Barry TheTollOfHouseholdCleaningWork Report FINAL

The Toll of Household Cleaning Work Economic and Health Precarity of Immigrant Latinx Cleaners in New York March 2021: MAKE TH NE E W R Y O O A RK D DIGNIDAD, COMUNIDAD Y PODER.

The Toll of Household Cleaning Work Economic and Health Precarity of Immigrant Latinx Cleaners in New York March 2021

Make Th Ne E W R Y O O A Rk D

Dignidad, Comunidad

Y Poder

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Suggested citation: Make the Road New York, Selikoff Centers for Occupational Health and the Institute for Exposomic Research at the Icahn School of Medicine at Mount Sinai, & Queens College of the City University of New York (2021). The Toll of Household Cleaning Work: Economic and Health Precarity of Immigrant Latinx Cleaners in New York, a report by the Safe and Just Cleaners Study, March 2021.

Executive Summary Household cleaners face many challenges to their health and well-being at work including insecure employment, low wages, stressful working conditions and exposure to harmful chemical components of cleaning products. The Safe and Just Cleaners Study is a community-based participatory research partnership funded by the National Institute of Environmental Health Sciences. The study is collecting data on cleaners’ chemical exposures and other working conditions to develop safer cleaning approaches to reduce exposure for cleaners and their clients. The research partners, Make the Road NY, the Barry Commoner Center for Health and the Environment at Queens College, CUNY, and the Selikoff Centers for Occupational Health at the Icahn School of Medicine at Mount Sinai, are committed to making data available to affected communities, as they are collected, to influence ongoing policy and action discussions.

In this report, we present data from a survey of Latinx #FundExcludedWorkers and #Coverage4All are two policies household cleaners in NYC and Westchester conducted that can act as economic and health stopgaps, respectively, between June 2019 and February 2020. Key findings: to ameliorate some of the disproportionate impacts of the pandemic on low-income workers, like household cleaners.

n Housecleaning is mostly conducted alone, part-time, in All workers deserve to put food on the table, pay their rent, multiple homes, without a formal written contract, and and access healthcare. low-paid. n Many cleaners in our study do not earn enough income to cover basic expenses, experience high levels of income The Safe and Just Cleaners Study will be collecting insecurity, and live below the federal poverty level.

additional data in order to assess the impact of n On average, they are far less likely to have health insurance the COVID-19 pandemic on cleaner’s health and than other populations and do not access paid sick leave. wellbeing, employment status, and exposures to cleaning and disinfecting products. Data in this n Many commercial household cleaning products contain report also highlight the importance of greater chemicals that can be harmful to health and most transparency related to the chemicals that are cleaners are aware of this. However, numerous factors included in commercial household products.

exist that increase the risk of exposure. Household cleaners’ situations have become even more urgent since the COVID-19 pandemic. Follow-up discussions with participants have illuminated how job loss, significant increased use of disinfectants if working, and ongoing health access barriers have further stressed cleaners’ financial, physical and mental health.

Methods Data from this report were collected between June 2019 and February 2020 as part of a larger study funded by the National Institute of Environmental Health Sciences. The long-term aim of the Safe and Just Cleaners Study is to develop safer cleaning approaches so that household cleaners and their clients can learn to reduce exposure to harmful chemicals. In our commitment to contributing to ongoing policy and action discussions of affected communities, this report features cleaners’ overall health, and working and socioeconomic conditions.

Outreach to recruit participants boroughs in NYC (Brooklyn, Queens, Staten Island and Upper Manhattan) and Westchester, with a focus on Latinx dense n Brooklyn neighborhoods. We used a variety of outreach methods in n Queens urban and suburban communities: n Staten Island n Upper Manhattan n distributing fliers in neighborhood stores and n Westchester public spaces, n announcements at community-based organizations, n outreach at local institutions that serve the Latinx community including elementary schools, foreign consulates, and employment centers and, n referrals from participants.

