suddenly unsafe whereas cutting granite is safe. Even drywall or cutting concrete you're supposed to wear PPE.
Yeah, but it doesn’t kill you within a few years if you don’t, right?
Demolition, sanding drywall compound all is bad without PPE and Hepa filters.
You can buy a cheap yet very comfortable 5000 or 7000 series respirator from 3M for about $20 and the "pink pancake" P100 filters are another $12. If you're a hobbyist those ought to last you a year, maybe even 5 depending on what you're cutting. I do metalwork as a hobby and I can definitely feel it in my lungs (and taste it) the next day if the garage door is shut and I forgot to wear the respirator.
Effects depend on the particle geometry.
But as a general rule of thumb: if it's biologically inert and tough enough to stick around for awhile... it'll just stay in your lungs. E.g. fiberglass, cement, rock, paint.
I wear a respirator a LOT more these days than I did when I was younger.
Regulation is the only way to prevent labor from being treated as disposable by these businesses, regardless of the status of these workers.
Pretty much any aerosolized mineral is going to wreak havoc on your lungs.
How can I avoid buying these products or reduce exposure to these more dangerous materials if I'm a worker? Is porcelain "engineered stone"?
They should have ppe for any cutting, regardless, I agree.
So whether it is engineered or natural stone the problem is that stone cutting has dust that needs to be dealt with. But the emerging issue is that with the rising popularity of engineered stone, a higher percentage of countertops overall are hazardous to cut.
It seems that the US either lacks suitable health and safety legislation or fails to enforce it.
Does OSHA not require masks in these cases?
Management on the other hand should enforce masks as a means to avoid liability.
In cases like these you have to ban the dangerous material, or essentially kill the market for the products that use it.
BTW, I'm not sure how solid granite, soapstone, marble, etc. would be any better. Maybe my 30 year old totally fake Corian is back in style. But for the microplastics from scrubbing it?
There's a OSHA/NIOSH pamphlet linked through the original article (https://www.osha.gov/sites/default/files/publications/OSHA37...) with table and additional details.
The pamphlet said that in one study, a marble shop performing dry grinding (no wetting, nor other engineering controls) had airborne silica levels of 39-45 ug/m3, while a granite shop which also did not use engineering controls say 89-460ug/m3.
Contrast that with recent efforts to hire nearly one hundred thousand IRS agents to get a sense of the priorities of your leadership.
[0]https://www.fisherphillips.com/en/news-insights/workplace-sa...
Ukraine is a life or death situation you say?
Solicosis isn't?
How many tax men do we need before we get the government to do the bare minimum here?
That money is used to pay for things that the government does. What exactly is your beef here?
If you need to wear a respirator all day i'm told the most comfortable is an air supply and dragging a hose behind you.
The only problem is that a 6800-series costs $200, plus probably $30 a month in P100 cartridges given the level of particulates in the air, and that's more than these companies think their workers' lives are worth.
Try spending an hour in your shop constantly lugging heavy tools and wood around wearing that respirator on a humid 80 degree day, then you can be smug and waggle your finger at laborers for not protecting themselves.
I'm just one datapoint, but my assumption would be that if it's truly too much of a burden, their employer should be buying better respirators and/or filters.
Yes, I'm extremely fortunate that I can pay for help when needed, but I do quite a lot of my own work. So, if you're going to invent a guy to be mad at, maybe you should pick a softer target.
The respirator was actually not an issue.
They're a little pricey up front, but I figured it was cheap overall compared to the long-term costs of using something less effective. Having eye protection integrated as well is ideal, since it never fogs up.
Maybe you are meaning for medical staff? Yeah there's a fully unfiltered exhaust stream blowing downwards.
What's your solution for the full face with glasses? The spectacle kit looks like it's a frame that you need to get custom lenses put into. The few times I've worn mine (FF-400) I've just suffered the extra ear pressure, but it's not great. It's also a size too small because it was what was in stock at the start of Covid when nobody knew wtf was going to happen, but I don't see that increasing one size would change much. I plan to eventually trying to form a custom thing to hold a regular pair of glasses.
And have you really found the P100 cartridges need to be discarded every few weeks? The only things I've found say that particulate filters only need to be discarded when they become difficult to breathe through, and I've never actually reached that point.
And I'm assuming that a lot of silica particles will go through a P100 a lot faster than the stuff I do. ;)
However, all three organizations have been subject to decades of budgetary cuts/freezes/criticism by republican lawmakers and thus have a fraction of the inspectors they should.
https://blogs.luc.edu/compliance/?p=4470
https://www.kqed.org/news/11875988/minimal-to-non-existent-s...
https://peer.org/lack-of-scientists-dooms-epa-chemical-revie...
https://www.baltimoresun.com/news/environment/bs-md-drinking...
The Senate also is allergic to appointing a permanent leader of the ATF: https://www.pbs.org/newshour/show/why-the-atf-is-often-leade...
The way republicans have functioned for a few decades (after realizing that legislatively trying to kill the ATF, EPA, OSHA, etc is unpopular) is to hamstring the budget for those departments, tie up leadership appointments as much as possible, and then in hearings shout about how ineffective the agencies are.
It's like starving someone and then criticizing them for being lazy and inactive.
The same technique is used to attack social services. WIC, a food stamp program for mothers with infants and children, requires yearly "certification" which involves in-person interviews at offices that few and far between, often not public transit accessible, and so on. How is a mother who is so poor she needs WIC (and thus may not even have a car) supposed to afford to take a day off from work and travel to an office so someone can verify that her child still exists?
Compare that to other government programs that benefit the wealthy and corporations. Do people writing off luxury cars, entire homes, and bizjets have to show up at a regional IRS office (annually) to have their records audited, proving that the luxury property is actually being used for business purposes and they're entitled to a writeoff (or being given use of said property without paying taxes on it)?
I was the safety representative at a previous job. Management care a lot about safety and provided everything required, and high quality gear as well. Still people would cut corners and not use the equipment because it was faster not to. These where people paid by the hour, they have zero incentive to work faster. If people work on contact however, it's easy to create an environment where speed is priorities over safety.
Then they get written up, and eventually fired. Companies need to be stomped on(and are where I live), if they don't do this.
Of course they made so because otherwise it would be convenient to the company provide the safety equipment and not enforce their usage, this way getting work done faster (and thus have more profit).
There are plenty of people to blame, and there is plenty that can be done. This dumb ass "No regulations needed, free market will take care of itself" is how the rich put the poor or ignorant into early, terrible graves.
There's some small margin of workers who have access to protective gear but don't wear it, but in reality for most workers it's the job of the company to provide it and train workers to use it.
