Document BvM69k55Nk23L93noRojxQzrL

HEALTH / PAC Health BULLETIN Policy Advisory Center Volume 12, Number 4 HPCBAR March / April 1981 1-32 ISSN 0017-9051 This Work of Living When I was a little girl we moved from a mining town in southwestern Pennsylvania to a company town some miles away owned by George Westinghouse. We knew, you couldn't help knowing, that George in his benificence gave us our homes, our schools, our libraries, the stores where we bought our food. His architects and planners had designed the town right up from the narrow valley floor Continued on Page 2 Inside Special Survey of Occupational Health and Safety OSHA - The Act and Its Performance...... 7 OSHA - The Movement Speeds Up.... 13 Workers'Compensation-- The Benefits and the Doubt...... 18 DuPont - Better Living Through Chemistry........ 25 "S% Continued from Page 1 where the plant was squeezed along the river. We were Irish, so we had to live on Airbrake Avenue to keep us from mixing too much with the Slavs on the next street up the hill. None of the wage workers were high enough up to avoid the floods, though; for that people had to be middle management, living in one of the detached houses near the top. Where they never had to see us. They entered the plant wearing their white shirts directly from " their side of town. " We knew it didn't make much sense for our people to wear white shirts to work. When we hung the clothes out on the line to dry they turned gray from the coal dust and other pollutants at the plant. In our old town when my father came home from the mines he changed his clothes and showered in the basement and every Saturday morning he washed down the outside of the house. When we moved to the Westinghouse Valley the routine was the same, except more and more frequently when he got home he was too tired to change and shower. He'd lie on newspapers on the living room floor Lnot to protect the linoleum, but, he told us, to keep whatever he was carrying out of the house. We knew. Without ever reading the life ex- pectancy tables, we knew that our fathers and mothers and aunts and uncles who worked in the plant would probably never live long enough to retire. Except for the ones who lost their hearing or some fingers or the ability to breathe without gasping when they were fairly young so they stayed home disabled. Then someone else in the family had to go into the plant to make up the lost wages. What we didn't know was where you could get another job. My father died when he was 44 years old at his workbench wearing his safety shoes and goggles, his face blue as it had been my whole life. His lungs were black. The death record said heart attack. In families like the one I grew up in, life has to be planned around disability and early death. Workers'compensation was important, but I'll always associate it with angry, drunken men confined to the house, straining a family fabric already frayed. Worker safety was the steel plated - shoes and the goggles, the pathetic hosing of our houses. But no matter how hard we worked, and we all worked, we never got ahead. So when the workers struck, knowing the repossessions of the cars and the furniture would come, and the 2 Continued on Page 5 Vital Signs a gratified by his words. They may not be upset that OSHA regulations are lowering the death rate, depriving them of embalming business, but they are nervous about their substantial market in plastics production. Since scientists. discovered a few years ago that formaldehyde fumes cause nasal cancer in small animals, the Institute has vociferously opposed any suggestion that humans might also be in danger. The industry might be afraid that OSHA will take precautionary measures before waiting for irrefutable proof, whatever that may be. Preservative Conservatives Newly elected - Senator Dan Quayle (IN R -) didn't wait to take his seat on Capitol Hill before launching a strong attack on OSHA. Speaking to the For- maldehyde Institute on December 15, he urged that Congress remove the " presumption of innocence " from health and safety regula- tions (that's OSHA's innocence, not industry's), and require the agency to defend itself in the courts. " I don't think you're go- ing to see an abolition of ee They may not be upset that OSHA regulations are lowering the death rate ee OSHA, " he predicted, with perhaps a touch of regret, but this " dramatic shift " in the agency's mandate would be likely to ensure " much slower " rulemaking. Senator Quayle didn't quite say " They'll cut formaldehyde use over my dead body, " but his listeners were certainly 3 Hatch's Hatchet In an interview with the New York Times printed on January 25, Senator Orrin Hatch (Utah R -), new chairperson of the Senate Labor and Human Resource Committee, offered his balanced opinion of OSHA. There are serious safety and " Vicious means low, vindictive, petty and low down -" health problems in industry, he noted, but the agency has only exacerbated them: it's " vicious, mean, low, vindictive, petty, and low down -. " Health / PAC saluted this tough hombre who dares to stand his ground no matter which poor and working people suffer as a consequence. This is the same spirit that inspired that Country and Western classic, You've Worked For Us Long Enough, Ma, Now Get Out And Work For Yourself. Health / PAC Bulletin Tony Bale Pamela Brier Robb Burlage Michael E. Clark Barbara Ehrenreich Jaime Inclan Board of Editors Louanne Kennedy David Kotelchuck Ronda Kotelchuck Arthur Levin David Rosner Hal Strelnick Des Callan Madge Cohen Kathy Conway Doug Dornan Cindy Driver Dan Feshbach Marsha Hurst Louanne Kennedy Mark Kleiman Thomas Leventhal Alan Levine Associates Richard Younge Joanne Lukomnik Peter Medoff Robin Omata Doreen Rappaport Susan Reverby Len Rodberg Alex Rosen Ken Rosenberg Gel Stevenson Rick Surpin Ann Umemoto MANUSCRIPTS, COMMENTS, LETTERS TO THE EDITOR should be addressed to Health / PAC, 17 Murray Street, New York, N.Y. 10007. Subscription rates are $ 14 for individuals, $ 11.20 for students and $ 28 for institutions. Subscription orders should be addressed to the Publisher: Human Sciences Press, 72 Fifth Avenue, New York, N.Y. 10011. 1981 Human Sciences Press. Health / PAC Bulletin is published bimonthly by Human Sciences Press. Second - class postage paid at New York, N.Y. and at additional mailing offices. Postmaster: Send change of address to Human Sciences Press, Circulation, 72 Fifth Avenue, New York, N.Y. 10011. Articles from the Bulletin are indexed in the Health Planning and Administration data base of the National Library of Medicine. The drawings on pages 26, 30 and 31 by Mary Margaret Wade are from Sick for Justice, Health Care and Unhealthy Conditions, a special issue of Southern Exposure. This issue is available from the magazine for $ 3. Write Southern Exposure, P.O. Box 230, Chapel Hill, NC 27514. Other illustrations by Fred Wright, UE (pp. 7, 9, 12, 19, 21 and 23), Kathe Kollwitz (p. 1) Cold Comfort If you are susceptible to the flu and like to hedge your bets, you probably bought stock in Eli Lilly & Co. and Upjohn Co. last fall. As leading manufac- turers of antibiotics, they were bound to profit handsomely from the winter epidemic. So handsomely, in fact, that an analyst at the brokerage house L.F. Rothschild, Unterberg, Towbin estimated their earn- ings per share would jump by 4 14 and 13 percent in the first quarter of 1981. You probably know that an- tibiotics don't cure the flu. Doc- tors know this also, but they have found that antibiotics help prevent secondary infections such as bronchitis; show the pa- tient that the doctor can take decisive action, however inef- fective; and only cause dangerous reactions in some cases. Sick people who cannot af- ford to bring their flu to the doc- tor often load up on medicines they learn about from that ubi- quitous health guide, advertis- ing. So while you were wisely treating your flu with chicken soup, juices, and rest, you could have reached over to the telephone and bought shares in manufacturers of aspirin and other cold medicines. Sterling Drug, Schering - Plough, American Homes Products and Bristol Meyers - all are expecting earnings per share to rise 14 to 19 percent. -George Lowrey Work of Living Continued from Page 2 meals on surplus food we didn't know how to cook would come, it was for higher wages. Life seemed like a fringe benefit we couldn't ask for lest the plant close and take our jobs away. Times have changed. The occupational health people can tell the workers in the com- pany towns across the country exactly how much toxic poison they're absorbing every hour. But management can still explain that in- dustrial progress comes with some risk. And the workers still rise to the sound of the plant whistle, eat lunch when it blows again, file out the gate when it blows again, all the while hop- ing their kids can somehow get out of the smokefilled valley, beyond the stripmined hills. " I can't get you out of here, only an educa- tion can, " my father told me two days before he died. " Go to school and promise me you'll never marry anyone from the mines or the plant. Then get your sisters out. " In his mind dying was the penalty you paid for being too " dumb, " too uneducated, to escape. For him and for my uncle and aunt who are still in the valley, safety was and is largely in the hands of the engineers working for the bosses. If the choise is safety or food on the table and a roof, it's no choice at all. But we wanted to live. When high employ- ment rates gave workers greater power in the late 1960s, asbestos workers, coal miners, and others seized the opportunity to move beyond. wage demands. They resisted when corpora- tions cracked the whip with speedups to main- tain their profit rates and accidents rose 25 per- cent nationwide. Strikes over working condi- tions leaped from 16 percent of the total be- tween 1953 and 1960 to 30 percent in 1968-73 and an extraordinary 35 percent in 1974-77, according to figures extrapolated from Bureau of Labor Statistics reports by economist Michelle Naples. Caught between militant workers and man- agement insistence that there was no money for large wage increases, union leaders readily in- creased their emphasis on health and safety issues. Corporate executives were often happy to go along. The new provisions didn't appear to cost that much. They codified the company's responsibilities so workers were less likely to walk out every time someone lost a finger or was asked to mount an unsafe scaffold. 