Once a potential participant expressed interest, we determined if they were household cleaners and met the study’s eligibility criteria: they – Successful recruitment n worked as a household cleaner within the past 2 months and participation with their work including cleaning bathrooms and kitchens in apartments or houses, We recruited 925 potential participants of whom about two-thirds met the eligibility criteria. Among those n worked on a regular basis at least once per week, and, scheduled to complete the survey, 70% participated, and n had at least 6 months of work history as a household this rate was consistent across all outreach areas. Half of cleaner in the US.

the surveys were completed in Queens and Brooklyn with the rest distributed across the other locations. Half of the If a worker met the criteria, they were invited to complete participants were recruited during meetings, classes or other a 75-minute survey in a community location administered activities at community-based organizations, about a quarter by a fluent Spanish speaker. We rescheduled no-show were recruited through street outreach and public spaces, appointments at least three times before they were such as train stations and parks, about 15% were referred by considered a non-respondent.

another participant, and the remaining approximately 10% were recruited through other local institutions.

Demographics Latinx household cleaners in our study in NYC and Westchester are 99% cisgender women and tend to be middle-aged and immigrant, mostly from Mexico and Ecuador. They have lived in the US an average of 16 years. Additionally, forty-two percent of household cleaners self-identified as Mestiza, 19% as Black or Afro-descendant, 12% as White, and 2% as Indigenous. One percent of them speak an Indigenous language at home, such as K’iche’, Quechua, Nahautl, or Mixteco.

AVERAGE AGE (range 21–78) ENGLISH COMFORT LEVEL 45 years old n 38% Uncomfortable n 47% More or less comfortable n 15% Comfortable RACE n 42% Mestiza, or 2 or more races n 19% Black or Afro-descendant n 12% White n 2% Indigenous or Native American EDUCATION n 25% Don’t know n 31% Elementary School n 2% Prefer not to answer n 43% High School n 3% GED GENDER n 9% Some College n 13% Completed College n 99% Cisgender women n <1% Professional Degree n 1% Cisgender Men

Household Cleaners Surveyed

100% immigrant

Countries Of Birth

LANGUAGES SPOKEN AT HOME (at least some of the time) n 44% Mexico n 99% Spanish n 19% Ecuador n 14% English n 10% Colombia n 1% Indigenous language (K’iche’, n 10% Guatemala Quechua, Nahuatl, Mixteco) n 8% Dominican Republic n 4% Peru n 2% Honduras n <1% Bolivia, Chile, El Salvador, Nicaragua, Panama, Paraguay, Participants lived in the US an average of 16 years; Uruguay and Venezuela each only 5% had been in the US less than 2 years and 14% less than 5 years.

The Work of Housecleaning Employment Conditions Housecleaning is mostly conducted part-time, alone, in multiple homes, without a formal written contract and not well paid for the Latinx workers in our study. Despite a range of work experience, cleaners’ average hourly wage rate was just $15, similar to NYCs minimum wage as of Dec 31, 2019. Many also reported wage and benefit abuses, likely influenced by a lack of formal written contracts.

Considerable Work Experience Part-Time, Low Wages, And

Questionable Benefits

Most (65%) were not new to the profession and had worked more than 5 years as a household cleaner. Work hours: 22 hours per week n 5% <1 year n 30% 1–<5 years was the average work week and on average, cleaners have n 27% 5–<10 years 3 different clients per week. n 21% 10–15 years n 16% >15 years Wages:

$15 per hour was the average SELF-EMPLOYED BUT OTHER pay for household cleaners whether they were paid per

Arrangements Also Exist

hour or per job. While most are self-employed and work alone, some workers are employed through other methods. A small proportion Wage theft: use day labor hiring corners, once typically a space for 49% low-level construction workers. of workers reported experiencing wage theft n 76% Self-employed (work alone) and/or being paid below the minimum wage at some point.

n 10% Self-employed (work with another cleaner) No written contract for work: n 17% Employed by a cleaning agency 93% n 4% Employed as part of a cleaners’ had no formal written contract. A third of cooperative the cleaners only had an arrangement confirmed by text n 4% Hired from a “day labor corner” (31%) or email (2%), while the vast majority of them (60%) just had verbal agreements. Only 7% reported having a (NOTE: % sum to more than 100% because 12% reported formal written contract.

more than 1 work arrangement). Lunch breaks denied: of those working at least 6 hours for a single client, were not allowed a 30-minute break for lunch as is required under local law1.

Socioeconomic Conditions Many household cleaners in our study do not earn enough income to cover basic expenses, experience high levels of income insecurity, and live below the federal poverty level. This is a critical for nearly half of the research participants that are also the primary wage earners of their household. The COVID-19 pandemic has imaginably exacerbated these workers’ precarity.