You know the when these stores even supply this protective gear, they get the cheapest option that’s still legal.
Weirdly enough, that doesn't apply to car mechanics which seem to be dead set on bringing their own tools to work.
Not saying it's good or right, but there are incentives that push towards it.
I am a nerd and my glasses were falling off from the sweat. I think I was wearing a pair of work boots which may be required. But the guy giving me orders on-site was not my employer. These clients are well-aware that day laborers may not be back tomorrow. So why give us durable safety equipment that costs money? The day labor office is my employer, but they may not be accurately informed about the safety requirements of the client and the site. They may require us to purchase safety equipment at own expense, but if we don't know what the site requires, or how long we will be there, that's an up-front expense we are unwilling to part with.
Day laborers are one step up from the guys hanging out in Home Depot parking lots, whereby they are legal to work in these United States, but can't get a job anywhere else.
So it's a 3-way tug-of-war of vagueness and parsimony, and it always just ends up being nod-nod, wink-wink, do the best you can.
Objectively, it has a very high utility per dollar. Heat resistant, water resistant, knife resistant, stain resistant, etc.
Well, it depends on the situation.
If I, a factory owner, offer optional safety equipment that slows workers down a bit, but I also demand such high productivity that corners have to be cut - whose fault is it when the inevitable happens?
What if I, a factory owner, provide optional basic safety equipment costing $30 per person, but the mask makes the goggles steam up and the boots aren't comfortable? There's better safety equipment available for $300 per person - is it my fault for not buying it?
What if I, a factory owner, happened to start my factory by hiring macho tough guys who don't like wearing a mask, and subsequent hires learn that behaviour from them?
Generally I to listen to the craftspeople I employ on issues of safety because keeping them safe is the whole point of safety. But they and I have a shared responsibility to make sure, if they say the machine is actually safer without the guard, that they're right about that.
I actually worked in such a factory, so this is based on direct experience, and what I saw was people cut corners mostly because they were tired after long shifts, though lack of comfort was also a factor due to the heat.
The employer did try to make everyone wear the gear and had inspections and most people wore most of the stuff most of the time, we even won a safety award at one point for going so long without any OSHA-recordable injury. But we weren't perfect and one day I helped bandage a guy who was airlifted after slicing his arm open in a really bad way, something the kevlar wrist protectors should have stopped.
So I would say that employers do try, to the limit they can, but all accidents happen during gaps. And the employees tend to have their own interests in comfort or cutting corners that sometimes conflict with their safety. More limited shifts and attention to comfort might help, but it's not always clear how to provide that.
You can still have things like the guy who got crushed by his forklift after rushing to dump a hopper of trash by doing something really dangerous while unloading it because he wanted to hurry and finish so he could go to his family for Christmas vacation. And it's not easy to stop that kind of thing, even if you do a lot of warnings and inspections to yell at people who don't do things right and pay attention to close calls.
Go on…
After all, if you get a minor injury and you know getting treatment will cost your colleagues a $200 bonus, you might keep quiet about it and tough it out to the end of your shift.
To achieve a good culture of safety, you need to make the rewards for safety strong enough to resist the rewards for cutting corners - but you also need to make sure a guy can get a band-aid from the first aid kit or tell his boss about a trip hazard with no disincentives.
If anything I'd worry more about the temperature of the floor or the number of hours worked, but it's hard when some people had second jobs or what have you.
With that mentality we'd still have 1800s lifespans
Even more surprising to me was Sunstein and his wife Samantha Power attending Henry Kissinger's birthday party after Power previously published a book basically pinning 150,000 deaths in Cambodia directly on him. They knew this guy is basically a war criminal and still went to celebrate his birthday.
In the old slashdot times, such a comment would probably have +5 insightful badge attached, here in HN in 2023, it is downvoted to hell.
I think this is poe’s law in action :) I did not read the reply as earnest.
Cass Sunstein was the administer of the White House Office of Information and Regulatory Affairs. The OIRA is given the remit to review drafted rules (ie regulations) that various federal agencies want to enact. The OIRA is supposed to perform an external cost-benefit analysis of the proposed regulations. OIRA is suppose to turn around rulings in 90 days.
While Cass Sunstein was administrator (2009 to 2012), various pieces of regulation were submitted for review, and ended up being reviewed for ~3+ years. Examples include:
* Requiring rear-view cameras (submitted for review in 2011, regulation finally passed in 2014 with a 2018 deadline for compliance)
* The silicosis workplace safety regulations (as mentioned - submitted in 2011, finally passed review in 2013)
* Coal ash handling regulations (from the EPA) delayed from 2009 to 2014
For the specific case of silicosis specifically, it doesn't appear that the OIRA ended up blocking the regulation, though it certainly slowed it down.
Some news articles:
* https://www.ucsusa.org/resources/attacks-on-science/white-ho...
* https://www.reuters.com/investigates/special-report/usa-regu...
* https://www.theregreview.org/2013/11/26/26-verchick-silica/
It is worth noting that these delays continued after Sunstein left office, and there's certainly evidence of OIRA significantly delaying review processes prior to Suntein's term as administrator.
Since the article is referring to "83 cases among countertop workers identified across the state [of California] since 2019", it's almost certain helmets would save more lives than anything you do about engineered stone. So what's the excuse there?
I'm not saying that we need more delays. I'm also not saying that there isn't room for more regulation here, but just slapping any poorly considered regulation down may not solve the problem.
It’d be interesting to see a cost-benefit analysis of OIRA’s cost-benefit analysis. All the delays aren’t free.
I've taught him well.
I’m pretty sure none of them wore masks when doing this. I honestly didn’t think to wear a mask either (since they weren’t and never really even warned us how bad it would be), but fortunately we were behind closed doors most of the time the particles were in the air.
Fortunately it was a granite countertop and not quartz. But I still can’t imagine that stuff is good to breathe on a recurring basis, and it still amazes me that they were fairly casual about the whole thing.
My guess is the industry just isn’t educating workers about the risks.
My guess is that the companies that did were undercut by the ones that didn't.
A relative of mine died of silicosis after having worked for years in the granite industry. Granite is probably as bad without adequate protection.
This article [1] indicates quartz contains about 2x silica vs. granite.
[1] https://blogs.cdc.gov/niosh-science-blog/2019/10/29/silicosi...
Granites are primarily composed of feldspar and quartz, which are both primarily composed of silica. Silica is the thing that causes silicosis, and when that granite was cut it was clouds of silica dust that covered your home.
You were no more safe in that granite dust than you would have been in quartz dust.
[1] https://www.osha.gov/sites/default/files/publications/OSHA37...