510 Corporations don't want to be blamed by their workers for every problem. They don't want competitors with less militant unions to get an edge in the marketplace. The problem, they feel, is government regulation. But it didn't work that way. Management quickly learned that once it accepted respon- sibility for improved conditions, workers began to say there should be less poison dust floating into their lungs or less noise deafening them to the point where they had to turn their TVs up full blast when they got home so they didn't have to lipread the evening news. And they wanted decent compensation for the damage they and their relatives had already suffered. Corporations are never interested in paying out more than they have to. They didn't want to be blamed by their workers for every problem. They didn't want competitors with less militant unions to get an edge in the marketplace. The answer of the most enlightened, as always, was government legislation. Then if anything hap- pened, they could say, " Don't strike against us, write your governor. " Union leaders, most of whom were happy to cool out rank and file activity, led the drive for state and national laws. The workers wanted whatever improvements they could get. But the Miners Health and Safety Act and the Occupational Health and Safety Act were only first steps. And grievances have to wait on Washington - a long, often disappointing wait for many. Even these victories turned out to be too much for corporations, however. The cost of compensation and environmental health inside. and outside the workplace have risen far above what they anticipated and they don't like it. Demands for " unshackling free enterprise " are ascendant in Washington, thanks in no small part to $ 200 million spent by conservative Political Action Committees in the last election. Beyond deregulation, the model for the Reagan Administration is the government of Prime Minister Margaret Thatcher in Britain. If " suc- cessful, " the results here as there will be unemployment levels unknown since the Great Depression and a drastic reduction in benefits for the unemployed. Workers, the Administra- tion hopes, will be too frightened for their jobs to demand higher wages or better working con- ditions. But the miners in Britain fought back, and it was Mrs. Thatcher who had to back down. My people won't give up easily either. -Louanne Kennedy Double Indemnity The Poverty and Mythology of Affirmative Action in the Health Professional Schools by Hal Strelnick and Richard Young " Exciting and will make a major contribution. " -Professor Sam Wolfe of Columbia University School of Public Health A Health / PAC Special Report. $ 5.00 each. Now available from the Health Policy Advis- sory Center, 17 Murray Street, New York, New York 10007 6 OSHA The Act and Its Performance ... TOO MUCH REGULATION 4. - a ? ? ? POISON! FRED CORIGHT 7 Among the vast body of voluntary standards which the private, management - oriented organizations had instituted by consensus was the now famous - split toilet seat provision. When militant coal miners, rising workplace injuries and a Democratic Congress willing to reward its labor allies combined to push through the Occupational Safety and Health Act of 1970, virtually none of its spon- sors expected it to have such far reaching - ef- fects. They saw it as a source of threshold ex- posure standards and plant inspections. Workers took it up as new light on the extent of workplace hazards and a stimulus to eliminate them. The Act also came at a crucial time in the broader public awakening to environmental dangers. Rachel Carson's Silent Spring, and other books had exposed the damage caused by pesticides. Many scientists, including Nobel Prize winner Linus Pauling, had denounced the dangers of nuclear fallout. Ralph Nader had exposed automobile defects and the auto companies had damaged their credibility even further by attempting to cover up the problems. Health scientists seemed to be finding connec- tions between food additives and cancer vir- tually every week, and pollution, cigarettes, and even X rays - came under attack. Important technical developments permitting more sen- sitive statistical analysis enabled scientists to pinpoint the origins of many diseases, par- ticularly cancer, with much greater accuracy, and the results were deservedly disturbing. Under Nixon, the federal Occupational Safe- ty and Health Administration suffered from various job related - diseases of bureaucrats, in- cluding foot dragging - and endemic torpor. Standard - setting moved forward at a feeble pace, especially for health hazards, and even then only under strong labor pressure. The first health regulation, which limited asbestos ex- posure, appeared in 1972 only after the Oil, Chemical and Atomic Workers and the AFL- CIO had jointly requested an emergency stan- dard. The neglect of worker interests, not to say lives, was best illustrated in the notorious " OSHA Watergate " memo of George Guen- ther, a hosiery manufacturer appointed as the first director of the agency. In it, Guenther vir- tually offered to sell delays in setting standards and restrictions on inspections in return for donations to the Nixon re election - campaign. It is a pretty damaging indictment of OSHA to note that the vast majority of its current stan- dards were established under Guenther, who gave an illusion of action by adopting the vast body of voluntary standards which private, management - oriented organizations had in- stituted by consensus. Among them were the now famous split toilet seat and ice water provi- sions, as well as hundreds of other rules now characterized as nitpicking. The mass media's shameful role in perpetuating the big business myth that these standards prove the disastrous results of " big government " liberalism and par- ticularly union initiated - OSHA regulation is a telling reminder of what the movement to safeguard workers'lives is up against. (This heads I win, tails you lose strategy is briefly discussed in John Mendeloff's important and often overlooked book, Regulating Safety.) OSHA Policy Shifts When the Carter Administration took over in 1977, OSHA's new leadership had to choose between two strategies. One was to ally itself closely with labor, build a strong base of popular support among workers and other groups, and hope to be strong enough to fend off the inevitable industry attacks. The second was to meet some worker needs while restrain- ing activity sufficiently to maintain support among key corporate sectors. The latter course has been the customary one for most regulatory agencies under Democratic administrations since Franklin D. Roosevelt. However urged on by activists within OSHA and the health and safety movement outside, the agency leaned toward the first course throughout the term of Dr. Eula Bingham. Whether this policy choice was deliberate or merely the consequence of an honest commit- ment to the Hippocratic oath will remain a secret until top officials publish their inside ac- counts if any do. While implementing a a traditionally Republican economic policy of high interest rates and planned recessions, the Carter Ad- ministration was willing to accept an activist OSHA to placate its powerful labor constituen- cy. In effect, in exchange for a few im- provements in health and safety, workers were asked to accept fewer jobs and lower real wages. Not surprisingly, they weren't rushing out to the polling booths to vote for Carter in 1980. PROGRESS Fewer But Better Under Eula Bingham, OSHA began to in- itiate standards on its own for the first time. The cancer policy standard marked the first attempt by OSHA to regulate workplace exposure purely on the basis of animal tests rather than waiting for a body count of workers. (See Bulletin, No. 79, 1977). The lead standard, adopted in 1978, was the first OSHA health. standard to include a full rate retention provi- sion. This protects the wages and seniority of workers who are laid off or transferred due to hazardous exposure levels in the plant. Another innovation in the new standards was the inclusion of mandatory worker training and education provisions. FORE MAN " Did you say you want to report this to the safety committee? Well, I am the safety committee. " FRED WRIGHT CARTOONS UNION " It's a great machine... Raised our output 100% while accidents increased only 50% " In retrospect, the two most significant OSHA measures were the Right Know - to - standards, assuring greater worker access to company ac- cident logs and company medical and ex- posure records. Adopted in 1978 and 1980, they were actively promoted in Congress and in many communities by labor unions and COSH groups. Despite the advances under Bingham, OSHA's health standards remain pitifully meager in comparison with the range and seriousness of the hazards. About 450 were in- corporated in the early days from manage- ment oriented - groups. Tens of thousands of materials in commercial use, few of them ade- quately tested for dangers, were left. unregulated. (See Bulletin, No. 44, Sept., 1972) By December, 1980, only 11 additional standards had been promulgated. (See Table.) Aside from an indication of OSHA's timidity, this miserable record is a tribute to persistent industry resistance - behind the scenes, in the OSHA hearings, and in appeals processes. === Almost all of the these standards are now on appeal in the federal courts. OSHA's safety regulations, largely em- bodied in the 500 small - print pages of OSHA's " General Industry Standards, " have been amended less than ten times a year on average, If the practices they are supposed to regulate changed at the same turtle's pace, the Table New OSHA Health Standards * Date of Standard Promulgation Asbestos 6/7/72 14 Carcinogens Vinyl Chloride Coke Oven Emissions Benzene 1/29/74 10/4/74 10/22/76 2/10/78 DBCP pesticide Arsenic Cotton Dust 3/17/78 5/5/78 6/23/78 Acrylonitrile plastic Lead 10/3/78 11/14/78 Cancer policy standard 1/22/80 * Source: OSHA, " Status: Health and Safety Stan- dards, " June 13, 1980. ( Last fall, among the many recommen- dations to President - elect Reagan for changing OSHA came the massive study from the Heritage Foundation. Unlike many of the Foundation's position papers whose flat earth - nostalgia has proved em- barrassing even for the Reagan Adminis- tration, this one appears to represent widely - held conservative positions. Its primary author, Robert Hunter, is a top adviser to Senator Orrin Hatch (UT R -), who oversees OSHA as Chairman of the Senate Labor and Human Resources Committee. The report asserts that the chief defi- ciency of OSHA is not the Act itself- which after all was signed by President Nixon - but the " policeman's orientation " of the OSHA agency. Conservative Re- publicans are not noted for objecting to police action by police, but this time they mean business: these words echo the preamble of the Schweiker bill (see arti- cle). So do many of the recommendations which follow, although like much Heri- tage Foundation literature they carry rightwing logic off the deep end. Among prescriptions: e Place major emphasis on " cooperative labor management - programs. " To en- courage them, the government should offer incentives such as reduced OSHA penalties for worksites with labor management - safety and health committees and " New Directions " 10 L grants for joint labor management - American economy would have completely collapsed a long