Primary Household Wage Earners Non-Primary Household Wage Earners

44% For the participants who were not the primary wage earners, reported being the primary wage earner in their they earned less per month but also worked less hours; likely household and are economically responsible for an average because they shared the financial responsibility with other of 2 other household members. family members.

Poverty: Income: 81% Monthly income from cleaning and other work combined: of the primary wage earners’ income was less n 44% $500 or less than $1500 per month, which is below the 2020 federal n 27% $501–1,000 poverty level of $21,720 for a family of 32. n 18% $1,001–1,500 n 5% >$1,501 Income: n 5% did not specify Monthly income from cleaning and other work combined:

n 29% $500 or less n 28% $500–1,000 Income Insecurity: n 24% $1,001–1,500 n 16% insufficient to cover basic n 16% >$1,501 expenses so you had to ask for a loan n 54% sufficient to cover expenses but it was difficult Income Insecurity: n 30% sufficient to cover expenses They reported high levels of income insecurity, saying their without problem income was:

Worried about not having enough clients: n 24% insufficient to cover basic n 7% Extremely expenses so you had to ask n 12% Very for a loan n 54% A little n 54% sufficient to cover expenses n 27% Not at all but it was difficult n 22% sufficient to cover expenses without problem Worried about not having enough clients:

n 9% Extremely n 26% Very n 42% A little n 23% Not at all

Housecleaning and Health Household cleaners in our study in NYC and Westchester, on average, are far more likely to not have health insurance than other populations. The proportion of cleaners who reported that they are uninsured is higher than the proportion of adults who are uninsured both in the US overall and in NYC. They also don’t access paid sick leave. Our study shows that cleaners are not accessing the health services they need to mitigate the health effects of their work. Their precarious employment conditions may cause them to accept unsafe working conditions that contribute to the negative physical, mental, and emotional outcomes we found. This unfortunate situation can complicate COVID-19 health care.

Challenges to Good Health

Overall Health Inadequate Health Protections

Self-rated health is a very powerful way of measuring Access to health insurance: overall health. Though a simple question it has been Almost half, 49% of cleaners reported not having access found to be a predictor of clinical health including heart to any kind of health coverage. This compares to 8% of US disease and longevity3. adults5 and 12% of NYC adults6. It is twice as high as the rate for the overall adult Latinx population in NYC (22%).

Overall, 30% of our cleaners reported their own health as “poor” or “bad” which is 8% higher than the rate reported by Reporting lack of health insurance: New York City adults in general and 10% higher than n 49% Cleaners all adults age 45-65 in the US adult population overall4. n 12% New York City residents Reporting health as “poor” or “bad”: in general n 8% US overall n 30% Cleaners n 22% New York City adults in general n 20% All adults age 45–65 in the US adult population overall Access to paid sick leave:

Despite the passage of a mandatory paid sick leave law in NYC in 20147: of workers did not receive any paid sick leave. felt they could not take sick leave (paid or unpaid) without reprisal. A recent telephone survey study8 assessing the paid sick leave law in NYC found that: of workers, such as those in the service industry, like cleaners, reported attending work while sick because they could not afford to lose pay.

Work-Related Health Conditions

High Skin And Eye Irritation Common Musculoskeletal Pain

Chemical components of cleaning products are known These can occur due to frequent bending, kneeling, lifting, to cause irritation of eyes and skin9. reaching and repetitive motions of the arms and hands associated with cleaning tasks and are often done in awkward postures. of workers complained of skin rash that improves when they are away from work. 62% 3x reported musculoskeletal pain during the higher than the rates of skin rash shown in previous three months that lasted more than a day, which all US workers based on a national survey using affected multiple parts of their body. The most common the same survey question9.

area was the back (44%). of cleaners complained of some eye reported working on their knees while cleaning irritation while working. the bathroom or kitchen. workers said that eye irritation was strong enough that they needed to leave the room POTENTIAL FOR EXPOSURE TO they were cleaning. REPRODUCTIVE PROBLEMS Research is ongoing and still not yet conclusive, but it has raised concerns about the potential for components of

Potentially Undetected Respiratory Problems

cleaning products to cause reproductive problems10. Many studies have shown that cleaning products can result in asthma and other chronic respiratory problems10. of cleaners reported that they continued to work while pregnant. reported that they currently have asthma, a similar rate as has been reported in all NYC adults11.

