Author(s):
W. Kip Viscusi
Source:
Journal of Policy Analysis and Management, Vol. 4, No. 3, (Spring, 1985), pp. 325-343
一樣先說沒有建設性的感想：
- 這樣反駁OHSA職業暴露許可標準乃至於打官司上訴到最高法院的情景，會在台灣見到嗎？ (那個民國101年要施行的光電業廢水標準，也可以寫成這樣的一篇研究才對)
- 風險的兩端永遠是成本代價與效益利益，如何拿捏分寸，即便丟給做高法院，法官不會也沒有能力考慮技術面與經濟面，只能"依法"做出讓"一般人" "驚訝"的判決....
- 勞資雙方與成本效益間的角力，把政府行政機關與法院扯進來，再加上經濟學家與職衛專家來攪和，讓此一單純的暴露許可標準的安衛議題充滿"政治味"
- 就研究方法而言，看各項變數間的各年度的變化趨勢圖說故事，也沒有很複雜的統計檢定與迴歸，主要創意在於"預測"與"實際"間的比較與整合各方的資訊
- 文章鋪陳與文筆都很棒，讓人當成偵探故事來讀的專業期刊文章(本文作者任教於法學院)
- 有要把環安當成career的夥伴，不管你的想法與立場為何，可以好好看這篇故事深思ㄧ下
Abstract
In 1978, OSHA took a major step in attempting to promote the health of workers in the textile industry, tightening its standard on cotton dust levels in textile plants. Because the OSHA cotton dust standard was widely believed to be ineffective, it became the target of a major political debate and a fundamental U.S. Supreme Court decision. The evidence indicates that the standard has had the expected beneficial effect on worker health, and at a cost much lower than originally anticipated. Nevertheless, the costs still remain very high, far higher than estimates of the value of the results they achieve or of the value that workers place on them. Moreover, much more efficient ways of achieving comparable results are available. Nevertheless, large firms in the industry now appear to have a vested interest in maintaining the standard in its original form and are unlikely to constitute a force for change.
本文的主要議題：
1.更嚴格的作業環境棉塵標準並未考量成本的因素
2.作業環境棉塵對於勞工發生棉屑沉著病(byssinosis)的因果關聯(因為很多有嚴重棉屑沉著病的病患有抽菸的習慣，或許棉屑只導致職業病發生的中介因子)
3.更嚴格作業環境棉塵標準的成本與效益是否相符
標準的緣起經過(GENESIS OF THE STANDARD)
由OHSA於1978/06發佈，導因於懷疑cotton dust and the disease byssinosis之間的關聯性
但byssinosis沒有一致性與顯著的症狀，只有好幾期不同嚴重程度的病徵：
1/2期：
Grade 1/2 byssinosis involves chest tightness or breathing difficulties on the first day of the workweek, normally Monday mornings(為何通常在周一早晨發作？令人好奇的現象！)
第1期：
Grade 1 byssinosis involves occasional chest tightness or breathing dif- ficulties on every Monday
第2期：
If the worker experiences such problems on other days as well, he is placed in Grade 2.
第3期：
Finally, workers suffering from Grade 2 symptoms and who show evidence of permanent incapacity are placed in Grade 3.
可逆的疾病徵狀，業界也常藉職務輪調的方式來改善此一職業病
When transferred to non-cotton-dust areas, workers who fall into the low byssinosis grades are likely to lose the symptoms of the dissease. Rotation of this type is now widespread in the textile industry.
即便是最嚴重的第三期，也只是使肺功能受限，不會進一步導致肺癌或生命縮短，
Only Grade 3 byssinosis and cases entailing disabilities clearly involve chronic health effects, notably diminished lung capacity. According to the evidence, this reduction of lung function is not a prelude to some other ailment, such as lung cancer. The worker does not face a major risk of early death, and he is not disabled to the same extent as are victims of severe accidents, such as those who have lost the use of their limbs.另外棉塵和棉屑沉著病(byssinosis)間的因果關聯尚未獲得確認：
Is cotton dust the cause of byssinosis, or is it some agent correlated with the presence of cotton dust? The link is difficult to distinguish because of the high rates of cigarette smoking among textile mill workers and the small number of chronic byssinosis cases.