time ago. Of course, even the best standards aren't worth much if they aren't adequately enforced. There was some improvement in procedures. under the Carter Administration, but the rate of inspections never rose above a modest two per- cent of all workplaces in any year. Larger fac- tories have been visited more often annually - if they have more than a few hundred employees. Fines, while still averaging a derisory $ 50, did go up, particularly for serious and willful violations. In any case, both OSHA and the companies know that the real cost of inspec- tions comes in the requirement to clean up. Many managers appear to be driven to distrac- tion by the large and unpredictable expen- One Reactior training ventures. * Target enforcement to worksites with poor safety records, such as exemption of " safe " worksites from routine inspec- tions. e Send worker health and safety com- plaints directly to management. Write performance - based standards to permit employers " flexibility " in com- pliance. * Make state OSHA plans " no less than full partners " with the federal pro- gram. In response to these proposals, the De- partment of Occupational Safety and Health of the national CIO AFL - cir- culated the following concise rebuttal which covers many anti OSHA - argu- ments currently in vogue: The Heritage Foundation's " blueprint " for the future of the Occupational Safety and Health Administration would turn the clock back a decade and have a devastat- ing impact on worker health and safety. The Foundation's recommended plan for the redirection of the Agency towards a cooperative stance with industry is nothing more than a call to return to the pre OSHA - Act period of voluntary com- pliance and poor workplace conditions. Using a current theme of conserva- tives, the Foundation attempts to blame the government for industry's failure to protect workers on the job. According to the Foundation, OSHA's so called - police- men's enforcement actions are responsi- ditures this might require. The largest employer of all doesn't have this problem: no federal, state, or local employees are covered under the OSHA act except by some unenforceable, voluntary paper plans. Anyone who imagines they don't need protec- tion might talk to a firefighter, a sanitation worker, or a public sector health employee. Also vulnerable are workers supposedly covered under a state plan " as good as or better than " what is offered under the federal OSHA act. This loophole, put in the Act to win passage in 1970, now applied to 22 states, Puerto Rico, and the Virgin Islands. While some states, such as California, have relatively strong programs, most of them are abysmal. Those of North and South Carolina, for example, provide as much protection as sneakers in a minefield, but like o Reaction ble for workplace injuries and illnesses. But the facts tell a different story. Since the OSHA Act inception, industry has fought nearly all new regulations and ma- jor enforcement actions. Forty percent of all serious citations are contested; in the oil and chemical industries the contest rate is ninety percent (90%) and major af- filiated unions report that corporations have adopted policies of contesting all violations regardless of the impact on worker health and safety. At the center of the Heritage Founda- tion's plan are recycled provisions of the Schweiker Bill which would exempt work- places from routine safety inspections and cut the heart out of the worker complaint process. Extensive testimony and re- search have documented that the pro- posed exemption procedures are un- sound, administratively unworkable and would remove vital protections for millions of workers on the job. Management - labor cooperative pro- grams are stressed by the Foundation as mechanisms for improving worker health and safety. But the proposed programs. would have labor give up present rights and protections, with no real voice or power over workplace conditions. To at- tempt to legislate cooperation of labor with management concerns that have ex- hibited a decade of bad faith, fighting the implementation and existence of the Act is to make a mockery of the labor move- ment and the collective bargaining pro- cess. the others they were approved by secretaries of Labor in the early 1970s. Besides these limitations, OSHA is cir- cumscribed by another restriction which could effectively destroy it without altering the legislation at all. Under Executive Orders issued by both Ford and Carter, all OSHA and other federal regulatory standards must in- clude a cost benefit - analysis. In the past, OSHA officials have vigorously resisted the most utilitarian interpretation of this provision, which would put a dollar value on human life- one item which doesn't seem to keep up with the rate of inflation. Instead, they have assessed the cost of compliance and then judged whether in- dustry would be seriously threatened as a result. This " liberal " interpretation is now under attack in the federal courts. Even if it is The Foundation would redirect all New =~ Directions Training and Education money to labor management - programs, deci- mating an impressive program of worker training (originally proposed by organ- ized labor) conducted by unions, companies, and universities, which has been supported by all sectors and praised by the Congress. Cost effective - performance based stan- dards for the gravest of hazards are the Foundation's recommendations for con- trolling exposures. OSHA standards are performance oriented and have been di- rected towards serious hazards such as asbestos, lead and cotton dust, toxic agents responsible for the death and ill- ness of millions of workers. But imposing cost effective - performance criteria or cost benefit - tests would put company pro- fits before worker health and place pri- mary reliance for control of exposures on respirators rather than engineering con- trols. And finally, state plans would be made full partners in OSHA enforcement de- spite the exhibited failure of these pro- grams to operate competently and effec- tively. In summary, the Heritage Foundation's blueprint is a plan to undo all the gains. and improvements in worker health and safety of the last decade; to take away worker's rights and protections on the job; and to give industry free rein to im- pose whatever working conditions it sees fit. J 11 0 If business were forced to pay penalties commensurate with the damage caused by inadequate standards, enforcing regulations would be a lot easier upheld, however, assessment of costs and benefits easily lends itself to distortions which would tilt the process still further in favor of employers. Young business executives appear to receive special training in accounting pro- cedures which enables them to overestimate the cost of complying with government regula- tions and underestimate the cost of fulfilling government contracts which all extra pay- ments for overruns. Paradoxically, OSHA's timidity in improving safety standards also opened it to attacks from the right. Because the accident rate is rising, political opponents have already disingenuous- ly charged that OSHA requires so much paper- work when it regulates toilet seats that com- panies can't afford to devote adequate time to protecting their workers from injury. It must be said that the occupational health and safety movement could also place more em- phasis on safety questions. As the article on workers'compensation in this issue shows, the defeat of the effort to federalize the program, a policy encouraged by the original OSHA Act, is another indica- tion of the movement for adequate health and safety. If business were forced to pay penalties commensurate with the damage caused by in- adequate standards, enforcing regulations. would be a lot easier. Whatever its failings, OSHA has achieved much, both in establishing standards and in arousing awareness of the need for health and safety measures in the workplace. The Reagan years will show whether the agency's decision under the Carter Administration to put its weight largely on the side of the workers will OUT IN TIME KEEPER Y Loeoe flTMoeZL PRED WRIGHT ~ " Punch your card on the way out! " enable it to survive. If it doesn't, we will know it is not because it did too much, but because it did too little. -David Kotelchuck Resource The Carcinogen Information Program, a project of the Center for the Biology Natural Systems, is dedicated to bridging the gap between scientific journals and the public. You can receive The CIP Bulletin, the program's monthly fact sheet, at no cost by sending a long, self addressed - , stamped envelope to: The Center for the Biology of Natural Systems Washington University Campus Box 1126 12 St. Louis, Missouri 63130 OSHA The Movement Speeds Up 13 Just five years ago a survey of 15 international unions found they had a total of 27 full time - health and safety personnel Now that the corporate right has assumed power, their faith healers are performing the Washington surgery, cutting the heart out of health and safety programs in the name of free enterprise. But contrary to the media myth of a Reagan landslide, they aren't preaching to the converted. Among the forces opposing them is one of the few mass movements to survive in the me ness - and meanness and post Vietnam - war prostra- tion of the late 70s. This alliance includes workers and their unions, health workers and other professionals. The Black Lung associa- tions and now the Brown Lung associations. The Oil, Chemical and Atomic Workers who struck Shell Oil. The Steelworkers who walked out at the Newport News shipyard. The textile workers organizing at J.P. Stevens plants. After the 1971 Occupational Health and Safety Act became law, concern with job hazards surged around the country. By 1974, over 93 percent of all contracts involving 1000 workers or more contained health and safety provisions, according to the Bureau of Labor Statistics. The United Auto Workers and the United Steelworkers both won agreements establishing fulltime health and safety representatives in major plants and regions. Both unions now have hundreds. Just five years ago a survey of 15 international unions with seven million members by the Health Research Group found just eight had a fulltime health and safety staff; all of them together could muster only 22 people, only one of them a physician. The Growth of COSH Activity has also mushroomed outside the union structure. More than two dozen com- munities now have a Committee on Safety and Health serving both organized and unorgan- ized workers. Initiated in some areas by workers and health professionals acting in- dependently, in others by the Occupational Health and Safety Project of the Medical Com- 14 mittee for Human Rights, these groups publish information on hazards, conduct conferences and training sessions, and provide technical services for workers and local unions. Among the oldest and strongest are CACOSH in Chicago, MassCOSH, and