Mental Health

of workers, or about 1 out of 6 workers We measured the levels of perceived stress and depression reported either a physician diagnosis of asthma or using two standardized measures12. night-time shortness of breath that improved when away n 24% of workers met the criteria from work. Night-time shortness of breath is a symptom for depression that may indicate asthma that has not yet been diagnosed n 45% met criteria for being highly by a physician. or moderately stressed

Paid hours of work are sufficient to get the job done well: A Nexus of Work-Related Stressors n 40% Disagree and Strongly disagree Work-related stress has been associated with increases n 43% Agree in numerous health problems, including heart disease, n 18% Strongly agree musculoskeletal problems, depression and overall mortality13.

One approach to measuring the causes (stressors) leading to work-related stress is to look at how demanding a job is, how much a worker feels that they can control the way they do their work, and the level of support they receive LACK CONTROL OVER CLEANING PRODUCTS USED from their employers13. Clients most commonly chose the cleaning products used.

Those products were often stronger than the cleaner desired and for many, they were not able to change products even if We found that many cleaners the products caused illness. experienced high demands, and Client chooses cleaning products used: lack control over their work and n 50% Always support from their clients .

n 18% Almost always n 32% Sometimes and never

High Work Demands

Cleaners felt that one of the major ways their work is demanding is because they feel rushed to get all of their Client asks or demands use of stronger cleaning products: tasks done. n 20% Yes Feel pressured to work quickly in order to satisfy their client: n 17% Sometimes n 20% Always and almost always n 61% No n 23% Sometimes n 56% Never Employer would change cleaning products if cleaner said that it was making them sick:

Do not use safety and health precautions in order to get the n 22% Never job done quickly: n 16% Sometimes n 20% Always and almost always n 48% Almost always and always n 32% Sometimes n 14% Don’t know n 46% Never

DAMAGING CLIENT BEHAVIOR Some signs of support from clients: While some clients’ actions are suspect at best and Surveillance while working: unacceptable at worst, many cleaners report some level of Watched by client, another person or a video camera personal support from their clients. while working:

n 29% Always and almost always Client values or comments positively on their work: n 28% Sometimes n 53% Always n 38% Never n 18% Almost always n 5% Don’t know n 29% Sometimes and never Disrespect at work: Experienced verbal abuse at work (for example, client screams or humiliates cleaner): n 13% Almost always n 18% Yes 10 n 19% Sometimes and never n 82% No Discriminated against or treated differently than expected when working due to one or more of the following reasons:

n 22% Being an immigrant n 20% Being Hispanic/Latinx n 25% Speaking their own language

Cleaning Product Use and Attitudes Many commercial household cleaning products contain chemicals that can be harmful to health and most cleaners are aware of this. However, numerous factors exist that increase the risk of exposure. Clients most commonly choose products, and cleaners believe it is necessary to use ones that contain “strong” chemicals, like bleach. Cleaners also feel that mixing products, which can produce dangerous chemical reactions, helps them to clean effectively and consequently, get the job done quicker. Using products that contain potentially harmful disinfecting agents was common even before the COVID-19 pandemic, and has since likely increased14.

Who Chooses The Products?

Our data highlight the importance The client chooses the cleaning products: of greater transparency related n 68% Always/amost always to chemicals that are included in n 23% Sometimes n 9% Never cleaning and disinfecting products so that workers and their clients can make informed choices about which products they use .

Problematic Product Labeling

Most cleaners thought that labels contain important

Are Products Potentially Harmful?

information about the chemical ingredients in the product. of cleaners agreed that cleaning products of cleaners said labels are always or can have a negative effect on health. sometimes in a language they could read. reported that it was necessary to use “strong” nonetheless thought the label was always chemical products when doing their work.

or sometimes hard to read.

Health Detracting Chemicals Frequency Of Use Of Products With

In Cleaning Products Quaternary Ammonium Compounds (Qacs)

And Sodium Hypochlorite (Bleach)

Based on workers’ reports of the cleaning products they used to clean 12 areas in the kitchen and bathroom, we estimated the frequency of use of products with Any of the 50% quaternary ammonium compounds (QACs) and sodium 6 Bathroom hypochlorite (bleach). tasks 51% Any of the 31% 6 Kitchen tasks 13% Either 59% Bathroom Kitchen or Kitchen 54% Areas n At least 1 QAC-containing Product n At least 1 Bleach-containing Product More than 50% of household cleaners use cleaning products containing quaternary ammonium compounds (QACs) or bleach, chemicals known to cause respiratory health problems .

