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Toxic Circles:
the Workplace Origins of
PART II: THE CHROMIUM HAZARD IN HUDSON COUNTY
PART I: MEDICINE'S CONTRIBUTION TO UNDERSTANDING OCCUPATIONAL AND ENVIRONMENTAL HEALTH Introduction Industrial pollution, a worldwide problem, reflects the conflict between economic progress and public health. Occupational diseases lie outside the mainstream of medical practice. Yet the heavy toxic exposure in the workplace provides the scientific base for environmental medicine. The clinical manifestations of industrial disease afford a first approximation of the more subtle effects resulting from lower exposure to environmental pollutants. Medical signs in exposed workers have been used as sentinel health events indicating the need to reduce occupational exposure. They also can serve as guideposts for identifying the adverse health effects of industrial pollutants that have spread from the site of origin into the environment. The individual biologic response to environmental toxins is modulated by multiple exposures over a lifetime, nutritional status, gender, life style and overall health status. Through medical surveillance, medicine makes an important contribution towards understanding environmental disease. Medical surveillance requires that individuals at risk be followed by serial medical examinations for life in order to determine if there is an increase in disease incidence as a consequence of environmental exposure. An internal or external measure of exposure is also required. Such prospective epidemiological studies are expensive but afford a number of special benefits. The subjects gain the benefit of serial health evaluations which can detect disease unrelated to the toxin of concern. A negative surveillance program carried out over a long period can provide reassurance about the absence of adverse effects. Efforts to reassure exposed populations without such substantive data have proven futile in the United States. Reassurance based on the absence of information because no adequate studies can be cited has often served only to undermine both political and professional credibility. Industrial Toxins and Carcinogens In our book, Toxic Circles: Environmental Hazards from the Workplace to the Community, we focused on case studies of occupational and environmental hazards in New Jersey. In all, seven toxins were the subject of intense scrutiny for the medical, environmental, occupational, legal and social consequences they had for New Jersey and beyond. Beginning in the 19th century, industrial toxins were produced in prodigious quantities in eastern New Jersey. Factories discharged sewage and industrial effluents directly into the streams. Even today, these toxins spread over land and time to remind a wary public and nervous politicians of the price for posterity. New Jersey serves as a paradigm for the environmental problems that afflict modern societies. The hidden costs of past prosperity have surfaced with a vengeance. With the heyday of New Jersey's industrial expansion fading into history, the residual wastes present an unanticipated burden on communities that perceive themselves as victims. The debate over who is responsible for the toxic residues of industry began over 100 years ago. Historical episodes that began as isolated industrial hazards in New Jersey have evolved into community issues of environmental contamination. The dangers of lead and mercury in the workplace were described by Ezra Hunt in 1886 in his report to the New Jersey legislature. Lawrence T. Fell added chromium and aniline dyes to the list of dangerous substances in his first report as inspector of factories in New Jersey in 1887. In 1924, radium was included among compensable diseases, at the height of the radium dial workers scandal of the United States Radium Corporation in Orange. The cause of scrotal cancers in wax pressmen was identified in the 1930s through a unique circumscribed episode at the Esso Bayway plant in Bayonne. Dioxin, a toxic byproduct of Agent Orange, manufactured in the Ironbound District of Newark, became a political issue after the exposure of soldiers and Vietnamese civilians during the Vietnam War. It remains a subject of controversy. Malignancies induced by specific toxins sometimes have unique characteristics that permit etiologic diagnosis. The first occupational cancer, scrotal cancer in chimney sweeps, was described in England by Percival Pott in 1775. Since that time, scrotal cancers have been repeatedly identified in mini-epidemics among workers exposed to petroleum and combustion projects, including the cases in Bayonne described above and described in Toxic Circles. Radioactivity causes leukemia and, when internalized, bone cancer. The danger of radioactivity was recognized early in this century but was widely ignored in the workplace and the environment. In New Jersey, a radium dial industry sprang up in 1917 in which young women painted radium mixtures on watch dials using fine paint brushes which they shaped into points with their lips. When mixed with appropriate phosphors, the dials glow in the dark for night reading. By 1924 deaths from radiation-induced aplastic anemia, leukemia and bone cancers began to occur in both the women and supervisory employees. The New Jersey pathologist, Harrison