PhilaPOSH. In the past few years these local groups have begun meeting together to share information and initiate joint activities. One of the first was a national campaign for a " Right to Know " stan- dard requiring companies to provide their workers with full information about potential hazards of materials they work with, exposure measurements and medical examination re- sults. Their effort, supported by organized labor, played a major role in the introduction of OSHA's two recent worker rights - to - know stan- dards. Fighting " Improvements " The Right Know - to - movement became truly national in the campaign to defeat the Schweiker Bill. Known as the Occupational Safety and Health Improvement Act of 1980, this gift to business from the ranking Republican on the Senate Labor and Human Resources Committee, now Reagan's Secretary of Health and Human Services, would have ex- empted 90 percent of all worksites from OSHA inspections. In addition, it would have virtually eliminated inspections triggered by employee complaints. (See Bulletin, Vol. 11, No. 4, 1980.) Corporate interests were soon celebrat- ing their imminent victory. Their usual Southern and Western allies on the Senate Labor Committee were augmented by virtually all the Democratic " friends of labor, " including New Jersey's Harrison A. Williams, author co - of the original OSHA legislation. Then workers heard about it, and they didn't keep their anger a secret. Union delegations went into congressional offices around the country. PhilaPOSH organized over 100 peo- ple, including workers in the United Electrical Workers, the UAW, and OCAW to picket Senator Schweiker's house in a demonstration which drew nationwide publicity. State and local union councils, assisted by the national AFL - CIO, held public meetings in eight cities. Unions and COSH groups initiated lobbying and other activities. " We were surprised, " admitted one senator hit by the barrage, " We didn't realize how upset people would get. " Nervous senators began withdrawing support and the bill, once considered certain to pass, died in the Senate. This was not the first attempt to gut OSHA. Although trade unions may devote too much at- tention to Washington, on a number of close health and safety votes labor's legislative staffs earned their paychecks. On several occasions, union lobbying was decisive in winning more money for OSHA and the National Institute for Occupational Safety and Health than either President Ford or President Carter requested. Occupational health and safety training, previously limited to professionals and management personnel, is now available to workers as well through OSHA's multi million- - dollar New Directions program. Once again, trade union support was crucial for Congres- sional approval. Many of the union health and safety staff members are funded wholly or in part through New Directions grants. The Reagan Administration hopes to either eliminate this program or place it under Why the Unions Acted American trade unions are not noted for their social activism. Yet, as indicated above, they have taken significant steps on health and safe- ty. Because in many cases the union member- ship has only become aware of workplace hazards through educational efforts initiated or at least supported by the leadership, rank and file prodding doesn't appear to be the reason. Even now, only a small, though important, frac- tion of active union members have worked on management control to improve " labor- management cooperation. " Lastly, the labor movement has persistently lobbied for more and stricter workplace ex- posure standards. A majority of the relatively few new health standards OSHA has estab- lished resulted from labor initiatives. Many more requests for permanent or emergency temporary regulations were turned aside. the issue. It is more likely that the initiative from the top comes from a combination of several factors: 1) Workplace hazards cause serious harm to many union members. At the same time, they can be prevented by concerted union action. This allows the unions to perform a very positive, visible service for their members. 2) Although political activists often see health and safety as obvious issues to promote worker control, they can also be approached in a typically bureaucratic manner. A profes- sional is hired to service "" the members, keep- ing their involvement to a minimum. 3) Particularly with an ostensibly friendly. federal or state administration, many advances can be achieved through government action. Not a few union leaders feel more comfortable with high officials than they do with their own members, and winning a few programs through lobbying can justify their continued emphasis on Washington and state capitals. 4) Unable to prevent increasing layoffs or win wage gains which keep pace with inflation, union leaders may decide health and safety is a good arena to obtain something for the members. 15 I Come Not to Bury OSHA, But to Embalm It One proposal for revamping OSHA was memorable more for its setting than its content. On December 15, 1980, Senator - elect Dan Quayle (IN R -) attacked. OSHA from the forum of the Formalde- hyde Institute in Washington, D.C. Never one to throw balm on troubled portant chemical. It is used not only for embalming where demand is relatively constant since, despite the plaints of the " extreme environmentalists ", the U.S. national death rate has not been chang- ing much recently - but more importantly as a cross linking - agent in plastics pro- duction. waters, the former Congressperson from Indiana said that Congress should re- move " the presumption of innocence " (sic) from OSHA regulations and require the agency to defend itself in the courts. This " dramatic shift " is likely to result in Lately the Formaldehyde Institute has become one of Washington's most active forums for attacks on OSHA. Perhaps because a few years ago scientists found that formadehyde fumes cause nasal cancer in small animals. Since then a " much slower " rulemaking, he said. But in true Senatorial form, he added, " I don't flurry of scientific activity has attempted to relate the animal results to human think you're going to see the abolition of OSHA. " (OSH Reporter, Dec. 18, 1980, cancers. The Institute has been in the scientific and public relations forefront in p. 764) the battle to defend free enterprise Commercially, formaldehyde is an im- against this body blow. a _, The Professionals The smaller group which preceded this new generation did not have a single professional The successes achieved by labor and COSH would have been much smaller without the new group, but like their predecessors, many of the younger ones have joined organizations such occupational health and safety professionals. as the Occupational Health section of the For the first time in recent decades, the cor- American Public Health Association, the porate near monopoly - on scientific and Social Concerns Committee of the American medical expertise has been aggressively Industrial Hygiene Association, and the Socie- challenged. ty for Occupational and Environmental Health. In the past, business was shrewd enough to find, encourage and fund industrial health Weaknesses of the Movement specialists. Its interests naturally shaped the Although the occupational health and safety process of medical and technical discovery in movement is small, it can honestly call itself a occupational diseases while giving it the patina mass movement. It does, however, have to of scientific objectivity. (A good example is the overcome several serious problems before it research on asbestos, Bulletin, No. 72, can achieve its full potential. Nov./Dec., 1974.) Recently, much to their Most importantly, the number of workers ac- discomfort industry scientists at OSHA hear- tively involved on a day day - to - basis is still ings on DBCP, lead, cancer, and other stan- relatively low, although this minority often has dards have heard their " objective " data torn to strong support within the union local. shreds by medical personnel and scientists Labor oriented - professionals must get their cooperating directly with workers and by pro- act together before they can give the workers fessionals employed by NIOSH and OSHA. full support. An inability to unite in a single or Many of these new professionals have been even several organizations seriously dilutes trained at the Educational Resource Centers. their influence. To cite one example, no Even if these are wiped out by the Reagan Ad- publication discusses the social and political ministration, they have already trained hun- issues related to their work, such as current dreds of specialists in all aspects of occupa- trends in the labor movement, how to confront tional health, incuding clinical medicine, other professionals in the field who believe in epidemiology, industrial hygiene, and nurs- the " neutrality " of science, and methods for 16 ing. training and educating workers. All of these ibe nA See ts eric fraser issues are taken up periodically in existing sometimes worry that COSH will intentionally forums, but the fragmentary nature of the or inadvertently take sides. discussion retards development and prevents Fortunately, all of these problems can be people entering the field from taking full ad- overcome. The degree of knowledge, the vantage of the expertise which veterans have number of involved participants is vastly acquired with great time and effort. greater than it was just ten years ago. And the The COSH groups, local membership organ- need is as great as ever. Imagine the press izations moving toward greater national coor- coverage if 123 people were poisoned by eating dination and cooperation, suffer no such struc- caviar and another 16,600 seriously injured. tural problem. Their primary difficulty lies in This didn't happen of course; these are the relationships with organized labor. Although figures for coal miners hurt on the job in 1980 these ties are vital, they are often tenuous. up to December 5. American workers may not Cultural and class differences create suspi- know the exact numbers, but they know their cions and misunderstandings. Contending lives are on the line. local or national factions within a union -David Kotelchuck 17 The Benefit and the Doubt Workers'Compensation in OSHA's First Decade " It's dark as the dungeon and damp as the dew, " goes the old miners'song, " Where the dangers are doubled and pleasures are few. " But just how dangerous wasn't clear until the 1950s. The miners knew that they died young, that their children would die young unless they escaped from the coalfields, but the textbooks told them coal dust was safe. When conclusive evidence of black lung disease was found, the situation was actually deteriorating. Giant new machines were pulverizing the coal, sending dust spinning in the air and down into the lungs of the miners. The United Mineworkers, once the champion of its members, had