Pain and Prejudice: What Science Can Learn about Work from the People Who Do It

Preface

MANY RESEARCHERS IN OCCUPATIONAL HEALTH never actually get the chance to talk to people suffering from the work-related health problems they study; their research keeps them in their laboratories, far from the factory floor. But for the past thirty-seven years, I have been lucky enough to be forced into direct contact with the world of work and made to see, hear, smell, and touch the environments that make workers sick.

When I arrived at the Université du Québec à Montréal (UQAM) in 1976, its Department of Biological Sciences had only existed for seven years. The political excitement of the 1960s and the quiet revolution had inspired the province of Quebec to create a publicly funded university. By the time I was hired, some professors and administrators had persuaded the university that it should do something for communities not traditionally served by universities, meaning unions, women’s groups, and community groups. After some negotiations, UQAM promised to pay professors to do research on topics suggested by these groups. UQAM created a community outreach service and even hired co-ordinators to link professors with community needs.¹

One day, the co-ordinators visited our department and asked whether anyone was interested in being a resource. My collaborator and friend Donna Mergler, a professor of physiology, encouraged me to participate; she was already giving educational sessions on the health risks of noise and asbestos. I couldn’t see how my doctorate in molecular genetics of lower organisms could be directly useful to the community, but I put my name down. A couple of months later, the co-ordinators called to tell me they had gotten a request for help from radiation-exposed refinery workers who needed a geneticist. My career took an irreversible turn.

Over the following years, Donna and I developed a research program in occupational and environmental health that benefited from community input. In 1990, we founded CINBIOSE,² a multidisciplinary research centre that has been able to support other community-friendly researchers with similar interests.

Stimulated in part by the program at UQAM, Marc Renaud, the new head of a provincial government organization that gave grants for health research,³ decided to offer a program unlike any other source of support for scientists. The grants would be given to university-community partnerships on presentation of a joint research program. In order to ensure that the scientists would listen to the community group, the group or a co-ordinating organization would control the money. The peer review committee rating the proposals would also have community representation.

CINBIOSE got a call from the community outreach office suggesting we apply. For the next fifteen years, until the program was abolished, we got large amounts of money to partner with the women’s committees and health and safety committees of Quebec’s three largest trade union confederations. Our original partnership included ergonomists, sociologists, and legal scholars, as well as the six union representatives. We called it l’Invisible qui fait mal (literally, The Invisible that Hurts), referring to the fact that occupational health risks in women’s jobs are often less impressive and obvious than they are in men’s jobs. This group sponsored dozens of research projects and interventions. We created a book on ergonomics and women’s work that European unions translated into six languages and we wrote a United Nations policy paper on gender and occupational health.⁴ Our legal specialists helped get new laws passed and old ones respected.

I have been surrounded by a strong, active, nourishing support system, favourable to labour, while doing research in occupational health. This explains why, even while in academia, I have been able to listen to workers’ stories and helped to understand them. I have been allowed to observe how lack of respect and understanding from employers, scientists, and the public affects their working conditions and thereby their health. I have been freed from some of the constraints of the scientific establishment and allowed to see how scepticism towards workers’ pain has influenced and even shaped the academic field of occupational health research.

The context in which we were able to develop these relationships is fast disappearing as the globe veers to the right. Canada’s conservative government has replaced community representatives with industry spokespeople on research granting organizations and peer review boards. The Faculty of Science at UQAM expelled CINBIOSE from its sponsored research centres and sent us off to the Faculty of Communication. Our provincial funder closed its doors and its successor decided that our publications were not being seen in the right academic venues. So it will not be as easy for those who come after us to cross the gap between the university and the community of low-paid workers, which I call the empathy gap – an inability or unwillingness among scientists and decision-makers to put themselves in the workers’ position.

I retired from teaching in 2008, although I continue to do research and supervise graduate students. In this book, I will explain some of what I learned from workers about their jobs, their health, and their lives. I will try to demonstrate how the gap in experience and interests between low-paid workers and the classes above them affects their health and the scientific discourse about it, with costs for scientific quality, for the public, and even for employers.

