Safety advocates are worried that lawmakers are getting ready to make it harder to penalize companies that don't keep track of workers' injuries.
Since 1971, the Occupational Safety and Health Administration has required many employers to keep careful records of any worker injuries or illnesses.
David Michaels, the former head of OSHA who now is a professor at George Washington University's School of Public Health, says the rules affect millions of Americans employed in "everything from steel mills to poultry processing plants."
Companies are required to keep injury records for five years, and he says this isn't pointless paperwork.
"The only way employers and workers understand what's going on in the workplace and why workers are being hurt is by looking at the log and by investigating the injuries that occurred," says Michaels.
If employers' logs are inaccurate, or fake, they can be fined. But in 2012, there was a big change that made it a lot harder for the government to punish companies for bad logs. A court ruled that if a worker got injured — maybe burned, or cut — and that injury didn't make it into the log, the government has only six months to check the log and issue a fine.
Michaels says there just aren't enough safety inspectors to catch problems that fast. And the effect of this change has been dramatic — citations for bad record-keeping have dropped by about 75 percent.
"Enforcement actions around record keeping are way down," he says. "And the big cases that OSHA used to have where they could issue fines because an employer had not recorded dozens of injuries — they've essentially disappeared."
So, government officials wrote up a new regulation, to basically put things back the way they'd been for the agency's first four decades; that rule was finalized late last year.
But a slew of industry groups oppose it.
"The regulation was trying to do something that OSHA didn't have the authority to do," says Marc Freedman, executive director of labor law policy at the U. S. Chamber of Commerce. "And I know I've heard various comments on the other side, that this is bad for good employers. But at the end of the day it's about the rule of law."
That's why he wants Congress to act. Lawmakers can review and cancel regulations issued in the last days of an outgoing administration, under the Congressional Review Act. The House has already voted to do away with this one, and the Senate is expected to vote soon.
Rosario Palmieri, vice-president for labor, legal and regulatory policy with the National Association of Manufacturers, says ditching this regulation will help businesses "that have had the uncertainty hanging over their head about whether they could be cited for record-keeping issues from many, many years ago."
But if Congress kills this, some worry that accurate record keeping on injuries will effectively become voluntary.
"There won't be any ability to make sure that injury and illness records are accurate," says Peg Seminario, with the AFL-CIO, which represents more than 50 labor unions. "Employers will have license and they'll know that they can falsify their records and not be held accountable."
That will make it harder, she says, to find and fix problems that hurt people at work.
That's why two former commissioners of the Bureau of Labor Statistics — one appointed by President George W. Bush and one appointed by President Barack Obama — have written lawmakers to warn that national data on workplace injuries would become less reliable.
"It is important to protect the accuracy of employer injury data, and passage of this legislation is likely to result in less accurate data," wrote Kathleen Utgoff and Erica Groshen. They note in their letter that this data is used to set national strategy for workplace safety and to provide benchmarks that let employers evaluate how well they protect workers.
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Doctors have treated thousands of people suffering from severe depression with ketamine. It's a hallucinogenic club drug also known as Special K, and it isn't approved for treating depression. But as NPR's Jon Hamilton reports, more and more doctors are giving ketamine to patients who've run out of other options.
JON HAMILTON, BYLINE: Gerard Sanacora is a psychiatrist at Yale University who has given ketamine to hundreds of patients. As a street drug, ketamine can be dangerous, and for medical purposes, it's approved only as an anesthetic. So Sanacora says sometimes other doctors tell him...
GERARD SANACORA: This is unethical. How can you be offering this to patients based on a limited amount of information that's out there and not knowing the potential long-term risk?
HAMILTON: But Sanacora says ketamine often does something no other drug can. It relieves even suicidal depression in a matter of hours.
SANACORA: So if you have patients that are likely to seriously injure themselves or kill themselves within a short period of time and they've in fact tried the standard treatments, how do you not offer this treatment to people?
HAMILTON: More and more doctors seem to agree. Dozens of clinics in the U.S. now offer ketamine, and Sanacora says at least 3,000 patients have been treated so far. Early this month, he and other members of a task force from the American Psychiatric Association published a consensus statement on ketamine. It concludes that there is now compelling evidence that ketamine usually work even when other drugs have failed. But there are still lots of questions about ketamine. James Murrough is a psychiatrist at Mount Sinai Hospital in New York.
JAMES MURROUGH: We haven't had large-scale trials. We don't know how much or how often it should be given for it to be effective or safe.
HAMILTON: Murrough is an author of another assessment of ketamine that appears in the journal Nature Reviews Drug Discovery. He says there's an urgent need to answer questions about the drug's long-term safety because many patients require a dose every couple of weeks to keep depression at bay. Still, Murrough thinks the case for using ketamine is much stronger than it was just a few years ago.
MURROUGH: There's warranted caution that's balanced with, you know, an optimism which says we've never had a new medication for depression since the era of Prozac.
HAMILTON: Prozac arrived in the 1980s and became the first of a class of depression drugs that target the neurotransmitter serotonin. Ketamine acts on a different neurotransmitter called glutamate. And Murrough says that has got drug firms excited about the possibility of creating a whole new class of drugs for depression.
MURROUGH: Companies are reopening programs. They're pulling drugs off the shelf that they've already developed that they know act on the glutamate system.
HAMILTON: One promising candidate is a chemical sibling of ketamine called esketamine. It's now in the final phase of testing before consideration by the FDA. Yale psychiatrist Sanacora, who consults for companies developing ketamine-like drugs, says he's optimistic.
SANACORA: This is probably the most interesting and exciting new development that I've seen in my career and probably going back over the past 50, 60 years.
HAMILTON: Jon Hamilton, NPR News.
(SOUNDBITE OF BONOBO SONG, "KERALA") Transcript provided by NPR, Copyright NPR.