棉屑沉著病的威脅是否被誇大？
相關研究顯示藉著工作輪調可以讓此依職業疾病的徵兆獲得緩解，如果無法頻繁的讓勞工進行職務輪調，則可藉著配戴呼吸防護具(一般的棉布口罩即可，不需N95或豬鼻子)的方式來預防
然而OHSA在工會的壓力下(在有其他可能選擇的情況下，勞工通常反對與排斥使用個人防護器具)，在1978年制定棉塵法規：不單單只有設定作業環境當中的棉塵濃度限值，還包含工程控制措施、醫學監控與PM時的呼吸防護均納入規範；另外各特別的是針對不同暴露族群訂定不同的管制標準(200 micrograms per cubic meter of air for yarn manufacturing, 750 ug/m3 for slashing and weaving operations, and 500 ug/m3 for all other processes.)
相關醫療監控(健檢)應於1979年中上路，但該產業可於1984才適用此一新的嚴格暴露許標準
不同的暴露濃度標準反映出不同的工程改善成本，估計如下表
然而針對Mill Slashing & Weaving 而言，新標準為750 micrograms per cubic meter ，換言之對照表1幾乎不必付出改善的成本？同時成本效益之間沒有存在等比例的線性關係
因此針對Yarn Preparation而言，此部份作業的職業病患，其嚴重度大多為第1/2與1級而已，預防棉屑沉著病(byssinosis)成本預估約為$60萬/per case，如果在考量要預防更嚴重等級的病患出現，邊際成本將上升到$200萬/per case。
極端的邊際成本造成了對效益的質疑。
經濟學家與勞工部長出場
讓總統收回與擱置先前的成命，但隨後在勞工部長呼籲與請命下，卡特總統還是頒布了這項法規(總統任兩造擺佈，跟國內的狀況差不多！)
Economists in the Carter White House opposed the standard after it had been proposed by OSHA." Led by the chairman of the Council of Economic Advisers, Charles Schultze, they were successful in obtaining President Carter's support in a decision not to issue the standard. After a subsequent appeal by Secretary of Labor Marshall, the president reversed his earlier decision and decided to issue the regulation.
最高法院與法官出場
美國紡織製造業協會控告OHSA，棉塵法規的效益不符合成本(導致製造廠商權益受損)
然而法院認定OHSA的職責是在可行的前提下"capable of being done."，盡量降低風險，無須考慮成本 The court concluded that OSHA had to promote risk reduction as long as there was a technical possibility of compliance, a criterion that the court interpreted as meaning "capable of being done."
作者認為，所謂capable of being done的程度跟$與成本支出有關，因此最高法院的判決，在實務上沒有多大意義
In actual practice, the Supreme Court's criterion has little prac- tical meaning. Almost any risk can be reduced further through additional expenditures.
而這樣的判決造成極大的後續衝擊：
Under President Reagan's Executive Order 11291, the Office of Manage- ment and Budget has attempted to impose a benefit-cost test on new regulations, but in recognition of the Supreme Court decision it has specifically exempted cases that "violated the agency's legislation." Accordingly, agencies may sometimes disregard the balancing of benefits and costs, as in the case of the EPA ambient air standards for which the Clean Air Act specifically prohibits any consideration of costs.