I will describe how I learned about the reality of work at the bottom of the social hierarchy and was confronted by how little employers and the public know about that reality. I came to understand how the science I had learned in school and from my colleagues was often inadequate to interpret the effects of low-paid jobs on workers’ health. And I will try to show that, because of its ignorance of many real working conditions, the science of occupational health does not always do as good a job as it could in finding out about all workers’ health.

Toward the end of the book, I try to examine my academic field a bit more critically. Do occupational health scientists just lack empathy with people of lower status? Or are there more structural problems at work? It seems to me that there is a complicated interplay between scientists’ training, their personal attitudes towards workers, and their economic and social interests. I have no expertise in political science or economics to help me tease out these relationships, but I do know that scientists could be more helpful than we are in improving workers’ health. My last chapter tells some success stories that can suggest paths for change.

But before discussing solutions I have to explain how I experienced the gap between workers and scientists and how my colleagues, students, and the workers I came to know pulled me across that gap.

This book owes a lot to my students and collaborators, from whose work I have freely borrowed. They will be cited in the text, but I want to mention specifically: Donna Mergler, Ana María Seifert, and Nicole Vézina, who showed me how to do occupational health research with respect for workers; Katherine Lippel, who made me aware of how complicated occupational health policy is; Stephanie Premji and Jill Hanley, who led me to the story of the many ways that immigrants’ health is affected by their specific workplace conditions; France Tissot, Stephanie Premji, and Susan Stock, who have worked with me on the hidden inequalities in epidemiological analysis; Carole Gingras, Lucie Dagenais, Jocelyne Everell, Céline Charbonneau, Nicole Lepage, Micheline Boucher, Pierre Lefebvre, Marie-France Benoit, Ann Potvin, Ghislaine Fleury, Gisèle Bourret, Michelle Desfonds, Sylvie De Grosbois, Martine Blanc, and Sylvie Lépine, among others, who helped me again and again to understand the needs of the workers in their unions; and Florence Chappert of the Agence nationale pour l’amélioration des conditions de travail (France) who gives me hope. I also sincerely thank (in no particular order) some of the courageous worker-friendly scientists who have encouraged and inspired me: Barbara Silverstein, Laura Punnett, Hester Lipscomb, Céline Chatigny, Cynthia Cockburn, Patrizia Romito, Annie Thébaud-Mony, Laurent Vogel, Maria De Koninck, Jeanne Stellman, Jim Brophy and Margy Keith, Romaine Malenfant and Robert Plante, Ghislaine Doniol-Shaw, Danièle Kergoat, Catherine Cailloux-Teiger, Ruth Hubbard, and Åsa Kilbom. And the many generous workers who let us observe them and explained what we couldn’t see.

More specifically I owe thanks to Melissa Wakeling, Glanmore National Historic Site, Belleville, for the reference used as an epigraph for chapter 7, to Donna Vargas for information on the Montreal Day Nursery (chapter 2), and to Chantal Lavigne of Radio-Canada for generously sharing her research results on teachers (chapter 8).

I was lucky enough to be encouraged by the Scribblers: the late Martin Kevan (we miss you), Barbara Scales, Ana María Seifert, and Pierre Sormany. Pat Armstrong and her graduate students at York University were very helpful, especially Suzanne Day. Katherine Lippel, Harry Glasbeek, Cathy Walker, and Daood Aidroos gave very helpful comments on parts of the book. Amanda Crocker, my editor at Between the Lines, and copy editor Cameron Duder both made important, thoughtful suggestions for improving the manuscript. I didn’t take everyone’s suggestions, but I appreciated all of them. Thanks to Gloria Steinberg for keeping me going, and to my wonderful family, in-laws, and stepfamily for their love and support. And of course to Pierre for input and support with the book, the title, the research, and my life.

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