grown sclerotic and corrupt. State officials listened to the mineowner plaints of reduced profits. The federal government heard them also, and had little interest in paying for proper inspection or compensation. Mineworkers had no one to rely on but themselves and a handful of doctors willing to speak out on the evidence of rampant black lung disease. In December, 1968, miners from Fayette and Kanawha counties in West Virginia met to form the Black Lung Association and de- mand compensation legislation. In February, 1969, a wildcat strike began in a single West Virginia mine. Within five days, 42,000 of the state's 44,000 miners were out. They didn't go back to work until a health and safety bill was passed and signed 23 days later. Victorious in West Virginia, the miners pressed on at the federal level. Again they met indifference. As often happens, a tragedy was 18 necessary to shame the government into action. After 78 miners were killed in Consolidated Coal's huge No. 9 mine in Farmington, West Virginia, the opposition fell back and the 1969 Coal Mine Health and Safety Act became law. For the first time, black lung was legally recognized as a disease, and federal compen- sation for occupation health and safety had established a foothold. Just a year later, Presi- dent Nixon signed the Occupational Health and Safety Act. Since these laws were passed, efforts to obstruct, undercut, and dilute them have been continuous. Under the Reagan Administration, this counterattack has become bolder, not only a frontal assault on regulation, but an attempt to gut the Black Lung Program. Behind the ra- tionale that the budget must be balanced lies a fear that the movement begun by the coal miners is rapidly spreading. In this environment, it is not surprising that if workers'compensation were a person instead of a program, it too would be demanding aid to the disabled. Despite some improvements in the early 70s, this granddaddy of U.S. social in- surance programs staggers along, a program of leftovers for those who have given their health and lives at their jobs and their survivors; they've exhausted their ability to provide pro- fits, so the system puts them out to pasture where the grass is sparsest. The National Commission The workers'compensation laws which originated in the second decade of this century were a tradeoff: workers gave up their right to sue their employer for negligence and in ex- change got state systems that promised swift payment for occupational industries without regard to fault (see Bulletin, July August / , 1976). Since employers would pay the cost of injuries, proponents argued, they would have a strong financial incentive to institute safety measures. This turned out to be weak scaf- folding. By the late 1960s, the system was a shambles: real benefits received by disabled workers were falling and accidnet rates were rising; workers and their survivors were bear- ing the major burden of work related - disabilities through reduced income; taxpayers were subsidizing much of the rest. Often hostage to long court battles over causation and extent of disability, benefits were neither sure nor swift. The federal government had three choices in dealing with this national disgrace: federal takeover; pressure on states to reform; or benign neglect until the system became so scandalous that public clamor for reform would be overwhelming. Senator Jacob Javits (NY R -) opted for the pressure approach, using the leverage provid- ed by the federalization of occupational safety and health regulation. He attached a rider to the OSHA act setting up a National Commis- sion on State Workers'Compensation Laws, a mixed bag of 15 presidential appointees representing the various interest groups in- volved and three cabinet members; only two of the members were from organized labor. Despite its conservative composition, the Commission's report, issued in 1972, conclud- ed that " State Workmen's Compensation laws in general are inadequate and inequitable. " The report offered 19 " minimum essential recommendations " and expressed the hope that compliance by the states would roughly equalize costs throughout the country, eliminating fears that companies would move from state to state in search of lowest benefits. The 19 recommendations had two major thrusts: extend coverage to more workers and provide higher benefits. In the event the states fail to implement the recommendations by July 1, 1975, concluded the commission, congres- sional action should be taken to guarantee compliance. Senator Javits kept the pressure on by in- troducing a federal minimum standards bill only three months after the Commission pub- lished its report. The bill never went anywhere, but continuing versions over the years kept the possibility of federal involvement alive. In ad- dition, in 1972 Congress amended the Longshoremen's and Harbor Workers'Com- pensation Act to create what was in effect a model compensation law which went well beyond the Commissioner's 19 recommenda- tions. Within a few years, however, it became clear that the proponents of reform had underestimated the strength of the opposition. Speaking before Congress in 1978, John Bur- ton, Chairman of the National Commission, 7. ee . ad \\ SOLVENT ae 19 At present the battle can't even be described as a stand - off because inflation is on the side of the belt tighteners observed, " These various developments from 1972 to 1975 and the virtual stagnation of reform since then, plus the widening of cost dif- ferences among the states - make the case for federal standards even more compelling now than in 1972. " Throughout this period the AFL - CIO main- tained its consistent support for a federal system, but eager to get at least some progress it backed various versions of the Javits- Williams minimum federal standards bill. However even this legislation was too much for the strong business lobby, and as support for workers'compensation waned, Javits Williams - was watered down to the point where then union federation withdrew its support. Without federal prodding, there is little likelihood the states will accomplish much, since their pace in recent years has resembled that of a toy soldier winding down. By the end of 1979, the 50 states and the District of Colum- bia were in compliance with an average of only 12 of the National Commission's 19 modest basic recommendations, and there has been lit- tle improvement since. Higher Benefits The single most significant improvement in workers'compensation over the past decade has been in benefits. When the National Com- mission recommended in 1972 that maximum temporary and permanent disability benefits be at least equal to the state's average weekly wage, only Arizona was already there. In most states, increases in the ceiling had lagged far behind wages in the 50s and 60s, but between 1973 and 1977 state maximum, benefits rose an average of 84 percent and a majority of the legislatures had reached the commission's standard by 1979. Workers also gained from a reduction in the waiting period for benefits to three days in many states. This was another key Commission recommendation because many workers are disabled for a short time. For single 20 workers off the job for three weeks the average wage replacement nationally rose from 44 per- cent in 1969 to 58 percent in 1978. Naturally, for many workers even receiving benefits equal to 100 percent of the state's average wage means a drastic cutback in in- come, but business resistance mobilized so quickly that only a handful of states met the Commission's 1977 goal of disability benefits equal to 133.3 percent of the average wage. At present, the battle can't even be described as a standoff because inflation is on the side of belt tighteners. Only 12 states provide automatic in- creases for death and permanent disability benefits; in the rest, labor must press for one- shot catch - up boosts. Partially disabled workers are even more vulnerable. Their benefit programs generally offer only a small fraction of lost earning poten- tial and ignore the plight of the many whose disability brings dismissal, compelling them to take a lower paying job or leaving them without any employment at all. Florida and New Jersey have taken the lead in reducing these benefits even further by tying them more closely to ac- tual wages lost rather than taking probable future wages into account at least minimally. The National Commission made few recom- mendations in this area, asserting that it was complicated and required further study. Even the partially disabled who get benefits are fortunate compared to those who are in- eligible for any at all. As in many other cases, the most exploited, least organized workers are slighted in compensation legislation. Coverage has risen from 84 percent of all workers in 1971 to 88 percent now, but the other 12 percent is excluded by many states through measures such as exemptions for agricultural and domestic workers, size of firm restriction, and non compulsory - inclusion provisions. While the Gross National Product was grow- ing, many corporate leaders were willing to agree to improvements in workers'compensa- tion as long as it they were predictable and not too expensive, but then the economy began to stagnate and the cost began to shoot up as a result of broader coverage, higher benefits, escalating medical costs, and leng thening periods of disability. Between 1972 | and 1978 the cost PRM to employers ee jumped from 1.14 BENZENE CAUTION BENZENE BENZENE Camer percent of covered payroll to 1.85 per cent. Business leaders don't want a moratorium, they want a rollback, pres sing their old argument (threat) in state legislatures that unreasonably q. "-_-_-_-ygE, high compensation en costs are causing them to close down or move. Occupational Diseases When an accident happens, you can debate who is at fault, but it's hard to deny something occurred. When some one suffers from a disease, causality is the first line of debate and where there is doubt that the cause is occupa- tional, workers generally lose out. The National Commission's essential recommendations in- cluded little that could help close the wide gap between the epidemic of serious occupational illnesses and the few cases eligible for compen- sation under current laws - - not to say the far fewer that are actually filed. Some states have improved their laws, bring ing them closer in line with medical reality: statutes of limitations have been extended and more commonly run from the time the worker knew he or she had the dissease, rather than from the date of disability or last exposure. But many states still have restrictive statutes that define occupational diseases within a framework of " accidents ", refuse to compen- sate " ordinary diseases of life " preferring to compensate only diseases uniquely caused by work. Thus, some workers who find it difficult to obtain compensation for lung cancer may find it easier to obtain benefits