This isn’t the same as something like a virus, where it’s more binary.
To be clear, I’m not arguing to prove I’m right (because I’m certainly not an expert and am open to being wrong), I’m trying to understand more about how particle inhalation can have varying risks (or not) based on density.
I’m mostly just curious about the science, and whether/why it is more binary than I’m understanding, vs. just taking some random HN strangers’ words.
I quick search on Amazon for "Stone Cutting Dust Cover" gave plenty of cheap looking clear plastics covers with a hole for a vacuum cleaner. I bet there are pro variants available of those.
The problem is not lack of education but lack of enforcement of regulations.
Wasn’t great but the rent was cheap, until it wasn’t
I wish I ONLY had to clean the surfaces once a week.
In my country and city unfortunately -- even though I dont live near a major road or construction site -- dust is everywhere. Within 24 hours or less of wiping clean, you can see a visible layer of dust on any horizontal surface in home.
dust is everywhere ..haven't learnt to classify it into types :)
Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher.
There's incentives for our government to protect workers from risks that will cost a fortune to fix.
In America, there's only the "because it's the right thing to do" reason, which is never enough for anyone to actually do anything.
Yeah one heck of a perverse incentive.
Someone taken out of the workforce may qualify for that if they don’t already qualify for disability insurance or similar payments (although I’m not 100% clear if those are funded via private disability insurance or public programs)
First, Medicare pays a lot more to healthcare providers than Medicaid. Medicare pays more for more medications than Medicaid, and has fewer prior authorization requirements for those medicines. Fewer providers will accept Medicaid, and people using Medicaid will receive less or worse healthcare than those in Medicare.
Second, Medicaid is administered by each state, and there is a lot of variability on how easy the state makes it so people can actually get healthcare. Lots of states straight up refuse money simply to punish people of a certain socioeconomic class because it happens to win votes.
Bottom line, Medicaid is so leaders can claim they are helping poor people get healthcare AND keep taxes low. Medicare is for actually delivering healthcare to people because that contingent makes up a huge proportion of votes.
And yes, even Medicare is not delivering all healthcare, as it has multiple tiers to deliver differing amounts of healthcare to different socioeconomic classes.
I love how there is even an Additional Medicare Tax. The political lines in the US are very much old v young, but some of the young, especially politically active ones, vote with the old since they are among the wealthy young, and the rest do not participate enough, or do not have sufficient knowledge about how resources are being meted out and how they will be affected now and in the future.
Like I could just book a one way flight to LA and become a US citizen because reasons ?
https://www.uscis.gov/about-us/our-history/overview-of-ins-h...
That said, overstaying tourist visas (aka just hopping on a plane and then not going back) is a very popular form of illegal immigration into the US.
I'm all for helping people but you cannot import the world's misery and expect it to be smooth, first because it doesn't solve anything, second because it just doesn't work from a simple demographic point of view.
The taxes part is the same; only the healthcare half is different.
Maybe subsidies for selling fresh fruit and veg also.
I guess you could tax their victims instead though... they don't have a lobby so theyre probably easier to take advantage of.
Nobody is the victim of choosing to eat a cake.
Coming any second now, right behind robotaxis, with the only difference being that robotaxis will probably actually happen within the lifetimes of the current “laptop class”.
High caloric density is what you want if you need to be able to feed your country in war, so we subsidize these foods.
No one wants to eat just plain corn though, so companies process it into other foods that are then sold cheaply because they are receiving these large subsidies.
People end up consuming large quantities of these foods because they are cheap, and our brain reward centers a pre-wired to love lots of cheap easy calories.
Knowing all of this, it makes perfect sense to tax the living crap out of highly processed foods that are made from subsidized ingredients. You're just taking back the subsidy you put there in the first place, and shaping consumer behavior for the greater good (which is a common use case for taxation).
The consequence of this would be that the subsidized food gets exported to a country that doesn't tax it, at which point you're subsidizing some other country's food.
The US is also a large net exporter of food, implying there is more than enough domestic production for wartime needs. Also, the US hasn't been in that kind of a war in almost a hundred years and MAD makes it unlikely that it ever would be again. The obvious conclusion is to eliminate the subsidies.
If theyre smart they won't take this shit either.
Nice of you to let Americans sacrifice their health on $othercountry's behalf though.
What do you suppose the chances are of 100% of other countries imposing a similar tax on this type of food?
> Nice of you to let Americans sacrifice their health on $othercountry's behalf though.
Stop subsidizing it and you don't have to tax the subsidy back out.
Quite high. Agricultural dumping is typically frowned upon even more than regular dumping. Half of the reason for the WTO's existence was to get countries to stop being so trigger happy about doing this.
At least for removing the subsidies you only have to fight the businesses.
I will never be punished for being over- or underweight since I am good. The universe would have to be broken for me to be taxed.
Sugar tax, coal tax, corn syrup tax, worked-your-employees-90h/week tax? Sure.
And what about physical activity ?
The best public investment to promote physical activity is designing cities to enable "the gym of life"!
https://youtu.be/KPUlgSRn6e0?si=GDmrYq-XQtn9SaKx
This is not exactly the best use case for arguing about Canada versus US healthcare policies.
Edit: Actually over a quarter.
Look at Germany. Look at France. Look at what's happen to Japan because such an option isn't as viable.
It's simply not politically feasable to say, "Without immigrants, our economy is f'ed."
And yet, that's what politicians in Germany are saying: "Denn Deutschland braucht sie dringend: Durch die seit Jahrzehnten sinkende Geburtenrate gibt es auch weniger Arbeitskräfte. Diese Lücke konnte lange über Zuwanderung aus dem EU-Ausland gefüllt werden. Doch inzwischen reicht das nicht mehr aus." (https://www.spdfraktion.de/themen/neustart-migrationspolitik, the social-democrat representatives in Parliament)
"Because Germany needs them urgently: Due to the declining birth rate for decades, there are also fewer workers. For a long time, this gap could be filled by immigration from other EU countries. But this is no longer enough."
To the detriment of their origin countries who suffer from losing their best and brightest. How "Northern countries exploit the South again" is a (rather quiet) talking point that I believe will become louder in the future.
> While there are no accurate figures representing the number or composition of undocumented migrant population in Canada, estimates range between 20,000 and 500,000 persons
> Research suggests most undocumented individuals live in large urban centres and typically work in seasonal and informal sectors, such as construction, agriculture, caregiving and housekeeping.
> Undocumented migrants are a vulnerable group due to their lack of immigration status, as was seen during the COVID-19 pandemic. They have limited access to health care, social services or employment protections.
Source: https://www.canada.ca/en/immigration-refugees-citizenship/co...