Martland, who described radiation disease, noted that the women themselves glowed in the dark due to the radium and phosphorous they ingested at work. The plight of these women attracted considerable media attention in 1928 but the experience was soon forgotten. The United States Radium Corporation not only continued to deny the causal relationship between the deaths and cancers in their employees and radium, but discarded wastes from the highly contaminated workplace into surrounding land. Eventually this radioactive soil was sold to a neighboring suburban town, Montclair, New Jersey, as inexpensive land-fill upon which new homes were built in the 1940s and 1950s. Recently, the soil under the Montclair homes was found to be highly radioactive and the government purchased the contaminated houses only to demolish them. Another industrial hazard for which New Jersey can claim special experience derives from the petro-chemical and dye industry which developed in the first quarter of this century. Aniline dyes discovered in Germany at the end of the 19th century were identified as a cause of bladder cancer by Rehn in Germany in 1895. During the first world war, manufacture of these dyes was taken over by the DuPont Corporation in the United States; the resulting epidemic of bladder cancers among DuPont workers is still being seen in New Jersey hospitals. Whether the aniline dyes, the beta-naphthalamines, contribute to the development of bladder cancers at the low levels of exposure encountered after dispersion of wastes in the environment remains unknown. Chromium similarly is a well-recognized cause of lung cancer in the industrial setting. In addition, certain chromium salts produce severe kidney disease, acute tubular necrosis, when injected into experimental animals. There is no evidence, however, that environmental exposure to chromium dusts dispersed in landfills produces kidney disease, but then, this question has never been adequately examined. Other carcinogens with which we have special experience in New Jersey include dioxins and PCBs. Dioxin was produced as an unintended byproduct of the defoliant, agent orange, used by the United States to remove jungle hiding places in the Vietnam War. In experimental animals, dioxin is a potent inducer of cancer, indeed the most potent carcinogen known. The United States Environmental Protection Agency has recently designated dioxin a probable cause of cancer in humans. However, almost all studies of dioxin in human populations have failed to show an increased incidence of cancer. Such studies are flawed because of the short time intervals for follow-up involved and the relatively small populations studied. A few cancers in excess of the number expected in the population appearing many decades after exposure may be impossible to detect in studies of only a few hundred individuals over a decade. The same is true of PCBs. Both of these carcinogens have been found in large quantities in the Passiac River which passes through Newark, New Jersey and flows into New York Harbor where the presence of PCBs and dioxins has become a major source of public controversy. The disposal of contaminated sludge in the harbor and river remain unresolved environmental issues in our communities. Industrial Toxins and Neurologic and Kidney Disease Thus far I have addressed only carcinogens dispersed by industry. Neurologic and kidney disease result from exposure to arsenic, mercury, lead and organic solvents. Chromium and cadmium have been associated with kidney disease in the workplace but of these only cadmium has thus far been shown to induce kidney dysfunction following environmental exposure. The marshes and rivers that lead from New Jersey to New York contain many other toxins added to them over two centuries of industrialization. Mercury was added to the rivers from felt hat manufacturing centers and from thermometer manufacturers. In part, this mercury is bound to river bed and harbor sediments and is relatively inert. On the other hand, elemental mercury is slowly metabolized by microorganisms into highly toxic organomercurials such as methyl- and ethyl-mercury which enter the aquatic food chain. Methyl mercury derived from industrial effluents was responsible for Minimata disease in Japan among villagers who consumed local fish as the mainstay of their diets. This devastating neurological syndrome has not been identified in the United States. In New Jersey few people eat anything that comes out of the local rivers but periodic reminders are issued to local sport fishermen. The health consequences of ignored warnings have not yet come to our attention. Another industrial toxin that has gained increasing importance as an environmental contaminant is lead. Lead has been used by humans for at least 7,000 years and its toxicity was recognized at least 2,000 years ago. In the 18th century, as a result of the description of the Devonshire colic arising from contaminated apple cider by Sir George Baker, peripheral neuropathy from lead poisoning, also known as "painters palsy" or "wrist drop", was widely recognized. At the beginning of the present century, in addition to wrist drop, and abdominal colic (lead colic), anemia was recognized to result from excessive lead absorption. Contemporary descriptions of lead poisoning include cerebral disease, lead