if they are fortunate enough to have asbestosis as well. Workers in the tobacco and cotton industries are out of luck because all they get is lung cancer. For every successful serious occupational disease claim there are several with similar fac- tual situations who never file. Many workers and widows are simply unaware they have a FW. ( legal " remedy ", as it's called, for their respiratory diseases, cancer, hearing loss, etc. Awareness that their illness could be job- related has grown rapidly among workers in the last decade, but knowledge of workers ' rights to compensation and how to file claims has lagged behind. Although some unions have played an important part in informing their members and putting them in contact with representatives and attorneys who can help. them file and win, most have a long way to go. Simple apathy is partly to blame, particularly since unions could stanch the drain on their health and welfare funds by shifting the respon- sibility to workers'compensation. Some occupational groups, such as asbestos workers, are winning their cancer, total disability, and death cases in most states around the country; yet there has been no flood of serious occupational disease cases despite. -- industry claims that the most common occupa- tional disease is " compensationitis. " Disease Reforms One major deterrent to pressing claims for serious occupational disease is the prospect of long litigation, often leading to a settlement for far less than might have been awarded. As 21 Peter Barth and H. Allen Hunt report in their survey of foreign compensation systems: Only in the American states does one find the adversary procedure used as a way to resolve disputes, including such issues as diagnosis, etiology, and the extent of im- pairment. The common practice in Europe and Ontario is to hold hearings. and find fact without using attorneys and, commonly, without a private insurer or employer challenging a claimant's posi- tion. Claims are subject to challenge in some form, but it is usually the social in- surance agency that does this rather than a private party. In the United States, insurance companies are able to stretch out cases for two years or more even when they are exactly the same as dozens of others which have previously been compensated. As if the illness itself wasn't devastating enough the absence of a strong ad- ministrative set - up which seeks out potential cases, finds the facts, and moves cases through quickly becomes cruel and unusual punish- ment to families with valid claims who find themselves impoverished, sick, and under pressure from complicated legal proceedings which might end up giving them nothing. A law worthy of emulation which took effect in California on January 1, 1981 provides that im- mediately after a claim for an asbestos - related disease is diagnosed by a claimant's physician and a Compensation recommended Board - in- dependent medical examiner, and an officer of the Compensation Board has determined the worker was exposed in California, payments for temporary disability can begin from the Asbestos Workers Fund even when the claim is being contested. While beneficiaries of the Black Lung Pro- gram are grateful for the gains of a long strug- gle, opponents in Congress and out regard it as a bad precedent, " too expessive " a " raid on the Federal Treasury " which invites new groups to knock on the door. Other single disease com- pensation advocates will have to work hard to build the kind of political support in Congress that passed the Black Lung Program. It may be that they must show more strength at the state level before another round of workers'compen- sation reform goes back on the national political agenda. Right to Sue Under workers'compensation laws, workers 22 have a " fault no - " system, with no right to sue their employer for negligence, punitive damages, pain or suffering. But as they have found out just how fast and loose corporate America has played with their lives, some workers have found ways to get back in court using the valuable weapon they gave up. With the aid of ingenious, dedicated- and pro- sperous - a ttorneys, they are making an end run around their employers and suing third parties, manufacturers of products involved in producing occupational illnesses and injuries. The Wall Street Journal recently estimated there are 8,000 asbestos lawsuits alone, double the estimates of a year ago. Evidence of willful negligence or a failure to warn against cor- porations is convincing judges and juries to override carefully constructed corporate legal defenses. Companies, naturally, are very distressed. They fear not only large awards and set- tlements, but the public spectacle of widows and disabled workers proving in court that their misfortune stems from employer negligence. In 1980 the California Supreme Court ruled that Reba Rudkin, an employee at Johns Manville's Pittsburg, California plant, could sue his employer outside the workers ' compensation system. The majority opinion held that they were following " a trend toward allowing an action at law for injuries suffered in the employment if the employer acts deliberately for the purpose of injuring the employees of if the harm resulting from the in- tentional misconduct consists of aggravation of an initial work related - injury. " Rudkin's at- torneys can now go to court to prove their con- tention that Johns Manville - was guilty of " fraudulent concealment of the condition and its cause " - in this case Rudkin's fatal lung cancer. Confronted by this vigorous expansion of the right to sue for damages from someone else's employer, if not always from your own, some industries are proposing Federal programs to improve workers'compensation for occupa- tional diseases in exchange for, you guessed it, removal of the right to sue on the grounds pro- ducts liability or practically anything else. An occupational health and consumer pro- tection bill more in tune with the 1970s revela- tions of corporate cover - ups has been ad- vocated by Representative George Miller (Cal D -.). His bill would establish mandatory jail terms for corporate officials who knowingly conceal hazards from their employees and the public. At a more modest level, some states have voted increased benefits to workers harmed under conditions in violation of an OSHA regulation. Right to Know Another important development is the wave of state " Right to Know " laws that go well beyond current Federal legislation. They now are on the books in New York, Connecticut, Maine, Michigan, and California, and legislative battles will soon be fought in many other states over measures which give workers the right to know the composition and health hazards of toxic substances at their workplaces. These laws make it easier to document occupa- tional disease cases and create labor - led coali- tions with environmental and community groups which can push through similar legisla- tion which goes beyond the workplace. Towards a National Movement American business is quite right to feel threatened by demands for compensation. They involve more than a desire to maintain in- come levels, more even than a determination to make those responsible for tragedies pay their share. When the victims raise a challenge, they force corporations and government agencies to provide public explanations and accounting for acts akin to murder. They expose the human cost of doing business, a deep moral failure in the way our production system is organized for private profit. The legitimacy of corporate in- terests is questioned as we are all compelled to ask ourselves, if these companies are capable of such crimes against their own employees, what are they doing to the rest of us? As yet there is no national organization or movement, but the banner of " Compensation! " is rising over diverse issues: occupational diseases, dangerous drugs, environmental disasters. Most occupational efforts have focused on the state level; among the victories, still few, is a small bridgehead in the compensation system won by brown lung vic- tims in the Carolinas. Workers suffering from asbestosis are mobilizing in the shipyards; the recently formed White Lung Association has developed a successful organizing model in Los Angeles which they have brought to other cities; networks are forming to help victims negotiate the compensation system and pro- blems of living with a time bomb - in their bodies. With the help of these groups, asbestos workers are often winning their compensation cases and lawsuits. Last year, 18,000 Kentucky workers marched to the state capital to demand reform of occupa- TERY COML tional disease compensation. Around the coun- try the old legislative game monopolized by in- dustry lobbyists and the state labor federations is breaking down. Sometimes alone, sometimes with the help of Committee on Safety and Health (COSH) groups, labor is organizing mass support to take the initiative away from business and insurance interests. The labor movement has also become more active in training workers to identify and han- dle comp cases in their own shops. The Workers Institute for Safety and Health, a research and education organization set up by the CIO's AFL - Industrial Union Department and the Ohio AFL CIO -, has developed an ex- citing program in Ohio to train these compen- sation stewards. Pilot projects for similar pro- grams are being developed in several other states. Even long term - compensation recipients have begun to organize. The Massachusetts. Organization of Disabled Workers, working with MassCOSH, has been pushing for cost - of- living increases for those already receiving compensation with drives directed at the media, labor movement, and state legislatures. As inflation cuts deep, similar organizations to obtain equitable benefits will probably spring up in other states. A mass movement won compensation for black lung and provided the motor force for workers'compensation reform in the 1970s. 23 Much of this energy was channelled into strengthening federal intervention with hopes that OSHA would sharply reduce occupational accidents and illnesses, that the reform momentum would continue and that the Washington would finally step in and reorganize the workers'compensation system. These hopes have dimmed; the new mass movement beginning knows it has to be stronger, broader - based, and prepared to build alliances across the entire range of en- vironmental activists. -Tony Bale Health / PAC Bulletin Individual $ 14.00 Institution $ 28.00 Student $ 11.20 Volume 12: 1980-1981 (six issues). Health / PAC Bulletin is published bimonthly on a volume year basis from the September - October issue to the July August - issue. THE HEALTH CARE HIERARCHY The Health / PAC Bulletin doesn't have to boast that it's better than the competition; there is no competition. No one else offers independent analysis of health policy issues from prenatal care to hospices for the dying; covers medical