Pain and Prejudice

What Science Can Learn about Work from the People Who Do It

Karen Messing

• Publisher: Between the Lines
• Year: 2014
• Print ISBN: 9781771131476
• eBook ISBN: 9781771131483
• Topic: Philosophy
• Subtopic: Occupational & Industrial Medicine

In 1978, when workers at a nearby phosphate refinery learned that the ore they processed was contaminated with radioactive dust, Karen Messing, then a new professor of molecular genetics, was called in to help. Unsure of what to do with her discovery that exposure to the radiation was harming the workers and their families, Messing contacted senior colleagues but they wouldn't help. Neither the refinery company nor the scientific community was interested in the scary results of her chromosome studies.

Over the next decades Messing encountered many more cases of workers around the world—factory workers, cleaners, checkout clerks, bank tellers, food servers, nurses, teachers—suffering and in pain without any help from the very scientists and occupational health experts whose work was supposed to make their lives easier. Arguing that rules for scientific practice can make it hard to see what really makes workers sick, in Pain and Prejudice Messing tells the story of how she went from looking at test tubes to listening to workers.

Chapter 1

Factory Workers

WHEN I WAS LITTLE, MY FATHER took me for a morning to the factory where he was an executive. To my delight, he let me sit at the line and watch the women wiring radios. The red, blue, and yellow wires had to be soldered in the right places in each radio. The women even let me play with the coloured wires while my father was busy. This occupied me for a while, but then I got down off my chair and went to see my father in his office. I had something on my mind. I asked him, “Don’t they get bored doing the same thing all day?” He replied, “No, they don’t. They’re not smart like you, Karen.”

I was floored. My father was telling me that these grownup women were not as smart as me, a five-year-old who had a pretty good idea of my low rank in society. What he was saying didn’t seem too plausible, but he seemed to be sure of what he said. I puzzled over this for a while and never forgot it.

Many years later, circumstances conspired to suggest to me that my father might have been mistaken about the intelligence of workers. When I was seventeen, I was suspended from my university for a piece of minor mischief and it would be three months before I would be allowed to go back. I applied for jobs in a bookstore and several restaurants and was finally hired as a waitress at a cafeteria known for its quick lunches. I was supposed to supply each customer with a tray, napkin and silver, take the order and yell it to the kitchen staff with the right code name, in detail, for each preparation (special hold the green, burger New York . . . ). For each of the ten or so main dishes, I had to supply the right side dishes or condiments. If the order appeared with all its fixings in due course in the window from the kitchen, I had to give it to the right customer. If it didn’t, I had to negotiate with the kitchen staff, trying to balance the customer’s grumbling against the way Henry the cook, a scary guy, would get annoyed with me for nagging him.

I was a pretty terrible waitress. The women who had been doing counter service for several years were able to handle orders from four customers at a time. Slap! Slap! Slap! Slap! went the trays on the counter and the silver and the food on the trays. But I never could manage juggling more than two customers. And – most humiliating for an honours Ivy League student – the biggest obstacle was not physical, it was mental. For the life of me, I couldn’t manage the cognitive challenge of getting the orders and their details right and following their progress for more than two customers at a time. Beverly, a girl my age who had been hired just before me, was a great comfort. She explained little tricks she had picked up, like forgetting about the parsley on the egg if there was a long line of customers. And it was getting to know Beverly that put the final touches on my growing suspicion that people could be working class and bright at the same time. She had all the stigmata of a life in poverty – missing teeth, uneducated speech patterns, sole support of a new baby – and she was at least as quick mentally as I was. We had a great time together making fun of the managers and the kitchen staff until I went back to university and my real life.

It was also in this job that I began to understand about power relations between employers and workers. Beverly and I were paid what was then minimum wage, $1 an hour. To me, even in 1960, this seemed a tiny amount of money, and I couldn’t understand how Beverly and her baby could live on it. Especially since the employer made us pay him for cleaning our uniforms. It seemed to me that we shouldn’t have to pay for this since the uniforms didn’t belong to us. But the manager quickly made me understand that if I wanted the job, I would pay for the cleaning and I would shut up. And a few of the customers were quite as efficient in getting across the idea that if I wanted to keep the job, I wouldn’t object to any of their patronizing or flirtatious remarks. If I smiled enough, sometimes they would even leave me a quarter on their tray.