encephalopathy, which is seen in both industrial workers and in children who consume lead-containing paint chips, a behavior called, pica. In adults, excessive past lead absorption can induce hypertension, hypertensive and atherosclerotic cardiovascular disease and stroke. Despite vigorous warnings since the 17th century, only in the 1970s were lead paints outlawed in the United States. The danger of deteriorating lead-painted housing to children six months to six years of age remains a major environmental hazard. In this case, the dispersal of lead paint was intentional rather than accidental and for profit. Lead paints remained in use because neither the public nor the paint industry was concerned about long term environmental consequences. Because children who ingest lead paint chips sustain severe encephalopathy resulting in seizures and sometimes death, considerable attention has been paid to this problem in the last few decades in the United States. Severe permanent brain damage was recognized in the early part of the century in children who survived lead encephalopathy. Only recently have the more subtle defects in neurobehavioral development resulting from low-level environmental exposure in children been recognized. For populations as a whole, the reduction in intelligence because of this preventable environmental hazard has broad social implications. At the same time, a reduction in intelligence of only a few IQ points cannot be attributed solely to lead in an individual. Over the past two decades in the United States, the acceptable or safe blood level in infants has been progressively reduced from 40 ug/dl to 10 ug/dl. Lead poisoning offers a special opportunity for long-term population surveillance. More is known about lead than any other toxin commonly encountered in the environment and the workplace. The techniques for measuring lead are widely available, well standardized and relatively inexpensive. In addition, monitoring for lead can substitute for other toxins that are more difficult to assess. We have begun detailed surveillance of childhood lead exposure in a community in the United States that has expressed anxiety about the fall out from a new high volume waste incinerator. Although many toxins are potentially dispersed into the community with the airborne incinerator emissions, lead is most widely feared and most easily measured. Using lead as a marker to monitor the multiple potential toxic hazards emanating from the incinerator has not only permitted control of lead-poisoning in these children but has enlisted the constructive participation of the community. Such participation reduces the adversarial relationship between the public health workers and the community and sustains the credibility of government and health care professionals. Conclusion In conclusion, we have tried to indicate the contribution that medicine can make towards the elimination of environmental hazards derived from the industrial development. Occupational disease provides a framework for identifying potential environmental hazards. Sentinel health events in the occupational setting indicate medical consequences of unbridled environmental contamination. It may yet be possible to learn from the past mistakes and thus spare future generations some of the burdens that accompanied rapid economic growth. To accomplish this, the disciplines concerned with the health of individuals and those concerned with the health of populations must communicate effectively. The price to be paid for the failure to cooperate at first will fall on the victims of environmental contamination. Eventually, the cost will be shifted to all segments of society. The financial and political cost of correcting widespread contamination from industrial pollutants is enormous and avoidable. top
of page or PART II: THE CHROMIUM HAZARD IN HUDSON COUNTY 1970: New Jersey Laws Enable Effective Action of Remediation and Health Surveillance Studies Three million tons of chromium wastes, the byproduct of chromite ore production, are scattered throughout Hudson County, New Jersey's most urbanized and densely populated county. Jersey City, the county's largest city and the state's second largest city, is home to the major portion of the waste. From 1890 to the early 1970s, three companies (PPG, Inc., Allied Signal, Inc. and Diamond Shamrock) processed chromate ore to produce chromium used in paint, stainless steel, chrome plating, photographic chemicals and leather tanning. As a result, the county became the second largest site, after Tokyo, of hazardous chromium wastes in the world. The companies sold and gave away these wastes beginning in the 1950s; Jersey City and other towns used the wastes for landfill. By the late 1970s, these wastes were discovered in playgrounds, ballfields, public buildings, businesses, private homes, vacant lots and manufacturing plants. Because of its history as a home to industries such as pottery, glass making and producers of oils and chemicals, New Jersey was among the first of the states to address issues of hazardous waste production and occupational and environmental health. In 1970, a state Department of Environmental Protection was established. In 1976, the New Jersey Spill and Compensation Act, the model for the federal "Superfund" program was passed. Under this law, producers