carelessness for women and on the job poisoning; offers incisive international reports and lively briefs on domestic health developments. If you already know all this and have a subscription, why not do a friend a favor and fill in his or her name on the form below before you run out of 15 stamps? Remember, nine out of ten radical doctors recommend the Health / PAC Bulletin for fast relief of health care policy mystification. Please enter subscription (s) for: Health / PAC Bulletin Check: (1 Order 645-5 Individuals $ 14.00 Y' Order 646-3 Institutions $ 28.00 To: Name Renew your subscription today! If You Liked Address This Issue, City State Zip 1 Check enclosed (deduct 10% of order) 0) Bill me (plus postage and handling) You'll Love the Next Six Y' Charge: Y' Am.Ex.Vi sa Y' OE Master 24 No. Signature Du Pont Better Living Through Chemistry By Robert Steinbrook " They want to be God to the people, " Earl McCune told a 1976 House subcommittee panel, " They want to be infallible. They don't want to admit or do anything to suggest they have not been doing the proper thing all along. " McCune, a fundamentalist Baptist, didn't ap- preciate people playing God. The safety chair- man of the independent Association of Chemical Employees at the Belle, West Virginia, plant of E.I. Du Pont de Nemours & Co., he was at the hearing to tell the subcom- mittee about cancers among his fellow workers. One of them stood next to him, squinting one eye in the glare of the television floodlamps. Where the other eye had once been was a hole the size of a baseball. McCune had a list of Belle plant workers like the one beside him who had lost organs and were clinging to life, and of those who had recently been operated on for throat cancer, he said, " We can prove this man has been exposed to excess amounts of nitrosamines, dioxane, chloroform and beta naphthylamine - , as well as other experimental or suspect carcinogens, but what good does it do for us to have such facts? " Four years later the mystery remains; the deaths continue. After enduring a long litany of company responses and evasions, times of despondency and moments of encouragement, McCune has left the plant where he worked for 20 years. The management may well be happy to see him gone. Earl McCune, commented one un- comfortable Du Pont executive, stands out " like the Empire State Building in Kansas. " Most Du Pont employees don't belong to unions. They don't make public accusations against their employer's health and safety policies, general- ly considered among the best in the American chemical industry. But " best " is a relative word - and the Belle plant is not the only Du Pont facility with a tragic story: * Blasts rocked the Carney's Point, NJ, plant in 1969 and 1978, killing a total of ten workers. and injuring 60. The plant was closed in the summer of 1978. More than 350 dye workers in Salem, NJ, have died of bladder cancer according to company statistics, one of the worst occupa- tional health disasters in American history. The lung cancer death rate is significantly above normal among chromium pigment workers at the Newark, NJ, paint plant, ac- cording to a 1976 study by the Dry Color Manufacturer's Association. This danger was noted by German scientists during World War II. Thousands of Du Pont workers in Kentucky, New Jersey, and Michigan have been ex- posed to high concentrations of chloroprene, the building block of Neoprene synthetic rubber. In 1936, the company's own scien- tists published an article concluding that chloroprene was a " toxic compound " which causes " severe irreparable damage " of " most vital organs in laboratory animals, including 25 26 Wade illustrations illustrations illustrations illustrations by Mary Margaret Wade Aside from millions of dollars, the explosives trade earned Du Pont the sobriquet " merchants of death " central nervous system depression, sterility and degenerative changes in the male reproductive system. " * In May 1977, Du Pont announced " serious suspicions " that acrylonitrile, the 24th most widely used chemical in the world, was a human carcinogen. More than 1,300 workers exposed to it between 1950 and 1955 at the Camden, SC, textile fibers plant had been found to suffer " highly statistically signifi- cant " excess incidence of cancer, largely of the lung and colon. Chemical plants are complex and many of the compounds handled in them are extremely dangerous. Some people argue that it's a miracle that disasters aren't more frequent. Du Pont executives proudly point out that the com- pany's rate of one disabling accident for each four million hours on the job is exceptionally low in the chemical industry, one tenth the average, and only one fortieth the rate for all industries. However as the list above indicates, there are good grounds for wondering why the chemical giant's record couldn't be signifi- cantly better. The Du Pont Empire Eleuthere Irenee du Pont de Nemours, the son of a French nobleman prominent in the ear- ly days of the French Revolution, began con- struction of the company's original black powder plant on the banks of Delaware's Brandywine River in 1802. Corporate mythology dates the management commitment to safety to an explosion there in 1818 which killed 40 employees. From the manufacture of black powder and later of nitroglycerine and dynamite, Du Pont diversified in the 20th century into pigments, plastics, acids, lacquers, and paints. Still, the big money came from a near monopoly - grip on explosives from the Spanish American - War to Hiroshima. Aside from millions of dollars, this trade earned Du Pont the sobriquet merchants " of death " at the 1934 Nye Committee Senate hearings of war profiteering. Du Pont's image problem worsened with the bladder cancer revelations at the Salem dye works. The public relations department swung into action. At a time when other corporations were spending million teaching consumers to differentiate a Cheerio from a Post Toastie, Du Pont's management began expounding on " corporate responsibility " with fervor sur- passed only by the oil companies of the late 1970s. These efforts to promote " better living through chemistry " were aided by a product which needed no advertising to win the hearts and legs of millions of Americans. During World War II, Betty Grable auctioned off a pair of nylon stockings for $ 40,000 to aid the war ef- fort. When peace came and supplies were shifted to civilian production, " nylon lines " formed outside stores in cities throughout the country. Along with cellophane, Lucite plastic, rayon, neoprene t- he first commercially suc- cessful synthetic rubber - and hundreds of in- dustrial raw materials, nylon transformed Du Pont into a multinational corporate giant, with annual sales totaling $ 12 billion. In Delaware, the company casts a huge shadow. The Company State, an intensive study by Ralph Nader researchers, notes that one worker in nine there is employed by Du Pont. Largesse it has bestowed on the populace includes schools, highways, and the current governor, Pierre S. Du Pont IV. Despite occa- sional carping by citizens groups or a rare newspaper article - Christiana, the Du Pont family holding company, only recently sold the state's largest paper - local citizens appear to be unconcerned by their envelopment in this corporate paternalism. A 1976 Philadelphia Bulletin poll indicated that 91 percent of the state population approves of the company. Few feudal lords outside the Persian Gulf would go to more extraordinary efforts to retain this local favor. When a thick cloud of chlorine and titanium tetrachloride gas emerged from its Edgemoor, DL, plant in 1975, Du Pont 27 27 representatives fanned out over the area to of fer compensation for gas related - damages ranging from a dead duck and its unhatched ducklings to medical bills and unused theatre tickets. When a Newport, DL paint plant threw pigments up its smokestacks, tinting the entire town blue, the company literally scrubbed it clean, and even hired a dog groomer to brush out " blue cocker spaniels. " Corporate Safety Running around paying off dead duck owners is clearly an expensive and unsatisfac- tory method of dealing with health and safety. Du Pont has developed an elaborate and well financed system for dealing with problems at earlier stages. " The health of our employees is not something we put on a balance sheet, " was the unequivocal declaration of James I. Reilly, vice chairperson - of the company - wide en- vironmental affairs committee. Chaired by one of the corporation's five senior vice presidents - , the committee brings together Du Pont's top. medical, legal, safety, environmental, and public relations staff; all new product lines and major capital improvements must obtain its ap- proval. Most members of the committee are engineers and technicians who have climbed up the corporate ladder, imbued at each rung with the conviction that environmental and health concerns are simply more challenges to solve. Their list of industrial health and safety in- novations is indeed impressive. In 1915, the company appointed American industry's first full time - medical director; soon after it joined a handful of other companies offering employees free regular medical checkups. In the 1930s, the Haskell Laboratory for Toxicology and In- dustrial Medicine, one of the first such facilities, was established. When the American Academy of Occupational Medicine was set up in 1946, a Du Pont doctor became the first president. In 1954, the company's medical department published a complete textbook, Modern Occupational Medicine, which ranged as far as the rehabilitation of alcoholics and redesigned the workplace to reduce stress; a long section discussed controlling chemical hazards. When a second edition appeared in 1960, it contained a chapter on occupational diseases most companies preferred to ignore, including asbestosis and berylliosis. The 28 Haskell Laboratory, which has expanded its staff to over 200, puts as many as 20,000 tissue specimens under the microscope to check a single chemical for carcinogenic effects before certifying it safe for manufacturing use. In ad- dition, since 1956 Du Pont has maintained a tumor registry for employees at 80 plants to assess potential links between toxic chemicals and cancer even today, few companies have followed this example. Until the recent federal focus on occupa- tional health and safety regulation, Du Pont was generally far ahead of any government re- quirements. Their programs also occurred with hardly any pressure from organized labor at plants, a strong impetus to improvements elsewhere; throughout the corporation's em- pire there are only 32 large independent unions and 10 locals of national unions. Speaking for the corporation, James Reilly promised, " If we can't protect our employee's) " I said that it would not help my investigation of the bladder cancer problem if they would not provide management that would cooperate with me. " " health, we