等於讓環保與安衛主管機關可以放手制訂出不考慮廠商成本效益的嚴苛標準
一個很弔詭與有趣的大哉問：
誰能夠來審判失職失誤的法官？監察院？還是人民團結起來違法包圍法院，要求撤掉法官？
資方勢力的反撲與OHSA的冥頑不靈
雷根政府年代針對一些沒有生產性的法規重新評估與考量鬆綁，然而OHSA還是不願意將職務輪調與始用呼吸防護具的規範納入法規當中，儘管前兩者相較於換氣等工程改善而言更具"成本效益"
資方勢力的衰退
僅管在雷根政府年代，業界資方積極遊說放寬此一法規標準，然而不少大廠已經在卡特年代就已經持續投資進行改善(已經支出所需的2/3)，而且大廠認為此一法規有助於"壓抑"其他小廠，所以到最後要求鬆綁法規反而沒有成功(因為業者自己不團結，OHSA也沒有改變此一法規標準與架構。
成本與結果(COSTS AND CONSEQUENCES)
對於廠商而言，要達到此一標準必須投資換氣與過濾系統，如果還達不到標準，則必須全廠整修或更換設備
According to a 1983 estimate, the industry would spend about $171 million on ventilation equipment and $428 million on new production equipment between 1978 and the time when full compliance is achieved.
雖然以上支出可能導因於更嚴格的法規，但其中一大部分也跟工廠的生產力提升有關
about $353 million of the $428 million of new production equipment was intended for that purpose, rather than to meet the standard.
結果到了法規生效時，因此依法規增加的額外支出大約只剩246M
Consequently, capital costs specifically attributable to the standard will amount to only $246 million by the time compliance is achieved.
但以上這筆費用包含資本支出與操作費用，轉換之後大約每年的支出約為53M(作者沒修過會計學？只不過很多搞環境成本會計的也沒把資本支出和overhead的費用支出分清楚...)
而此一支出最大的目的在於提升勞工的職業健康，勞工健康的改善可用該行業的傷病比率作為指標，然而初級的棉屑沉著病(byssinosis)不見得會需要請假反應於傷病指標數據上
用過去(1960-1977)統計資料回歸的方法來產生所謂的預測Predict資料
The statistical manipulations generate the "predicted" values shown in Figure 1
可參見page 17 附錄的 Table A1：
解釋變數：平均每週工時、產業中女工的比例、產業中的勞工總人數與時間遞延的係數
R-Square約為78%
而作者針對1977-1980職災率飆高的解釋：the increase in risk was a phenomenon associated with cyclical fluctuations in the industry.
導入新的機台的學習適應期反而造成更高的職災率
There are several conjectures one might advance to explain the increase in injury rates. First, the higher level of lost workday accidents may have been a consequence of the new technologies that were introduced in connection with meeting the standard. These technologies often involve faster production speeds and higher productivity both in yarn preparation and in weaving. The pattern shown in Figure 1 is consistent with the hypothesis that the new equipment may have led to a temporary increase in accidents associated with a learning period.
其次新法規的導入(如健康監控的部份)，使公司必須更注意與提報相關病例
A second possible explanation for the accident increase is that the imposition of the cotton dust standard made firms more vigilant in their reporting of injuries and illnesses;
也由於職災率的指標受到以上因素的干擾，所以必須在看其他指標(以驗證新法規對於勞工健康的促進)
以上職災率的前後期對照，顯現不出新法規對於勞工健康的提升
另外看離職率指標
女工比例、ln(薪資率)、ln(每週工時)、ln(每週加班時數)
薪資/工時與離職率呈反比、女工比例/加班時數和職率呈正比....
1977年以後導入新法規以後實際離職率彽於預測，無法完全歸因於工作環境的改善，但至少可說有某些關連性....
成本效用的估算(ESTIMATING COST EFFECTIVENESS)
前一章節的分析比對與歷史回顧已經提供了一些基礎(但無法下定論)
在效益effectiveness部份的估算，引用職衛專家對於減少此一職業病發生的評估，如表2
Table 2 summarizes our estimates of the reduction in byssinosis cases between 1978 and 1982 brought about by introduction of the standard, as well as the additional reductions to be anticipated after 1984, the year when full compliance was to be achieved. Although OSHA did not require that firms comply with the cotton dust exposure requirements until 1984, firms had made sufficient changes by 1982 to justify the assumption that over two-thirds of the anticipated reduction in byssinosis cases was already occurring in that year. In short, the estimates suggest that the firms' health- related investments were already having a substantial impact.