Bathroom Areas QACs and bleach have been tied to chronic respiratory problems and irritation of skin and mucous membranes and eyes10. The Environmental Protection Agency created List N to certify which disinfectants are effective during the COVID-19 pandemic and required manufacturers to disclose the active disinfecting agent15.

Mixing Products: Common But Dangerous

Mixing cleaning products can create chemical reactions that can produce more toxic exposures. Nonetheless this practice was common. of workers mixed products when cleaning the bathroom or kitchen. cited getting the job done quicker as a reason for mixing.

Policy Recommendations The data in this report demonstrate how Latinx cleaners face significant risks to their health and well-being and this has become even more urgent since the COVID-19 pandemic. In this section, our study provides compelling data to support two current legislative campaigns: #FundExcludedWorkers and #Coverage4All. These proposed New York State programs and initiatives would improve household cleaners’ lives and others in New York State by addressing the disproportionate economic and health impacts from COVID-19.

#FundExcludedWorkers The Latinx immigrant household cleaners who were surveyed are less likely to be eligible for state unemployment benefits due to immigration status and informal domestic During this pandemic, I lost my work history. The drastic recent job loss in this workforce job for four months, and as a has left many unable to pay their rent or feed themselves and their families, despite providing frontline services consequence, I currently owe cleaning people’s homes.

rent, electricity and gas bills, and Exclusion from social safety nets also means that my daughter’s college tuition . I workers must put themselves at risk in order to have often had to stand in line for four a source of income. Consequently, cleaners’ exclusion from unemployment benefits and economic emergency or five hours to receive a food relief has exacerbated their own and their families’ pantry donation so I could feed economic devastation.

my family . I have not received any According to a study by the Fiscal Policy Institute16, New government financial support due York State has collected 1.4 billion in unemployment to my immigration status, despite insurance taxes from undocumented immigrants, in addition to what has been previously estimated as a net $12 billion paying taxes . One of my biggest collected in taxes annually by the federal government.

fears that does not let me sleep at Unfairly, undocumented immigrants cannot access a night and generates anxiety and cent. Since COVID-19, the overwhelming majority have not received any support from federal and state governments. stress is knowing that I can lose my home and have nowhere to go with my family .

— Lilia, household cleaner, Queens, NY

While essential and excluded workers and many of the #Coverage4All surveyed participants suffer, the wealthiest New Yorkers have tripled their gains. New York State is home to the As this report uncovered, nearly half of the household highest concentration of billionaires around the globe, cleaners in New York that we surveyed do not have health and since March 2020, 118 billionaires gained $77 billion in insurance. This is significant because being uninsured is wealth17. However, this small elite pays a lower tax rate than linked to higher rates of chronic disease, as individuals most New Yorkers. without coverage are more likely than their insured counterparts to avoid seeking necessary medical care for In a moment of mass desperation and economic inequality, fear of the associated costs18.

New York state must increase taxes on the rich and direct the increased tax revenue to create a $3.5 billion emergency Our study found that cleaners experienced musculoskeletal relief fund for excluded workers. This would ensure pain as well as skin, respiratory, and mental health problems. retroactive wage replacement for 1.2 million New Yorkers Moreover, household cleaners overwhelmingly indicated that excluded from unemployment benefits. they do not have any paid sick leave, and almost half are afraid to take sick days due to fear of reprisals, despite the As proposed by State Senator Jessica Ramos and Assembly fact that they have a right to do so.

Member Carmen De La Rosa, New York should provide Unemployment Insurance (UI) and Pandemic Unemployment This is concerning, given that workers are at risk of Assistance (PUA) to immigrant workers regardless of status. contracting COVID-19 if they go to work with increased Additionally, business owners and the self-employed who proximity to commuters and clients. Moreover, they are at lack documentation to apply for small businesses relief, and risk of losing their homes, food, and other basic necessities people recently released from incarceration or immigrant if they lose their jobs for exercising their right to call in sick.