don't make it. " To illustrate this com- mitment, Du Pont officials often cite the history of Kevlar, their " better than steel " fiber. After the company proudly announced the discovery of this synthetic, so strong commercials show a single thread holding up a boxcar, scientists at Haskell found through animal experiments that a solvent used to manufacture it, HMPA, is a potent cause of animal cancer. As a result, Kevlar production has been limited to " market development quantities " while researchers seek a replacement solvent; Du Pont estimates that lost sales run into the tens of millions of dollars every year. The Fatal Flaws Given this apparent devotion to employee health and safety, explaining why a Du Pont plant and nearby factories have given Salem County, NJ, the highest cancer death rate for white males in the entire country requires a peek behind the nylon curtain. Helpful information has been provided by Dr. Wilhelm Hueper, a former Du Pont scientist who proved the relationship between a dyestuff used at the plant and bladder cancer and later headed the National Cancer Institute's en- vironmental cancer section for 16 years. In Larry Agran's book, The Cancer Connection, Hueper described his rude awakening to the politics of corporate medicine nearly 50 years ago. " When I first visited the dye works for collec- ting exposure information, I was shown the beta naphthylamine - operation, " he told Agran, " I said to the foreman,'You have a very nice clean plant here.'He said,'Oh, you should have seen it last night. We worked all night to clean it up for you.'" " Hueper then asked to see the facility using " Now "..., the result of that letter was that I was never permitted to see the dye works again " ee benzidine, the other potentially carcinogenic substance at the plant. The plant manager resisted. Heuper insisted, and was reluctantly escorted to a building up the road. " When I saw that, I knew why they didn't want me there, " he related, " This building they did not work all night to clean up for me. The benzidine was spread all over the place, inside and outside, on the loading platform and on the road. " Outraged by what he had seen, Hueper hur- ried back to Wilmington, where he received an even greater shock. " I wrote a letter to the president of the company telling of the condi- tions, " he told Agran, " and I said that it would not help my investigation of the bladder cancer problem if they would not provide plant management that would cooperate with me. Now, the result of that letter was that I was never permitted to see the dye works again. This was my introduction to industrial ethics and professional medical integrity. ". In 1938, Dr. Hueper produced humanlike bladder tumors in dogs by feeding them betanaphthlamine and published his results in the Journal of Industrial Hygiene. Shortly after- ward he was fired, ostensibly for economic reasons. It might be argued that postwar management was more enlightened, but exposure to beta- naphthylamine and benzidine continued at the Salem County plant until 1955. Of the 2000 workers there between 1919 and 1955, about 350 have suffered from bladder cancer. The Belle, West Virginia, plant is still in operation, and 155 hourly employees died of cancer between 1956 and 1976. Du Pont's own epidemiologists have concluded that since the company - wide average cancer rate would have predicted only 127 cancer deaths, there was a 95 percent chance the difference was medical- ly significant. Three cases of eye cancer among them were particularly unusual, since the disease is so rare that one case would be unusual in a group that size. Doctors from Har- vard Medical School came down to investigate, but reported in the New England Journal of Medicine that they could find no conclusive evidence pointing to any causative factors. Earl McCune had strong suspicions, however. He brought a bottle of water with him to work every day because he knew Du Pont was getting the plant drinking water only a thousand yards down the Kanawha River from the place it dumped its waste. Between February 1976 and March 1977 alone there were 16 illegal chemical discharges into the river. " We're up there to make a living, " com- mented one worker when the news came out, " not to commit suicide. " Du Pont has now closed its water treatment plant and hooked the factory into the Charleston area water supply. Similar patterns emerge in other Du Pont cancer disasters. When the lung cancer pro- blem was noted at the Newark, NJ, plant, Dr. Ir- ving Selikoff of Mt Sinai Hospital in New York pointed out that even if Du Pont's staff had missed the earlier German studies on the link. between chromium compounds and lung cancer, " It is now... 25 years at least since good studies were done in our country, largely in New Jersey, showing that chromates cause cancer. Nothing was done. No controls were in- stituted. " Although Haskell Laboratory researchers. had published a paper on the carcinogenic danger of chloroprene exposure in 1938, 29 perhaps as many as 10,000 of its workers have been around high concentrations over the past 41 years; Du Pont didn't even begin monitoring chloroprene vapors at is plants until 1972, and didn't become really concerned until Soviet studies indicated that chloroprene is linked to lung and skin cancer. Du Pont disputes these findings, but since then Soviet scientists have shown that males who work with the compound suffer a reduction in the number and motility of their sperm and their wives have a dispropor- tionate number of miscarriages and children with birth defects. Dr. Peter Infante of the Na- tional Institute of Occupational Safety and Health (NIOSH) called the Soviet evidence " so overwhelming " that further studies are not necessary. Du Pont says chloroprene is " coming up clean " in many Haskell tests. A company study. showed no statistically significant lung cancer death increase among close to 2000 workers surveyed, but provided no explanation for the high rate among mechanics at the Louisville plant. " They told us their studies have indicated no danger at all, " said Dudley Lacy, president of the union representing 1,300 workers at the plant, " They make it sound like you can drink Is Du Pont prudently refusing to overreact to less than definitive studies and moving quickly to pro- tect workers when the evidence is clear? a chloroprene and it will probably make you healthier. " No workers at the plant have been given comprehensive tests by either NIOSH or the government to investigate the dangers, par- ticularly to reproduction. " We're a little leery of that sort of thing, " explains Robert M. Pros- ser, research and development manager for Neoprene, the synthetic rubber chloroprene is used to produce. " You start asking employees questions about their sex lives, whether they are using contraceptives or trying to get preg- nant and you have a problem. " Weighing the Evidence Is Du Pont prudently refusing to overreact to less than definitive studies and moving quickly to protect workers when the evidence is clear? Or is it fighting a rearguard action to avoid costly cleanup operations at many plants and to play down hazards that should have been cor- rected many years ago? These questions defy easy answers. It is sim- ple to say that small exposures to some chemicals can cause tumors 15 to 20 years later. But deciding whether a particular substance " does or doesn't " is not. Animal 30 studies must first be extrapolated to humans and then the effects of alcohol, cigarettes, auto exhaust, diet and other chemicals factored out. Many epidemiological studies, with good reason, conjure up visions of " garbage in, gar- bage out " statistical shenanigans, not scientific truths. Despite these notes of caution, Du Pont's ex- periences are obviously a cause for concern. The growing roster of chemicals proven to cause cancer suggests that the factories which produce them are inherently hostile en- vironments. An excellent safety record on cut fingers, explosions and the like is no protection for workers against the more insidious and chronic exposures to low levels of tumor pro- ducing agents. Or is it fighting a rearguard action to avoid costly clean - up operations at many plants and to play down hazards that should have been corrected many years ago? Du Pont discounts this indictment, maintain- ing that it is on top of the situation. Indeed, of- ficials say they are going to waste hundreds of millions of dollars in the next decade comply- ing with federal environmental and health regulations that offer no benefit to anyone. The public relations offensive, focusing on air, water and noise pollution, concedes that most of the $ 700 million already invested is justified. But it suggests that about a quarter of Du Pont's projected $ 10 billion capital budget for the 1976-1985 decade will be squandered on the senseless anti pollution - measures. Yet the company's safety - first image is mar- red by the bladder cancer fiasco, the chloroprene story, the handling of the chlorine gas leaks at the Edgemoor, Del. plant, and the on going - saga of the high cancer rate at Belle. In January 1977, Du Pont brought the federal probe of the West Virginia plant to a halt by de- nying investigators unrestricted access to the medical and employment records. Later, a NIOSH team spot checked - records at Belle. * { EMERGENCY ON a8 BREAK GLASS - oqeMage. S8 FIS FEST 9 Instructions: HO AGS OFA _ 898 PLE MCE J UTE Lao te intide Rt ddl 098 39 g g DAG They found " very poor " files, loaded with " in- 08 ternal inconsistencies, " " errors, " and omis- sions. They documented " poor quality control " by finding two cancer deaths, one from lung cancer, the other from leukemia, in 14 folders inspected at random which had not been reported to NIOSH or recorded in the com- pany's tumor registry. Thousands of records had been destroyed between 1971 and 1976 because of " limited storage facilities. " At about the same time that Belle plant manager Fred Winterkamp was telling all per- sonnel that " there is no evidence that employ- ment here has adversely affected the health of employees, " NIOSH's Dr. Joe Wagoner was predicting that a full scale - study " will probably identify an excess risk of cancer of particular organs associated with employment at the Belle plant. " He warned that " Du Pont data and analysis of that data as submitted by Du Pont do not deserve to be taken at face value, " because they were tabulated " in ways which minimized the chance that excess cancer risks would be noted. " As the Du Pont experience shows, even at the most safety conscious - firms, death is a cost of doing business - a cost borne by the workers. Du Pont's motto " Better living through chemistry, " has a hollow ring, considering the workers who have died unnecessarily. (Robert Steinbrook is a resident in medicine at the University of California, San Francisco.) 31 Human Sciences Press 72 Fifth Avenue New York, N.Y. 10011 32