For the next few years, I behaved myself and finished university and graduate school. My only close encounters with low-paid workers took place as a customer. It wasn’t until I got a job as a biology professor at the Université du Québec à Montréal (UQAM) that I had another, very different kind of contact.

In 1978, a problem arose at a phosphate refinery near Montreal. The men who worked there heard that the ore they processed was contaminated with radioactive dust. The refinery’s waste rocks had been sold to the province as road paving, and a technician had noticed that the roads emitted radiation and worried that commuters might be exposed. Reading the newspapers, workers in the plant learned for the first time that the material they handled was radioactive and dangerous to human health. They called the union, who called the university outreach office, who called me. I was the only potential resource who came close to knowing anything about radiation and genetic damage. The union health and safety counsellor and I drove out to the south shore of the Saint Lawrence River one cold day and met with the union executive in their little union office. There were six men in their thirties and forties who had spent years in the plant. They told us that not only was their workplace full of radioactive dust, but the workers had been taking home the factory waste to use as phosphate fertilizer in their gardens. I knew little about the effects of radiation on humans, but I gave the six men the Genetics 101 version of how radiation works: its energy can damage chromosomes and thereby change genes, and altered genes don’t work as well, possibly affecting health. I glibly mentioned that the damage could be passed on to the next generation and beyond.

“So my daughter’s problem could come from my job?” asked the union president “Jean-Jacques.” With a bump, I woke up to the fact that I wasn’t in my classroom and should have been gentler. Too late – I had created a shock. Of the six men around the table, five were married, four had children, and those four each had a child with a significant health problem, from cleft palate to clubfoot. The fifth married man had a pregnant wife, and he and, suddenly, I were both worried about their future child. And, yes, several months later the child was born with a serious birth defect: she suffered from tracheal-aesophogeal fistula, a condition where there is a hole between the air passage and the digestive tube running from the mouth to the stomach.

I had no idea how to approach human genetics professionally, but it was clear to me that someone had to do something to find out whether there was a problem at the plant. Thus began a frustrating and mystifying period where I tried to contact qualified people – university professors and medical researchers – and interest them in helping those hundred men exposed to radiation to find out what was happening to them and their families. Mystifying because, for some reason, none of the logical people to contact showed any interest in getting involved in a situation that was, to me, humanly compelling as well as scientifically fascinating. I first called a genetics researcher at a children’s hospital in Montreal and, in my innocence, started out on the wrong foot: “I’m Karen Messing and I’m a biology professor at UQAM and we have an agreement with a union to give them information on health and safety risks and we need an expert on human genetics.” “No, I’m not interested in working for a union” was the reply. “No, I didn’t mean the union would hire you, it’s just that these people are exposed to radiation and have malformed children and I don’t have the expertise to judge whether the radiation is causing the problem,” I explained. “No, I’m not interested in working for a union,” he repeated.

One of the union executives whose wife had had a malformed child was referred to a local hospital genetics counsellor I will call “Dr. Tremblay.”¹ Dr. Tremblay told him, “These things just happen, we’ll never understand them. But they could not be associated with your work.” I heard about this and tried to reach Dr. Tremblay to find out why he thought they could not be associated with the executive’s work. I left messages for him and then for others in his service, but no one returned my calls. And so it went, even though I edited any mention of the union out of my subsequent phone calls. None of the people whose job it was, none of the researchers whose expertise it was, would meet the workers as a group or study their situation. Just imagining a potential conflict with an employer was enough to put off my colleagues, who, to do them justice, hadn’t met the distressed fathers. And truly, talking with them was maybe best avoided. I still haven’t forgotten the face of the man who said, “I worked all my life in this crummy plant to keep my family safe and healthy and now you’re telling me I maybe gave my son his heart problems.” Or the fiancée of another worker who explained to me that she had broken off her engagement because she wanted to have children and was afraid of radiation damage.

At that time, I had just joined our biology department and my research program in genetics was aimed at developing and strengthening a fungus that would kill mosquitoes. I had gotten a grant with two of my colleagues, entomologists who knew how mosquitoes should be killed, and we were doing well. I had hired some students who were busy growing fungus on plastic dishes and floating their spores on the surface of water where the mosquito larvae lived. My department was happy it had hired me because I had shown I could get grants from federal and provincial sources.