Until this year, asylum-seekers could transit through the United States into Canada under the Safe Third Country Agreement, by crossing the border at an irregular crossing like Roxham Road.
Sources: https://www.cbc.ca/news/politics/deal-roxham-road-migrants-b...
https://www.cbc.ca/news/canada/canada-asylum-seeker-increase...
https://web.archive.org/web/20230601135133/https://www.nytim...
https://www.pewresearch.org/short-reads/2021/04/13/key-facts...
https://www.indexmundi.com/factbook/compare/canada.united-st...
So seems like Canada has many fewer immigrants of this type than the US.
They also allow international students at diploma mills to work 40 hrs a week, above the table.
It's a sham.
Is there any evidence of this? That the Canadian Gov cares more about workers than the US Gov?
>Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher.
What evidence do you have that this is the case?
>In America, there's only the "because it's the right thing to do" reason, which is never enough for anyone to actually do anything.
Is this your opinion or is this the reality. I don't know if you have ever walked by a construction site in Toronto to see guys cutting cement or stone. None of them have masks. Sometimes they will have a wet saw when cutting cement on the street but that is to reduce dust for traffic and pedestrians and not so much for their health. The Canadian Postal Union fought the Federal Gov for years to provide an environment where paper dust was considered a health hazard and workers need to be protected. Many postal workers suffered from COPD because paper dust was too fine for the Lungs to filter. What about farmers and dust? I'm sure they suffer just as much as American farmers.
I've come to realize Canadians suffer from an inferiority complex and have to constantly try and make comparisons to make themselves feel better, it's a strange phenomena.
- Expat....
From a cost perspective it’s best that people die suddenly. If I live a fairly healthy life into my 80s and die of a heart attack, I might not necessarily have cost my insurer that much, as opposed to if I suffer from a chronic illness for 10, 20, 30 years.
Cancer is now usually not a sudden death sentence - treatment is good enough now that most cancers caught early can be treated and patients often go through multiple remissions before it or a complication from treatment finally gets them.
Insurers very much do not want their customers getting cancer, because it is invariable an extraordinarily expensive condition to treat and treatment can go on for years.
Small clarification - early detection is most often curative and cheap.
The really expensive part is that several advanced stage cancers (even IV with widely disseminated metastatic disease) now survive for many years on treatments costing low to mid 6 figures/year.
It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law.
> It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law.
The evidence in favor of mass screening programs in the hope of early detection is actually weak to non-existent [1].
> In total, 2 111 958 individuals enrolled in randomized clinical trials comparing screening with no screening using 6 different tests were eligible. Median follow-up was 10 years for computed tomography, prostate-specific antigen testing, and colonoscopy; 13 years for mammography; and 15 years for sigmoidoscopy and FOBT. The only screening test with a significant lifetime gain was sigmoidoscopy (110 days; 95% CI, 0-274 days). There was no significant difference following mammography (0 days: 95% CI, −190 to 237 days), prostate cancer screening (37 days; 95% CI, −37 to 73 days), colonoscopy (37 days; 95% CI, −146 to 146 days), FOBT screening every year or every other year (0 days; 95% CI, −70.7 to 70.7 days), and lung cancer screening (107 days; 95% CI, −286 days to 430 days).
There are large institutions, both nonprofit and commercial, which stand to gain by convincing people that mass screening is useful and important. The available scientific evidence does not support their position.
[1] https://jamanetwork.com/journals/jamainternalmedicine/fullar...
What you want to do is look at stage at presentation, treatment costs by stage, and screening costs. These were done for nearly every recommended screening program.
The available evidence behind currently recommended screening programs unequivocally shows improved cancer-specific survival and earlier stage at diagnosis.
> What you want to do is
No, what I want to do is assess whether broad screening programs actually make people live longer. Overall survival is the correct metric. Evidence in favor of the claim is lacking.
> none of the studies are sufficiently powered for OS.
"Sufficiently powered" is relative to what size of effect you want to detect--which you haven't specified, so I'm not sure how you can make the assertion that none of the studies are sufficiently powered.
> The available evidence behind currently recommended screening programs unequivocally shows improved cancer-specific survival and earlier stage at diagnosis.
These outcomes ignore negative effects of screening on people who don't have cancer, which is why I'm not interested in them. And yes, there are negative effects, and no, they are not negligible.
Correct according to whom? If you want to choose only one metric quality adjusted life years is likely the best one.
While OS may be your goal that's not the primary endpoint of screening programs.
Some examples of why OS is limited: breast lumpectomy vs mastectomy and systemic therapy or polypectomy vs neoadjuvant therapy and colonic resection are both associated with very high morbidity that is very important to patients. The vast majority of patients care about quality of life.
> "Sufficiently powered" is relative to what size of effect you want to detect--which you haven't specified, so I'm not sure how you can make the assertion that none of the studies are sufficiently powered.
We do not expect any one screening program to have a large change on overall survival because there are many ways to die, very few studies are powered to detect the small differences expected. The reference below does some modeling and discusses cancer-specific vs all-cause mortality for your perusal.
https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.2476
> These outcomes ignore negative effects of screening on people who don't have cancer, which is why I'm not interested in them.
See morbidity discussion around delayed diagnosis above.
> And yes, there are negative effects, and no, they are not negligible.
As you're choosing to limit the discussion to overall survival, do you have any data to support the claim that screening has more than a negligible negative effect?
There is a better argument to be made for other harms of screening like cost and stress but if we want to discuss these negative effects of screening we also have to step back from overall survival and discuss morbidity benefits.
ETA:
> 2) that I'm misinterpreting something, given that I didn't really offer any interpretation at all.
This is your interpretation, and is an incorrect one:
> The evidence in favor of mass screening programs in the hope of early detection is actually weak to non-existent [1].
The evidence you cite says nothing about early detection and treatment paradigms.
By all means, if you have studies showing that broad screening programs are beneficial in terms of overall (not cancer-case only) QALY then please share them. I'm guessing you don't.
> As you're choosing to limit the discussion to overall survival, do you have any data to support the claim that screening has more than a negligible negative effect?
Do you have any data to support the claim that screening has more than a negligible positive effect on overall survival? (No).
Stop trying to put the burden of proving a negative on me. If you want to advocate for spending ten of billions of dollars annually (not to mention time and stress) on broad screening programs you bear the burden of demonstrating that's useful.
If we can afford to spend the money on screening everyone certainly we can afford to spend less money to run a large randomized trial screening only some people, but advocates of the screening programs won't stand for it because they are convinced of their own righteousness and refuse to admit uncertainty about whether the screening programs are actually doing more good than harm.
I gave you one.