detention with no hope of getting work are barred from UI No worker should have to choose between their health and and PUA. source of income, which is why access to paid sick leave and health care should be a right. Having health insurance may also reduce workers’ stress related to financial community organizations, highly recommend that Governor difficulties by decreasing their concerns about medical bills Andrew Cuomo and New York state legislators tax the if they get sick or have an accident19. All workers deserve to wealthy and urgently pass the “Worker bailout fund,” take care of their health, their lives, and that of their families.

bill (S4543) to provide emergency relief. Thus, ensuring economic stability for essential workers, like the cleaners As we know, many immigrants of color have been in this study. disproportionately impacted by the pandemic, and this is not surprising when inequality is rampant. As revealed in this report, household cleaners experience economic insecurity and health disparities, which may stem from economic determinants and inadequate access to care that were exacerbated by the pandemic. According to a COVID-19 deaths have been linked to health insurance gaps, and this is deeply concerning given disparate outcomes in COVID-19 infection and death.

Employers, policy makers, worker’s rights and health advocates, and household cleaners can unite to improve healthcare access. The Coverage4All campaign aims to create a statewide health insurance option for New Yorkers who are excluded from eligibility for coverage because of In April 2020, I had COVID-19, their immigration status, starting with those most directly but I never went to the hospital affected by the pandemic. It is also an opportunity to expand coverage to all New Yorkers at a time of utmost need.

because I do not have health insurance . Due to the pandemic, in Coverage4All is part of the Health Care for All New York campaign, and is driven by a coalition of community my work I am forced to use strong members, community organizations, health care providers, cleaning products such as bleach legal service providers, labor and immigrant groups, as well and [other] disinfectants, which as health care consumer advocates, and led by Make the Road NY and the New York Immigration Coalition.

cause me breathing difficulties and severe eye irritation . Going to Coverage4All is currently advocating for New York State to allocate $13 million to create a temporary state-funded government hospitals is not always Essential Plan bill (A1585/S2549) for New Yorkers with an option because sometimes I income up to 200% of the federal poverty level. The feel discriminated against and state should dedicate funds to make ALL low-income, undocumented New Yorkers eligible for the Essential Plan.

ignored for not having health Our study provides compelling data to support the need for insurance . Once, I went to the legislative solutions such as those proposed in this bill. emergency room because I had miscarriage symptoms, but I was told that everything was fine and sent me home, and that same day I lost my baby, and I could never get pregnant again . We all deserve access to health insurance regardless of immigration status; it should be a right, not a privilege .

—Leticia, household cleaner, Queens, NY

Conclusion The Safe and Just Cleaners study is a community-academic Additionally, household cleaners surveyed use many partnership that is investigating working conditions and cleaning products that contain chemicals that are potentially exposures to chemical components of cleaning and damaging to their health. Moreover, the demands they disinfecting products among immigrant, Latinx household face to use more toxic cleaning products combined with cleaners in NY. These workers tend to be isolated from their inability to control which products are used may one another, are vulnerable to poor working conditions and further detract from their overall health and well-being. The health precarity. The findings in this report, based on survey importance of greater transparency in product labeling could data from 402 immigrant, Latinx household cleaners in NYC help both household cleaners and their employers make and Westchester, provide evidence that these workers earn better informed choices about these products.

insufficient income, experience economic precarity, and are Despite the aforementioned potential threats to their health subject to work environments that negatively impact their and well-being, almost half of the cleaners we surveyed health and well-being. did not have any health coverage. The current COVID-19 Our survey data demonstrate that most of our study pandemic has likely further compromised household cleaners’ participants had income levels that placed their families below health and well-being given how potentially vulnerable these the federal poverty level. Furthermore, despite working as workers were even before the pandemic began. Hence, in household cleaners for an average of 16 years, the workers this report, we present two policy initiatives proposed by in our study commonly face violations of their labor and broad community coalitions—#FundExcludedWorkers and human rights including suffering discrimination, verbal abuse, #Coverage4All that would help reduce the disproportionate wage theft and a lack of paid sick leave. Basic workers’ rights impact of the COVID-19 pandemic on these and other covered under the NY Domestic Worker Bill of Rights are also affected workers and their families.

often violated, and household cleaners are often unprotected by federal, state, and city labor and safety and health laws and regulations. Working part-time and often without any formal contractual agreement with their employers also contributes to their vulnerability to these abuses. It is time for our voices as household cleaners to come together to make our needs heard, for us to be treated fairly, and our work to be valued and safe .