What was I going to do about the refinery workers? I talked it over with Micheline Cyr, Ana María Seifert, and Claire Marien, three very bright undergraduate biology students who were looking for a term project. They offered to look at the radiation exposures with me. Week after week we read about radiation and discussed how to deal with the scientific and human issues at the factory. We felt terrible because we had no way of knowing whether the children’s problems were in fact due to their fathers’ work, and no one would help us find out. We didn’t know whether to reassure the fiancée or to commiserate with her.

We were especially concerned because we were learning more about the working conditions at the plant. We met a veteran worker who told us how dusty it was. He explained to us that when the workers needed to have dental work done, their dentist made them stop working for weeks before; otherwise their jaws were too weakened by exposure to the phosphorus in the dust, and the dentist was afraid to damage them. (A year later, when the employer allowed us to tour the plant for the first time, every surface was dusty. We felt dusty ourselves, inside and out, after just a few minutes.)

The union arranged a Sunday morning breakfast with the men and their families so they could fill out a questionnaire on their reproductive histories, to give us some idea whether there were too many miscarriages, stillbirths, or malformed children. Micheline, Ana María, Claire, and I went to a small church basement where the wives served us bacon and eggs and pancakes. I gave a presentation about the effects of radiation on health. This time I was a bit more tactful but the audience was understandably tense. Still, the wives were glad to have a place to ask their many questions. Most of the workers were too young to have had children and so only thirty wives filled out the questionnaire. Their answers confirmed that there might be a problem but we couldn’t really be sure because there was such a small sample to work with.

The scientific literature was not much help to us because it only talked about rays. It was full of calculations about the doses people would get from an external source of gamma or X-rays, but I couldn’t find anything about what happened if you swallowed radioactive dust. How long would the dust stay inside you? Would the radioactive elements concentrate in certain organs? Given that the radiation was not outside the body, all the calculations in the scientific literature about the distance of the human body from the radioactive source were no use to me. So we needed some way to find out whether the radiation was causing damage.

I had been to school with Professor Abby Lippman of McGill University, who had done her Ph.D. in genetic counselling. She was able to introduce me to a clinician who knew something about how to examine human chromosomes. Dr. Naomi Fitch kindly offered to teach me how to examine the chromosomes myself, so I went to her lab for re-training. (This was at a time when scientific institutions were less rigid; today, no department or funder would give a newly hired professor enough slack to dabble in extraneous research fields.) The union was able to access a little money via the UQAM-union agreement, enabling me to hire Micheline, Ana María, and Claire to help out with the chromosome study. We collected blood from a small sample of workers and prepared slides with special staining to be able to see the chromosomes. The students and I examined the slides (which had been mixed in with slides from other people so they could be classified “blind”) and we all thought we saw many more signs of damage in the samples from workers than those from people who didn’t work at the refinery.

When we sent our report to the union and the employer, some other geneticists finally got interested. In fact, I got a call from the president of the Canadian Genetics Society asking for my slides – he had been consulted by the employer and wanted to do a counter-expertise (a paid contrary opinion). And, after more than a year of silence, Dr. Tremblay the genetics counsellor finally called me back. He told me the employer had also consulted him and had told him to threaten me with a lawsuit. He warned me to drop the whole idea of doing a study.

Further education about the workings of North American science followed. The students and I were still worried about our lack of experience in examining human cells and wanted to have independent confirmation of our results from someone not associated with the union or the employer. A friend of a friend was a recognized expert on occupational health in the U.S., a professor at a major school of public health. When we contacted him, he offered to re-do our study. We were delighted, since we needed to know whether it was true that the refinery workers’ chromosomes had been damaged. “Professor Ivy” came, took blood samples, and disappeared from view. A few months later, all the (French-speaking) workers received a letter in English on the letterhead of his prestigious university saying their chromosome tests were negative and they had no problems. We did not get a copy, but the union called us and said our results had been wrong. When I phoned him for confirmation, Professor Ivy told me that sending the letters was a secretary’s error and that he had not yet looked at the samples. He had been busy with other things; he was negotiating tenure at his job. He offered to send a letter of correction to the workers but never did that either, resulting in further confusion. During our phone call, he did ask me for permission to use a photograph of one of the workers’ blood samples in a textbook he was editing, because he had never seen a worker’s chromosome damaged in that particular way.²