> Stop trying to put the burden of proving a negative on me.
You're making the claim there's more than a negligible negative effect not me.
> Do you have any data to support the claim that screening has more than a negligible positive effect on overall survival? (No).
Did I say there is a sizable positive effect on overall survival? I said it's irrelevant.
No you didn't, you gave me a simulation study that discussed what kind of sample size might be necessary to find statistically significant effects in all-cause mortality. There's not a single mention of QALY in there. Please stop misrepresenting things.
> You're making the claim there's more than a negligible negative effect not me.
The cost itself is a nonnegligible negative effect.
> Did I say there is a sizable positive effect on overall survival? I said it's irrelevant.
You're wrong.
It's borderline fraud, in my humble opinion, to go around suggesting that massive interventions should be evaluated based on their effects only on the people who benefit most, ignoring the negative effects on the other 98% of the population. Which is exactly what you did in your first reply to me:
> What you want to do is look at stage at presentation, treatment costs by stage, and screening costs. These were done for nearly every recommended screening program.
> The available evidence behind currently recommended screening programs unequivocally shows improved cancer-specific survival and earlier stage at diagnosis.
This approach to evaluating an intervention is intellectually dishonest and emotionally manipulative. Any evaluation that does not take into account the other 98% of the population--through overall survival or QALY or some other metric--is giving an extremely biased picture of what the intervention is actually doing to the population as a whole.
Several screening programs like breast have been rigorously evaluated from costs, benefits and harms. I know very well what the negative effects are, do you? You haven't mentioned anything specific or provided estimates of harms yet you're the one making the assertion.
> You're wrong.
So if we're all wrong, what's the argument and where's the evidence without resorting to no OS benefit ignoring that this is again not the point of screening.
> It's borderline fraud, in my humble opinion
Your humble opinion disagrees with the entire medical community, including the study you initially cited. So we're all fraudulently screening for what purpose? You know that physicians don't collect billings or work fee for service in academic medicine correct?
> Which is exactly what you did in your first reply to me:
Did I say that was the only reason to screen and ignore the harms? I used that as an example of why overall survival is not useful as an isolated statistic.
You're the one who wanted to limit the discussion to one measure, I was pointing out the flaws.
In any case, anything that makes people die young, or more generally reduces people’s capacity to work (like many diseases of affluence) is incredibly expensive to society once you factor in indirect and opportunity costs.
The US is pretty much the only country to successfully reduce it, near as I can tell (perhaps Canada has had success too?).
https://uwaterloo.ca/tobacco-use-canada/adult-tobacco-use/sm...
[1] https://www150.statcan.gc.ca/n1/pub/82-624-x/2012001/article...
[2] https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article...
[3] https://www.macrotrends.net/countries/JPN/japan/smoking-rate...
[4] https://ourworldindata.org/grapher/sales-of-cigarettes-per-a...
Traveling outside the US to Europe or Asia (eastern/southern Europe or China in particular) it’s very visible, where in the US outside of a few locations it’s almost invisible now and notably uncommon.
Especially for educated or higher income folks, too.
I'm pretty sure the figures will look somewhat similar in most western countries.
The US healthcare system uses private insurance, implying that more use of the healthcare system raises everyone's premiums. And people without insurance then go to emergency rooms which are in turn still passing the cost onto private insurers. So voters already have the same incentive in order to avoid their premiums going up.
On top of that, insurance is optional. There is no guarantee a person will get affordable care. That's the entire point of the system! If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system.
How does that affect issues like this where an increase in overall costs would reasonably be expected to apply to all insurers?
> On top of that, insurance is optional.
More than 90% of the population has health insurance, which is well over the majority required to bring about legislation.
> If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system.
That certainly isn't true. Serious problems with the US healthcare system include AMA lobbying to maintain a doctor shortage, various patent laws and FDA rules that limit competition and increase costs and a malicious lack of cost transparency. None of that would be improved merely by routing the premiums through the government.
A more plausible conclusion from observing the results of an entity's involvement in something is that if it is incompetent with the thing you gave it to do, don't give it more stuff to do.
When my code doesn't work, I don't sunset the code, I fix it. Why would the best course of action be to stop trying instead of fixing the root of the problem?
About 90% of that scale requires sunsetting at least some of your code and doing something differently.
https://onlinelibrary.wiley.com/doi/full/10.1111/resp.14242
> There’s incentives for our government to protect workers from risks that will cost a fortune to fix.
There are many examples where this is inaccurate but let’s keep it simple and delve a little deeper into the silicosis problem presented in this specific study.
From the JAMA article:
Although a substantial number of the patients, including some of those who were uninsured or with restricted-scope Medi-Cal, likely had an undocumented immigration status, we did not directly collect information about whether individuals were undocumented immigrants.
Note that public health system in Canada is not “free”. Legal immigrants, documented workers, citizens and refugees have access to provincial or federal health insurance which pays for care.
Undocumented or illegal immigrants have neither (and also would not get WSIB which would be the payer for most silicosis cases) and actually have better coverage in California.
Additionally:
Ten patients (19%) were uninsured, 20 (38%) had restricted-scope Medi-Cal, 7 (13%) had Medi-Cal, 8 (15%) had private insurance, and 7 (13%) had workers’ compensation.
So 34/52 had some form of government provided or mandated insurance.
As an aside while restricted-scope Medi-Cal and uninsured rates are the surrogates for undocumented immigrants in this study, those over the age of 50 (or 19-25) are also eligible for full scope Medi-Cal but were not identified in this study. Medi-Cal will also be expanding in January 2024 to cover undocumented immigrants aged 26-49.
Even if we assume Canada’s silicosis incidence is lower, all of the above strongly suggests your public health system cost-savings incentive hypothesis is incorrect.
Sure, no axe to grind here. Do tell us your impartial take.
I also provided a reference that is open access but here is the relevant section for you:
In Canada, there are no national data on the incidence or prevalence of silicosis. In the province of Alberta, where silicosis is a notifiable disease, health insurance data revealed 861 cases with at least one reported diagnosis of ‘silicosis’ during a period of 10 years from 2000. These results were based on raw data and not a secondary review of primary imaging and clinical information. Data from 2000 through 2009 showed that only 29 workers' compensation claims were accepted for silicosis in Alberta. Data from Quebec's compensation system revealed 351 compensated cases of silicosis between 1988 and 1998. Of note, workers who participated in regular surveillance had milder disease at the time of compensation.
The JAMA study is from 2019-2022. Data that is 20-30 years old is relatively poor quality.
Changes in medicine, workplace safety rules and occupational trends makes it hard to compare to silicosis rates in Canada to the US in order to assess the claims of the comment I replied to therefore I think the relative incidence described in this review article (from 2022) is inaccurate.