of oils and chemicals pay a tax which goes into a hazardous waste cleanup fund; companies can also be made responsible for the costs of cleaning up hazardous waste sites. By 1990, refinements in this law, along with legal rulings on the intent and purpose of the act made it unlikely that corporations would refuse DEP's rulings on cleaning up toxic sites. In Jersey City, this law served as the basis for remediation of the chromium sites and for health surveillance studies of residents identified as being exposed to the hazard. Although the initial discoveries of the chromium hazard resemble the strong and often confused responses characteristic of earlier environmental crises (Love Canal, New York, multiple toxic contamination and Times Beach, Missouri, dioxin contamination), the management of the situation has differed. The environmental legislation helped set a procedure of accountability for remediation and health screening of residents. In addition, a multidenominational church organization in Hudson County, the Interfaith Community Organization (ICO) became involved in the chromium crisis (and other hazardous waste sites) when it could not identify land in the county that was not chromium-contaminated. The ICO had $5 million to invest in building low-income housing. State activity through the environmental legislation and ICO's efforts to insure community input into resolving the chromium issue, sustained chromium as a public issue in the county since the late 1970s. Since 1994, under the administration of Governor Christine Todd Whitman, debate about changing standards for remediation has been taking place. An observer noted: Under new proposals being discussed, the contamination level requiring a cleanup would be lifted so high that no site would be eligible for cleanup and the $200 million dollars would be returned to the corporations...the Whitman administration would define the problem of chromium out of existence and the polluters would receive a corporate rebate at the expense of public health...Is this the Whit-man urban strategy: "Let them eat chromium"? (Ashley, February 25, 1995, P.4) A central question in environmental health concerns the health effects of exposure to the toxin. The medical literature documents the dangers of excess exposure to chromium in the workplace. The nature of the risks of community-level exposure in the short and in the long term are unknown. Residents in Jersey City were able to prepare "a list of ailing children [which]...is a litany of rashes, headaches and stomach pains." One mother wrote of her daughter, "She runs fevers without having any cold," and another wrote, "One daughter has a rash on her leg; my son keeps getting sore throats and fevers and mouth sores" (Hanley, July 4, 1989, P.2). A physician may well identify causes other than chromium exposure for the ailments described by the mothers. Spill Act Medical Surveillance In 1989, in response to concerns of the residents and public health officials in Jersey City, the Department of Health, using funds from the Spill Act, contracted with the Environmental and Occupational Health Science Institute to conduct the "Chromium Medical Surveillance Study" on 97 students and 68 staff members of Public School 15, the Whitney Young Jr. School. One of the significant findings of this study is that students living on blocks where there were chromium sites had higher levels of chromium in their urine than did students living on nearby or distant streets (New Jersey Department of Health 1989). A second, expanded medical surveillance study was conducted through 1993 with a total of 2,224 participants; 2,205 were examined by a physician. Of these, six persons were identified with conditions in which chromium was suspected as "a possible cause or contributing factor." Among the six, four had skin conditions; three had nasal allergies (New Jersey Department of Health, October 1994). Delays in releasing the second report led to confrontations at public meetings between the ICO members and government officials, including Commissioner Robert Shinn, head of the Department of Environmental Protection in June 1994 and Gabriel Haytaian, a state senator and candidate for the US Senate in October 1994. In addition, in September 1994, the ICO subpoenaed the Department of Health to release the report. Finally on October 14, two days after the ICO meeting with Haytaian, the report was released by the Department of Health (DOH) with the summary findings identified above. ICO efforts hastened resolution of some aspects of the chromium issue, especially in the arena of state action, leading to victory for the group and the community. The ICO is a member of the Industrial Areas Fund (IAF), a group of community organizations whose efforts are based on the ideas of the American community organizer, Saul Alinsky. Since 1989, ICO developed a strategy of continuing interaction with the heads of state agencies concerned with chromium (the DEP and the DOH). By maintaining contacts with officials and a level of tension and confrontation during these contacts, the ICO goal is to bypass bureaucratic structures and rhetoric to gain, in this case, removal of chromium waste and protection of health for residents. The ICO entered the chromium crisis armed with a sophisticated and radical strategy. It recognized