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(Compare with, Ex. 4-77 (NIOSH data indicating 136,212 work vintage marijuana knowledge poster related chemical injuries treated in emergency rooms in 1986)). The HCS was promulgated to provide workers with the right to know

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and training to employees about the hazardous chemicals in their workplace. (Paragraphs , ). Worker turnover in many industries also increases the likelihood that the link between a workplace vintage marijuana knowledge poster chemical exposure and subsequent illness will be overlooked and will not be reported. This is particularly true for long-term health effects which develop over time, or after repeated exposures. Many chronic diseases are characterized by long latency periods of years or longer. OSHA believes that the reported data understate the extent of the health and safety problems caused by chemicals in the workplace. Lack of knowledge about health effects associated with chemical exposures contributes to the chronic underreporting of occupational illnesses (Exs. 4-44; 41). As the effects caused are diseases or physical

manifestations that may also occur in workers as a result of non-chemical or non-occupational factors, it is often difficult to identify such ailments as being caused by occupational exposures. Misdiagnosis is a problem and often symptoms are treated without realizing that the cause is an occupational chemical exposure. See, e.g., 53 FR (Ex. 4-178). During the HCS rulemaking, data collected about chemical illness and injury rates in manufacturing sectors showed that some 40-50,000 manufacturing workers experienced chemical source illnesses a year, and an average 10,000 worker compensation claims were filed annually in connection with chemical illness or injury in manufacturing . Employees in non-manufacturing industries were estimated to experience acute chemical illness and injury at the rate of 13,671 injuries, 38,248 illnesses, and 102 fatalities per year. 52 FR 31868. The chronic disease rate was 17,153 chronic illnesses, 25,388 cancer cases, and 12,890 cancer deaths per year. Id.