If you want to disregard my quality assessment, the discussion ends with the review article showing silicosis rates are 3x higher in Canada.
Can you elaborate on how any of this shows I have an axe to grind or that I’m biased?
Canadian data is poor quality. On any issue you might care to pick, the topic is better studied in the United States. I run into this all the time. For example, we make allocation decisions at a charity I volunteer at with, about what health problems unemployed LGBT people tend to have. We use data for American urban populations. The data doesn't exist for Canada, AFAIK. It's a smaller country! There's simply less research and statistic-taking done! It's a reasonable statement.
Besides -- commenting on the lack of good data usually implies the exact opposite of what you seem to think -- it is an admission by the poster that their argument is based on weak evidence.
Which is exactly why I limited my reply to a discussion about the California study and healthcare systems rather than reiterating the claims in the 2022 article I referenced which states silicosis incidence is 3x higher in Canada, based on 20-30 year old data.
Although I live in the US now I’m a dual citizen and practiced medicine in both countries, the only axe I have to grind with Canada is the harsh winters which are incompatible with my fragile desert descent body.
I'm enough of a pedant to annoy the fuck out of most anybody who knows me, but really? Look, there is no "free" health care anywhere, but it's a term that has (perhaps unfortunately) become widely used as a synonym for, depending on your sensibilities "no charge at the point of service" and/or "socialized health insurance and health care coverage".
And Canada is certainly one or both of those.
The metric "well, they don't provide it for undocumented persons" is a weird one, as is the use of California as a counter-example.
The comment I replied to asserts that the government incentive to reduce healthcare expenditures improves workplace safety, and consequently in the context of this article would have prevented silicosis/PMF in these patients.
I highly doubt most HN commenters are aware of whether undocumented migrants are covered in the Canadian system as they are in California, certainly the person I replied to was not, so I explain differences in coverage.
Consequently, the argument doesn’t hold water as the financial incentive for the government is stronger in California than in Canada as it relates to this study population.
> The metric "well, they don't provide it for undocumented persons" is a weird one, as is the use of California as a counter-example.
I'm not providing any counter examples, undocumented workers in California are the subjects in the article we are commenting on. Where in fact there happens to be socialized healthcare that you seem to think I'm arguing against.
You yourself seem to not understand this distinction with your comment: "no charge at the point of service".
There is always a charge at the point of service and a bill is generated. The difference with the US is that the Canadian healthcare system, which also functions mostly privatized, uses a single payer model so the government is the only one legally permitted to pay for insured services. In other words, each province runs a large insurance company and there is a law that states that no one is allowed to charge any person or company other than the government insurance plan for anything the government has deemed reimbursable for any person covered by the plan.
(So you don't misinterpret my statements again: while government run hospitals, but not the physicians working in them, do get capitation payments they also bill for some services. What is billed vs paid through capitation varies by province. Services rendered to uninsured patients are never from capitation funds and are always charged directly to the patient).
If the services rendered or you are uninsured, like the patients in the article study, it functions the same as the US and you will personally receive a bill in the mail with similarly obscene rates much higher than what the government insurance company would have paid.
This distinction has everything to do with the article and GP's point which asserts that the Canadian government will bear some cost for the care of the patients in the California study which is flatly incorrect. If there was no charge at the point of service none of this would matter.
I was thinking more broadly than just the US or Canada. In Scotland, for example, there is literally no charge at the point of service.
The discussion, and the part of my comment you quoted, is specifically about Canada and the US. So I'm not sure what you're even arguing or why.
Dad knew but he was stuck in the past of "It had to be done" mentality. And really as a high school drop out he really may not have understood the danger. For years he and my grandfather had a painting business with the paint at that time containing lead.
That is true with or without publicly funded healthcare.
https://news.ycombinator.com/newsguidelines.html
Edit: we've had to ask you not to do this on HN more than once before. Please avoid it in the future.
https://news.ycombinator.com/item?id=34492512 (Jan 2023)
https://news.ycombinator.com/item?id=34073107 (Dec 2022)
I can see how what I said would be construed that way.
Flamebait in a comment has to do with the most inflammatory thing it contains, not the most interesting thing. When a house is on fire, people don't admire the décor.
I suspect the problem is that welding related disease/problems show up quite quickly in most cases, and welding tends to be a higher paid industry. More room for margin on PPE and workers have higher demands.
The “safety squint” is still a thing.
People working in there weren't wearing any sort of hearing protection and became deaf within months. And after introducing pressured air driven equipment, they were all dying in a few years from silicosis. Until someone added water spraying to precipitate the dust into mud (wherein their issue became to fiddle caked in mud all day long in the dark, which I guess is an improvement over certain death). Which happened years later.
Thinking about the kind of life they had terrorizes me. I don't get how, for the longest time, people were fine with that. I mean no judgement on the workers, they probably didn't have a choice - but the people sending them in probably saw them as kettle.
Makes you think about the sort of progress in worker protection that was made since then. But also this kind of story reveals how people are still ready to profiteer from such deadly practices, if given the opportunity.
1: https://www.britanniaminemuseum.ca/
In the century between the 1850s and 1950s we went from not even having radio communications or the germ theory of disease to building nuclear submarines and fiber optic data networks.
Once we had penicillin and cities stopped dumping raw sewage into the water supply, people started to have better options and these kinds of businesses had to improve safety to attract workers.
If you had to choose between the job you have now and the ones they had then, how much more would they have to pay you to get you to choose the latter? More than it costs for the safety equipment, right? So they started installing it.
Then governments passed laws requiring it because politicians are adept at taking credit for good things that were about to happen regardless.
If the government isn't enforcing the law, what good is a new law for them to not enforce?
There's a stronger record of laws preventing a government from acting against workers and ones permitting workers to take matters into their own hands.
Striking workers were usually on the wrong side of the law though because they were using coercion and force to make every worker to participate in strikes (they could hardly work any other way without laws restricting “right to work”)
Well sure they could. The workers who agree with the strike go on strike and if that's enough of them to put pressure on the employers to meet their demands, their demands get met.
If it isn't, you've failed to convince your fellow workers that the light is worth the candle and if you don't want to work under the terms that they do, you can go work for someone else.
This is mainly a problem when there is no other someone else to work for, but now you're back to anti-trust rather than labor laws.
Or your employers can hire some thugs to disperse you and the other strikers. When you resist the governor will just use that as a justification to send in the national guard to “maintain law and order”. At least that’s how it often worked in the good old days..
> Well sure they could.