— Lilia, household cleaner, Queens, NY

The Safe and Just Cleaners Study Our organizations came together in 2017 for this community-based participatory action research project (funded by the National Institute of Environmental Health Sciences, grant #1R01ES027890-01A1). The survey was intended to understand Latinx immigrant household cleaners’ use, knowledge, and attitudes about commonly used cleaning products to help document exposure levels to certain chemical components. Research and other initiatives continue to generate safer work recommendations for household cleaners and their clients.

Meet the three partner organizations

Make The Road New York (Mrny) Barry Commoner Center For Selikoff Centers For

Health And The Environment Occupational Health And

MRNY builds the power of Latinx and

At Queens College, City The Institute For Exposomic

working-class communities to achieve

University Of New York (Bcche) Research At The Icahn School

dignity and justice through organizing,

Of Medicine At Mount Sinai

policy innovation, transformative BCCHE is an environmental and education, and survival services. occupational health research center The Mount Sinai Selikoff Centers for MRNY operates community centers at Queens College, City University of Occupational Health are dedicated in Bushwick, Brooklyn; Jackson New York. Our mission is to identify to providing cutting-edge clinical Heights, Queens; Port Richmond, and help rectify environmental and services with a focus on prevention Staten Island; Brentwood, Long Island; occupational threats to human health. to keep workers healthy and their and White Plains, Westchester. With We emphasize a scientific approach workplaces safe. A multidisciplinary over 24,000 low-income members, to gather information and develop healthcare team diagnose and treat MRNY tackles the critical issues solutions and interact extensively occupational diseases, evaluate the facing our community: workplace with people and organizations that working conditions of our patients, justice, tenants’ rights, immigrant determine or are affected by policy and suggest measures to improve rights, language-access, LGBTQ choices. The Safe and Just Cleaners work environments. The Institute justice, public education, health care Study belongs to the Immigrant for Exposomic Research and its access, and immigration reform. The Worker Studies program, is directed Occupational and Environmental Safe and Just Cleaners Study belongs by Dr. Sherry Baron, and supported by Hygiene (OEH) Laboratory to the Workers’ Health and Safety Dr. Isabel Cuervo. Current research complements the Selikoff Centers’ Program, is directed by Deysi Flores, and intervention studies examine the efforts by conducting research in coordinated by Jamie San Andres, impact of COVID-19 on the health occupational and environmental and supported by Ana Gonzalez. of low-wage, immigrant and other exposures and their impact on human insecure workers. health. The Safe and Just Cleaners Study is part of the OEH Laboratory directed by Dr. Homero Harari and supported by Maria Baldwin and Yujie Sun.

We would like to acknowledge the many partners, staff, and household cleaners themselves that have contributed to this report and study overall.

Endnotes 1 See Section 162 of the New York Labor law: https://labor.ny.gov/workerprotection/laborstandards/employer/meals.shtm 2 See federal poverty tables: https://www.census.gov/topics/income-poverty/poverty/data/tables.html 3 Mavaddat N, Parker RA, Sanderson S, Mant J, Kinmonth AL. Relationship of self-rated health with fatal and non-fatal outcomes in cardiovascular disease: a systematic review and meta-analysis. PLoS One. 2014;9(7):e103509.

doi: http://dx.doi.org/10.1371/journal.pone.0103509 4 Zhao G, Okoro CA, Hsia J, Town M. Self-Perceived poor/fair health, frequent mental distress, and health insurance status among working-aged US adults. Prev Chronic Dis 2018;15:170523. doi: http://dx.doi.org/10.5888/pcd15.170523 5 See US Census Bureau, Health Insurance Coverage in the United States: 2018 U.S. Census Bureau Table 4. Percentage of People by Type of Health Insurance Coverage by Household Income and Income-to-Poverty Ratio: 2017 and 2018:

https://www2.census.gov/programs-surveys/demo/tables/p60/267/table4.pdf 6 See NYC Health Data, Health Care Access and Use: https://a816-health.nyc.gov/hdi/epiquery/ visualizations?PageType=ts&PopulationSource=CHS&Topic=2&Subtopic=15 7 See NYC Paid Sick Leave Law FAQs: https://www1.nyc.gov/site/dca/about/paid-sick-leave-FAQs.page 8 Hall GS, Walters S, Wimer C, et al. Workers not Paid for Sick Leave after Implementation of the New York City Paid Sick Leave Law. J Urban Health. 2018;95(1):134–140. doi: http://dx.doi.org/10.1007/s11524-017-0218-2 9 St Louis T, Ehrlich E, Bunn T, Kanotra S, Fussman C, Rosenman KD. Proportion of dermatitis attributed to work exposures in the working population, United States, 2011 behavioral risk factor surveillance system. Am J Ind Med. 2014;57(6):653-659.