在導入新法規的1978-1982期間，所能可以預防與減少的所有病例個案數當中，約有2/3已經實現；顯示此一新法規的功效
而在成本Cost的部份，先前內文當中已經有提到，結合成本的資料，對照表2的估算，我們可以得到關於每減少一個不同嚴重程度病患所需付出的代價，結果如表3
Table 3 summarizes the result of these calculations for different grades of byssinosis. Obviously, these cost estimates exclude the costs of any increased accidents that may have resulted from the change in workplace technologies; but, given the tenuous nature of the link between those accidents and the cotton dust standard, that exclusion seems justified. The average costs per case prevented will be higher with full compliance than for the 1978-1982 period. This pattern reflects the expectation that the cost per case is likely to be higher for firms that were not yet in compliance by 1982 than for those in compliance by that date; a similar pattern is found in other regulatory contexts, and it is to be expected on theoretical grounds.26每減少一個有病情徵狀的病患，預估需要花費9000美元，然而和表1相比較，這個時期在預防此一職業病的公司成本明顯更少
而且相較於一個勞工的薪水，每年約25000元美金（視為創造的效益），花9000USD(來得到一位健康的勞工似乎還頗為划算)，但如果再看預防更嚴重病患所需付出成本：partial and total disable每人每年需要花37.8萬USD、Total Disable每年更需花費超過100萬USD(換言要花那麼多錢保障勞工的健康，乾脆工廠收起來比較快….)
備註：
考量的成本支出為立即，而利潤回收卻是逐年度遞延，本文使用折現率10%進行相關計算（以比較到底預先配合OHSA的法規要求投資相關設施划不划算，抑或拖到新法規生效後再投資，看哪一個會比較划算…）
靠，米國的律師真強，難怪打官司那麼花錢…… 此一法規存在的理由與貢獻就是要預防嚴重的棉屑沉著病(byssinosis)發生，就byssinosis cases over Grade 1 and disabilities而言，每個case每年還要花到5萬4千USD
顯然讓勞工使用PPE與job ratate的方式來預防會划算的多，但額外的無形成本則是勞工工作的舒適性。
以這個案例而言，造成無法走PPE與job ratate來預防此一職業病的最大障礙不是工會的反對，而是OHSA沒有出來塑造協調讓受到影響的勞工得到財務方面的補償機制(補償工作的不舒適與可能的職業病風險)
Perhaps the greatest impediment to the introduction of equipment solutions such as these may not be unions' opposition to such measures but rather OSHA's failure to fashion a mechanism for ensuring that there is adequate financial compensation for the affected workers
結論：
顯然讓勞工使用PPE與job ratate的方式來預防會划算的多，但額外的無形成本則是勞工工作的舒適性。
以這個案例而言，造成無法走PPE與job ratate來預防此一職業病的最大障礙不是工會的反對，而是OHSA沒有出來塑造協調讓受到影響的勞工得到財務方面的補償機制(補償工作的不舒適與可能的職業病風險)
Perhaps the greatest impediment to the introduction of equipment solutions such as these may not be unions' opposition to such measures but rather OSHA's failure to fashion a mechanism for ensuring that there is adequate financial compensation for the affected workers
結論：
- 一般雖然認為OSHA的法規對於工廠的安衛水準沒有辦法有顯著的影響，然而在這個案例當中，此一法規卻有顯著與戲劇性的影響
- 目前(1985)業界的執行水準，其實還達不到最高法院所要求的” capable of being done”，勞方雖然可以要求資方執行法院的命令，然而產生額外成本卻會超過勞工的效益與職場價值
- 就以下兩個基準，總結此一法規對於提升勞工職業衛生不是有效的工具：一種是就成本而言，另一則是相對於讓勞工配戴PPE的替代方案
- 就幫此一法規辯護的立場而言，此一法規除了減少相關職業病的發生外，另外還比原先預期更具成本效益也讓相關預防的成本降低(由於先前高估花費與廠商更新設備)
- 而資方對於此一法規不會再有較大的反彈，由於大廠認為此一法規 (所需的資本支出與日常費用)對於其他小廠形成競爭障礙
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