In an imaginary world maybe. In a society with no safety nets and and where any meaningful accumulation of savings is infeasible? Not so much.
> you can go work for someone else.
Under the same conditions. Labor has an inherently weaker bargaining position (due to certain pretty obvious factors) compared to business owners. Unless you have some external regulation or societal pressure and employers are behaving fully rationally (i.e. maximizing profits) that will always be the case for the majority of the workforce.
Now we're back to "everyone agrees that violence should be illegal."
> In a society with no safety nets and and where any meaningful accumulation of savings is infeasible? Not so much.
But then what difference does it make if you go on strike with 75% of the other workers or 100%? Either way the boss just waits two weeks until you all need to buy food.
Which still assumes that the employer is a monopoly. Otherwise you go on strike by taking some gig work in the meantime, which maybe sucks, maybe even sucks more than your current job, but it lets you make rent for as long as it takes for the employer to feel the need to meet your terms.
> Labor has an inherently weaker bargaining position (due to certain pretty obvious factors) compared to business owners. Unless you have some external regulation or societal pressure and employers are behaving fully rationally (i.e. maximizing profits) that will always be the case for the majority of the workforce.
There is no law requiring employers to pay anyone more than minimum wage and yet >98% of people make more than minimum wage. What explains this other than that employers have to compete with each other for labor?
https://en.m.wikipedia.org/wiki/Ludlow_Massacre
There's nothing better for workers than a competitive market. What's the boss going to do when the workers have the option to quit and get a better job somewhere else?
The only reason you need to strike is if there isn't any other employer offering better terms that you can go work for instead. Otherwise you can just threaten to quit unless they meet your terms and actually do it if they don't.
Conspiracies only work if the market is concentrated enough; if there are ten thousand employers and it's easy to start a new one then you're not going to be able to hold together a secret illegal cartel.
None of those actually work in a competitive market.
The government tends to default to supporting strikebreaking(and still generally does in any era, including this one) because industrialists, financiers and politicians share lines of mutual support: legal ownership of intangibles like a corporation acts as an alternative to feudal fiefdoms and warlords, in that it's less destructive and lets complex processes evolve.
Corporations are very effective at putting taxable assets on the books, which allows a more complex state bureaucracy, so politicians end up wanting the support of business for government power and expenditures. Financiers want their thumb on the scale, for the winners they picked to continue winning, rather than to run off and form a competitor. And the industrialists themselves, though they are often at the forefront of the most dramatic reorganizations, tend to get stuck in equilibriums where either they're the evil monopolist, or someone else is. Once you arrive at the equilibrium, the elite players lose their dynamism and are pressured to stay within the existing trends or lose their place.
Thus when the Pinkertons or their modern counterparts come in, the officials shrug and say "business as usual, business as usual". The system convulses when it becomes a riot and property is destroyed because that weakens the whole premise: less capital to deploy, fewer assets to tax, failure to return on investment. And people out of a job, but if they were rioting it may have been a crummy job. It creates a shock that can break the equilibrium and enable a different deployment of labor and capital in a new technological environment. That's essentially why the industrial era has so many short, distinct periods and upheavals within it; the sausage is being made, though it's ugly to witness.
What you're getting at is that market competition can be destroyed through regulatory capture. But now you're making the case for regulatory form and anti-trust rather than some kind of labor laws, which was kind of what I was getting at to begin with.
Trying to regulate an artificial monopoly is a fool's errand, not least because if they have the political influence to capture regulators and retain their monopoly then they can also interfere with the passage or enforcement of anything that benefits workers at their expense. So all efforts should be directed to breaking them into tiny, tiny pieces none of which have enough power to capture the government.
With no external control businesses tend to form cartels and/or adopt practices and regulations that are more hostile towards both consumers and workers than what governments can come up to.
On average anyway. Of course there markets and goods which are somewhat immune to this and exceptionally incompetent governments which can do significantly more harm than good.
Cartels are generally a result of government regulation, because they require something to be creating a barrier to entry that prevents new entrants from breaking the cartel.
You can also have cartels enforced by e.g. acts of violence or vandalizing competitors who won't join the cartel, but who claims that non-consensual violence or property damage shouldn't be illegal?
If you encounter an uncompetitive market in practice then you clearly have some kind of a regulatory failure, but the answer in these cases is not to pass more laws to mitigate the consequences of insufficient competition, it's to address whatever is causing the market to be uncompetitive.
They are often the result of companies bribing or otherwise coopting the government to enact those regulations.
> You can also have cartels enforced by e.g. acts of violence or vandalizing competitors
Or you could just abuse your dominant position by preventing your suppliers or retailers from doing business with your competitors, outright buying them, running them out of business by temporarily dumping your prices etc. these are all both more effective and more realistic options than outright violence.
> but the answer in these cases is not to pass more laws to mitigate the consequences of insufficient competition,
Having corrupt and incompetent governments leads to bad outcomes. That’s not particularly insightful nor does it automatically discredit any form of regulation.
> it's to address whatever is causing the market to be uncompetitive.
You’re certainly right. Sometimes this can be accomplished by reducing restrictions and sometimes by introducing additional laws. We should also take into account that unregulated markets are hardly ever competitive.
Which is the thing that does this:
> automatically discredit any form of regulation.
The default assumption is that a proposed regulation benefits powerful interests, because powerful interests are the ones who can have regulations enacted.
That doesn't mean it's a violation of the laws of physics for a regulation to do something good, but if you open the US Code to a random page it's not what you'd expect to find, and if someone proposes a new rule they should be viewed with skepticism.
> Or you could just abuse your dominant position by preventing your suppliers or retailers from doing business with your competitors, outright buying them, running them out of business by temporarily dumping your prices etc. these are all both more effective and more realistic options than outright violence.
These also require the market to already be uncompetitive. If there are a thousand suppliers and retailers, you have to be able to strongarm them all or your competitor can just use any that you can't. If there aren't regulations creating a market barrier to entry then new competitors can form and you have to buy them out for more than they make in the market which in turn is more than their entry cost, but if you do this then it's profitable to keep creating new competitors to make you buy until you run out of money. You can sell at a loss but with low barriers to entry now customers or retailers can go into competition with you just to force you to keep doing that forever and lower their own costs.
Also notably such things have been anti-trust violations for a hundred years or so without requiring any new legislation (and this is still a useful check when some other regulations have caused a market to already be uncompetitive or have high barriers to entry).
> Sometimes this can be accomplished by reducing restrictions and sometimes by introducing additional laws.