doi: http://dx.doi.org/10.1002/ajim.22311 10 See the Environmental Working Group: https://www.ewg.org/guides/cleaners/content/cleaners_and_health/ 11 See the NYC Community Health Survey: http://a816-dohbesp.nyc.gov/IndicatorPublic/VisualizationData. aspx?id=18,4466a0,11,Summarize 12 We used the Cohen Perceived Stress Scale (PSS) and the CES-D 10-item (CES-D) depression scale. Please see PSS: Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-396; please see CES-D: Radloff, L. A self-report depression scale for research in the general population. Applied Psychological Measurements.

1977;1:385-401. 13 Sauter S, Brightwell W, Colligan M, et al. The changing organization of work and the safety and health of working people: Knowledge gaps and research directions [Internet]. Cincinnati, OH: The National Institute for Occupational Safety and Health; 2002 [cited 3 Mar 2021]. Available from: https://www.cdc.gov/niosh/docs/2002-116/ 14 Chang A, Schnall AH, Law R, et al. Cleaning and Disinfectant Chemical Exposures and Temporal Associations with COVID-19 — National Poison Data System, United States, January 1, 2020–March 31, 2020. MMWR Morb Mortal Wkly Rep 2020;69:496– 498. doi: http://dx.doi.org/10.15585/mmwr.mm6916e1 15 We used data that was officially reported to the EPA as part of List N to verify the chemical composition.

See https://www.epa.gov/pesticide-registration/list-n-disinfectants-coronavirus-covid-19 16 See the Fiscal Policy Institute report “Unemployment insurance taxes paid for undocumented workers in NYS”: https://fiscalpolicy.org/unemployment-insurance-taxes-paid-for-undocumented-workers-in-nys 17 See the Americans for Tax Fairness press release: https://americansfortaxfairness.org/wp-content/uploads/NEW-YORK-ATF- HCAN-CANY-Billionaires-Report-Release-FINAL-7-1-20.pdf 18 See the Make the Road New York report “Safeguarding Immigrant Coverage Protecting and Expanding Health Coverage for all Immigrants in New York State”: https://maketheroadny.org/safeguarding-immigrant-coverage-protecting-and-expanding- health-coverage-for-all-immigrants-in-new-york-state/ 19 Lopez L, Hart LH, Katz MH. Racial and Ethnic Health Disparities Related to COVID-19. JAMA. 2021;325(8):719–720.

doi: http://dx.doi.org/10.1001/jama.2020.26443 20 See the Families USA report “The Catastrophic Cost of Uninsurance: COVID-19 Cases and Deaths Closely Tied to America’s Health Coverage Gaps”: https://familiesusa.org/wp-content/uploads/2021/03/2021-37_Loss-of-Lives_Report_AnalysisStyleB_ Final.pdf

MAKE TH NE E W R Y O O A RK D DIGNIDAD, COMUNIDAD Y PODER.

Deysi Flores Homero Harari, ScD Sherry Baron, MD, MPH Co-Principal Investigator Co-Principal Investigator Co-Principal Investigator Make the Road New York Selikoff Centers for Occupational Barry Commoner Center for Health deysi.flores@maketheroadny.org Health and the Institute for Exposomic and the Environment Research at the Icahn School of Queens College Medicine at Mount Sinai City University of New York homero.harari@mssm.edu Sherry.Baron@qc.cuny.edu dedniM noissiM yb ngiseD The Toll of Household Cleaning Work 20.

Make Th Ne E W R Y O O A Rk D

Dignidad, Comunidad

Y Poder

Co-Principal Investigator Co-Principal Investigator Co-Principal Investigator Make the Road New York Selikoff Centers for Occupational Barry Commoner Center for Health deysi.flores@maketheroadny.org Health and the Institute for Exposomic and the Environment Research at the Icahn School of Queens College Medicine at Mount Sinai City University of New York homero.harari@mssm.edu Sherry.Baron@qc.cuny.edu dedniM noissiM yb ngiseD