the stigma created by chromium; it used the state's interest in containing the crisis to ensure total remediation; it came prepared to mistrust institutions and their representatives, an understanding usually reached in the later stages of an environmental crisis. The chromium waste problem in Jersey City presents complex scientific, medical, technical, economic, legal, political and social dilemmas. Jersey City shares problems of poverty, troubled schools, crime, and drugs with other American cities; measures undertaken by government to address these problems are often inadequate. In the chromium crisis, citizens have found, especially in the medical surveillance study, attention to their problems. Since the state is mandated to address chromium exposure, chromium has become a symbol of government attention not otherwise available. Now remediation and surveillance by the DEP and the DOH are providing a resolution of anxieties. However, state action alone is not adequate. ICO activism on chromium has brought Jersey City residents into social dialog, identifying the need for the community's involvement in ridding the city of chromium wastes and in preventing future environmental tragedies. This environmental story in New Jersey, like others in the United States, argues for a community voice in determining the nature of industrial development. Communities that have a meaningful input at the outset will be able to ensure future health and safety. Until such a process is commonplace, however, vigilance and activism are essential to maintaining community environmental health. Cullen, M., Cherniack, M. G. and Rosenstock, L. (1990). Occupational medicine. New England Journal of Medicine, 322, 594-601; 675-683. Mullan, R.J., and Murthy, L.I. (1991). Occupational sentinel health events: An up-dated list for physician recognition and public health surveillance. American Journal of Industrial Medicine,19, 775-799. Sheehan, H. E. and R.P. Wedeen, (Eds.). (1993). Toxic Circles: Environmental Hazards from the Workplace into the Community. New Brunswick: Rutgers University Press. Wedeen, R. P. (1984). Poison in the Pot: The Legacy of Lead. Carbondale, University of Southern Illinois University Press. Ashley,
W. (1995, February 25). State should not weaken standards. Cogswell,
D. (1993, Spring). Making a difference: democracy in action. Dalton,
D. (1986). Hazardous waste legislation in New Jersey: 1976-1986. Edelstein, M.R. (1988) Contaminated Communities: The Social and Psychological Impacts of Residential Toxic Exposures. Boulder: Westview Press. Hanley,
R. (1989, July 4). Jersey City grows angry as it learns about chromium
threat. McGuire,
C. (1988, May 25). Hudson churches call for action on drugs. Morris,
A. F. (1986). Hazardous wastes in New Jersey: an overview. Parlun, W. P. (1991). The Complete Guide to Environmental Liability and Enforcement in New Jersey. Vancouver, B.C.: Speciality Technical Publishers, I-2. Pofeldt,
E. (1994, October 14). State to release chromium-exposure study. __________. (1992, November 9). Residential chromium sites clean: city beats deadline set by state, stays within $30 million budget. The Jersey Journal. New Jersey Statues Annotated, Title 58: Waters and Water Supply. 58:1 to 58:16, 344-345. New Jersey
Department of Health. (1994, October). Chromium medical surveillance ______________. (1989, December). Medical evaluation of children and adults of the Whitney Young Jr. School, Jersey City, NJ Trenton: Environmental Health Services, Division of Occupational and Environmental Health. Stapinski, H. (1993). Tainted gold: chromium contamination in Hudson County, In: H.E. Sheehan and R.P. Wedeen, (Eds.), Toxic Circles: Environmental Hazards from the Workplace into the Community 201-230. New Brunswick: Rutgers University Press. Sheehan, H.E. (1995, October 5). An Urban Community Faces An Environmental Hazard: "Let Them Eat Chromium?" The Mount Sinai Journal of Medicine, Vol.62 (5). Sheehan, H.E. and R. P. Wedeen. (1993). Toxic Circles: Environmental Hazards from the Workplace into the Community. New Brunswick: Rutgers University Press. Wedeen,
R.P., Sheehan H.E. (1993). Sharing the toxic burden. In H.E. Sheehan and
R.P.Wedeen, (Eds.), Toxic Circles: Environmental
Hazards from the Workplace into Every
civil authority must make pains to promote the common good of all, "Recognition
of the inherent dignity and of the equal and inalienable rights of all
members of the human family is the foundation of freedom, justice, and
peace in the world." "Everyone
has the right to work, to free choice of employment, to just and favorable
conditions of work, and to protection against unemployment. Everyone who
works has the right to just and favorable remuneration ensuring for the
individual and their family an existence worthy of human dignity, and
supplemented, if necessary, by other means of social protection." "Every
human person has the right to respect for their person, one's good reputation;
the right to freedom in searching for truth and in expressing and communicating
opinions....and the right to be informed truthfully about public events." "The
dignity of the human person involves the right to take an active part
in public affairs and to contribute one's part to the common good of the
citizens. " top
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