But many of the laws proposed to address problems caused by a lack of competition are not even attempts to restore competition. They're commonly attempts to mitigate the damage caused by the lack of it. And these laws typically make it harder rather than easier to actually restore competition, because regulatory overhead favors large conglomerates with legal departments, reduces the flexibility that could allow new challengers to find a niche or is just literally drafted by the incumbents to create a regulatory moat.
> We should also take into account that unregulated markets are hardly ever competitive.
There is no such thing as unregulated markets. Governments at a minimum enforce contracts and property rights, and then must do so in a way that doesn't enable market consolidation, e.g. by not enforcing contracts for the formation of a cartel or allowing one entity to buy all of the land in a city.
But regulations should be directed to pricing major externalities and promoting competition rather than trying to micromanage a society made rotten by other rules that make markets uncompetitive.
That really not true. Nobody forced them to adopt anything (in a literal way). It’s just that automated factories could produce more faster while paying their workers much less since they didn’t require skilled craftsmen.
Also artisans generally used a guild/cartel model which artificially constricted supply which inflated their incomes.
> out to make the Luddites look foolish and technological progress the hero of the story.
I thought it was pretty obvious to everyone that they were breaking machines because they eliminated demand for high skilled/high pay labour?
With this attitude we’d still be driving with leaded gas, living in lead painting rooms with asbestos roofs and spraying ozone layer destroying aerosols amongst a bunch of other things. The mechanism you described only really works with short term safety issues. If it takes years or decades for health problems to develop neither workers nor their employers tend to be particularly bothered about solving them.
The mechanism I described works for employment issues, because employees can choose not to take a job and more dangerous jobs carry a risk premium that both employers and employees have the incentive to reduce when reasonable safety measures are available.
With leaded gasoline and CFCs the victims have no option to refuse, and it's completely legitimate to prohibit harms and risks imposed on other people without their consent.
For some reason you’re making the assumption that most employees are as capable of estimating this premium as well as their employers and/or that it’s even possible to estimate this risk in advance?
This view also assumes that skills are perfectly replaceable, that there's no cost for requalifying for another profession, and that this is instantaneous or that people have some magical way to offset the opportunity costs of requalification while they train for another job.
The problem nowadays (and this is not exclusive to HN, although it is especially salient here) is that people like to fall between two ideological extremes: Either that the government is a inherently neutral and benign all powerful institution 100% of the time, or that free markets always exist, and are always pareto-efficient and that governments action is always some sort of rent-seeking parasite.
In the real world things are a lot more complicated. Not every thing can be solved with the heavy hand of government, neither the market itself is always able to reach the most humane solution. Politics is still needed, and we haven't reached the end of History.
It does not assume any of these things. The cost of switching jobs is not required to be zero. What it does is provide a ceiling for what the existing employer can get away with.
They may be able to get away with paying you 5% below market or subjecting you to an inflexible schedule and it isn't worth changing jobs to one that doesn't do that, but if they try to make you use equipment that will kill you then you just walk right out the door.
Moreover, this is why a competitive market is important -- if you're qualified to be a steel worker but the steel industry is a monopoly, you can always learn to be an aircraft mechanic, but that takes time. Whereas if the steel industry has 10,000 companies in it, you go and work for one of the others using your existing skill set. Which reduces what employers can get away with.
It’s not just people “profiteering” though? The story mentions workers standing at Home Depot. These are ordinary homeowners hiring these shops to custom cut countertops for them. It’s not some mega-corp mass-manufacturing counter tops.
And now half the people who should be trying to put a stop to it are instead talking about how we need low skill, low education foreign workers that can easily be exploited to keep consumer prices low.
A non-trivial number of these mine workers were arrested on trumped up charges like "vagrancy" for not having a job or "trespassing" for walking along a railroad. They would often be sold to companies as convict lease (cheap) labor. Essentially slave labor long after the Civil War since the 13th Amendment has the slavery loophole where it's allowed as long as you're convicted of a crime.
This disproportionately affected freed slaves in the South but was an issue for everyone everywhere since it introduced a profit motive to manufactured charges and inflated sentences. The extent that it predominantly affected Black folks and poor white folks had a lot to do with public sentiment not doing anything about it for a very long time.
To a not-small-enough extent, the same conditions exist today where labor can be coerced for little to no pay among the prison population, many of whom have been threatened with obscenely long sentences being shortened by accepting plea deals even when innocent or with extenuating circumstances. For-profit prisons often make the situation worse by further incentivizing incarceration on a larger scale.
The solutions exist, the problem is making people invest in them and stick to it.
I just am astounded, horrified. The answer to abusive management is simply rebalance power. The answer to abusive markets is pay more (Edit: better supply chain ledgers)
Just horrified
re supply chains - the simple way to stop sales of any product is a shelf market like this: "The product X was manufactured by the small child who last month was mutilates by a factory accident. Nice picture. our product has the following verified supply chain. but it's more expensive. your choice of course"
https://www.latimes.com/california/story/2023-09-24/silicosi...
Yahoo news is something I avoid like the plague.
Asbestos is apparently worse because of the sharp edges of the particles, but if I put any angle grinder dust under the microscope I see plenty of sharp bits too.
I think the actually harmful thing is that the dust is 'fresh' rather than being the result of years of chemical weathering which tends to smooth off the sharpest pointiest bits at nanometer scale.
https://medlineplus.gov/interstitiallungdiseases.html
https://en.wikipedia.org/wiki/Mesothelioma
the workers in the article are young and are dying from the effects of "plainer" silicosis (which is similar to asbestosis).
Engineered stone is created, it's not like natural stone, we don't have to cut it. They also have the choice to cast it, net shape.
They just need to redo their whole schema, they need to reconfigure their process to customize the engineered stone before its solidified, not after.
That's not viable. They are cut only after the actual physical space has been built (carpentry mainly) because measurements have to be taken then since nothing is perfectly true/plumb/square. Today the turnaround is about a week for the material to be cut and then installed. Sending it off to the manufacturer to create to spec would not only add several weeks to the process but significant expense.
Stone (both natural and engineered) can be cut safely. These shops just haven't been. Proper respirators, ventilation, and wetting will create a safe space to work in.
I think that's the problem, we're unwilling collectively as a society to pay the cost.
A modern example: I've seen gravestone engravers completely covered in stone dust while wearing only a thin handkerchief; no hearing, eye, or proper lung protection. Sure they should know the risks but you can't force people to not smoke tobacco or use proper PPE.
If that means steel-toed shoes, a jock cup, thick gloves, shooting glasses, amplifying mickey mouse muffs, sunscreen, bottled water, and a P100 respirator, so be it.
Safety regs are written in blood. And it only takes an instant or a culture of disregard to lead to later cancer, permanent disfigurement, or death. There are no old bold pilots or construction workers.