We never received any information about his analysis of those samples, so we never knew whether our results had been accurate, although Professor Ivy’s interest in the highly damaged chromosome seemed to indicate that there might be some problem. More importantly, to this day, over thirty years later, the workers have never been given any confirmation about their health status or the future of their children and grandchildren. Because of the episode with Professor Ivy, they were never sure they could trust us either. In light of all the conflicting information, the best the union could do was to bargain with management, offering to stop dealing with us if management would clean up the radioactive dust in the plant and install a new ventilation system. Management was happy to accept, and we were ousted. As far as we know, no other scientist has ever studied these workers’ chromosomes. The refinery closed in May 1992, leaving behind 1.2 million metric tons of radioactive waste to be disposed of by the public health authorities.³ Professor Ivy went on to head a U.S. government occupational health research organization and still has an excellent reputation in scientific circles.

My brush with radiation science was not over. During our study of the refinery workers I had read and learned a lot about radiation and its effects on human beings. I also got connected with a loose network of researchers in the new field of occupational health. In the 1970s and 1980s, people were just starting to become aware of industrial contamination. Dr. Jeanne Stellman of the Oil, Chemical and Atomic Workers Union in the United States had recently published Work is Dangerous for Your Health, which alerted workers to their chemical and physical exposures.

Two years later, because of my growing familiarity with radiation exposure, I accepted when a hospital union asked me to be an expert witness for an X-ray technician who was asking her employer for paid leave for the duration of her pregnancy. “Suzanne” had already had a malformed child, and several of her colleagues had recently had miscarriages. She didn’t want this fetus to be exposed to radiation and had left her job on her own initiative. She was trying to get back pay through a contract provision allowing for leave for pregnant women exposed to workplace risks.⁴ The employer maintained that she was not exposed to any risk because her dosimeter readings showed very low exposures.⁵ But the union estimated that the risk of accidental exposure was unacceptably high because workers said that the prescribed precautions were frequently ignored. Workers had seen medical students turning on X-ray machines before the technician had left the room, and they had counted the number of times the lead-shielded doors were inadvertently left open. They also didn’t trust the dosimeters because some technicians had purposefully left their dosimeters in front of the X-ray machine for long periods without ever hearing that their readings were abnormal.⁶

I thought the union had a chance of winning the grievance, but I did not realize what we were up against. At that time, in 1980, I was an untenured professor, thirty-seven years old. My only published research was on fungus. Although I had done a lot of reading and research on radiation, it would be five years before I would publish my first peer-reviewed scientific article about human genetics – the most important qualification for expertise. As I prepared for the hearing, I found out to my consternation that the employer’s expert was Professor Edward P. Radford. He had chaired an international commission on the effects of radiation on humans and had published hundreds of peer-reviewed articles and communications on the subject. Debate was currently raging in scientific circles about the effects of low-level exposures to ionizing radiation and Radford was among those who perceived those effects to be negligible. I felt scared and inadequate. I tried in vain to get other, better qualified scientists to replace me, but no one would accept going up against Radford, not even when the union offered to pay them at an appropriate rate for international experts.

The hearing, which I remember as taking place in a little dark room in Quebec City, was tough. A small army of lawyers had been paid to show I was wrong. Although there was a superficial resemblance to my doctoral defence, where three professors attacked my results, the stakes were much higher at this hearing. I felt naively as if my competence alone would determine the fate of the children of the radiology technicians, whom I had come to know and care about. I thought that if I did well, their futur...

Table of contents

• Cover
• Contents
• Preface
• 1 Factory Workers
• 2 The Invisible World of Cleaning
• 3 Standing Still
• 4 The Brains of Low-Paid Workers
• 5 Invisible Teamwork
• 6 Home Invasion
• 7 Teachers and Numbers
• 8 Becoming a Scientist
• 9 Crabs, Pain, and Sceptical Scientists
• 10 A Statistician’s Toes and the Empathy Gap in Scientific Articles
• 11 Can Scientists Care?
• Notes
• Index