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What's bothering today's shipyard workers?
ENVIRONMENTAL
REStARCH
(1976)
11,156-161
What’s Bothering
Today’s
FORREST E. Industrial
Clinics.
Shipyard
RIEKE,
Portland.
Workers?
M.D. Oregon
Shipyard workers of my acquaintance in the Pacific Northwest of the United States engage in new construction, in ship repair, and in ship dismantling (ship breaking). They may work in loft buildings, outdoors under a hot sun or in cold, clammy rain, and occasionally, in ice and snow. Ship repairs are often an emergency. performed under pressure. night and day with long hours of overtime. The employer may be the U. S. Navy operating in a huge, old establishment or a small private builder with one or two marine ways. Or he may be an erstwhile scrapdealer who drags ragged components onto an open field for sorting and salvage. Equipment and environmental controls may be excellent or abominable. used skillfully or not at all. Those I work with and those I serve are men and women of all ages and from widely differing stations in life; they may be owners, managers, nurses, office workers, leadmen. or laborers. Most are experienced craftsmen, electricians, carpenters. boilermakers, titters, and move-men, but they may be casual drifters and drunks with no skills and very little interest in safe performance. Some are young, athletic. and unmarked, but many are aged, hard of hearing, emphysematous. arthritic, or diabetic. Because of union insistence none has been medically examined to ascertain that they are placed in work commensurate with their physical capabilities. Despite these disparate circumstances. common personal and environmental problems can be identified. but the manager is bothered by different problems than the construction leadman or the scrap metal burner. Certainly the scruples and concerns which agitate occupational physicians, nurses, or hygienists often appear unrealistic and bother managers and workers hardly at all. In an international convocation, language may be a barrier to communication and even skilled translation may miss the point. A few years ago I attended a radioman from a Spanish ship who had suffered a shattered leg in a traffic accident. It took a number of days to work out simple words and sign language with agreed upon meanings. “Do you have pain?” drew a blank. I tried “dolor;” he a word connoting a troublesome. continuing nuifinally suggested “moleste,” sance without great pain. As the days passed “moleste” assumed different coloration and meaning; a brief ache after turning in bed; a concern for the future, about whether he would ever walk comfortably; and fear that his slightly deformed leg would alienate his intended bride back in Malaga. Webster’s Collegiate dictionary defines “bother” variously: “to annoy, worry, perplex; vi to feel care or anxiety; n one who, or that which, bothers; state of perplexity or annoyance: embarrassment. worry.” It says nothing about sickness or health, frequency, severity or chronicity. Nor does it even suggest that some bothersome nuisances shade into the lethal. Welding smoke is a bother to metalworkers; breathing of the smoke from melting zinc causes a transitory illness; but 1.56 Copyright All rights
Q 1976 by Academic Precs. Inc. of reproduction in any form reserved.
WHAT’S
BOTHERING
TODAY’S
SHIPYARD
WORKERS
157
the smoke produced from “burning” of cadmium scrap metal can kill those who cut the metal and those who are working nearby. In the field of ideation, ignorance is bliss while knowledge may be bothersome, indeed. For centuries asbestos dust caused no “annoyance, worry or perplexity.” In 1944, as an occupational novitiate, I wondered if the clouds of asbestos dust in ship construction might cause lung changes and suggested in-plant chest X rays of all those exposed. I was assured by experienced asbestos foremen that their dusty trade held no threat to health. I was unable to arouse any interest or concern; they simply could not be “bothered” to walk a hundred yards to get a free X ray during work hours. Times change, don’t they? New knowledge. intellectual curiosity, better epidemiology, and effective communication can arouse concerned leaders, managers, unions. workers, even politicians. Well directed “bother” can become an incitement to action. And corrective action usually bothers or means extra trouble for somebody. Through the years I have been fascinated by. and frustrated by, the variety of interpretations and reactions of well-intentioned people to extremely bothersome features of work processes and the work environment. In preparation of this communication I informally polled the views of personnel managers, a companyemployed safety director, several occupational nurses. an OSHA inspector, and a number of my patients to see what was bothering them at the shipyards. From this statistically nonsignificant poll I extracted an amazingly disparate list. over and above who gets paid too little for doing what. In the next few pages I shall editorially blend their ideas with mine. My views and opinions are drawn from 5 years of in-plant work at the Kaiser shipyards in World War II and from 25 intervening years of medical work with small plant operators and employees engaged in many pursuits, including boat building. ship repair. and ship scrapping. Some of my frustrating bothers will be better understood if placed in historic perspective. 1941-l 945: NEW SHIP CONSTRUCTION
Shipyard workers in World War II achieved production miracles in spite of great inconvenience at home and at work. Thousands of strangers from widely different states and socioeconomic origins flooded coastal cities, lived in hastily built housing projects, wrestled with shortages of food, transport, and medical services. and cheerfully learned new and dangerous trades. Major industries sprang up almost overnight, on vacant land, and in ill-prepared communities. In 1941, Portland. Oregon was a slow-paced agricultural trade center and the site of many lumber mills. Ship repair activity had employed a few hundred each year; within 2 years more than 100,000 were directly engaged in new ship construction. During these first years, builders divided their energies almost equally between construction of shelter. provision of other necessities of life. and erection of steel ships. Once the first keels were laid. inexperienced workers produced a plethora of injuries; falls, wounds, fractures, eye burns, and zinc-fume chills. Workmen were unaccustomed to scaffolding, noise, and heavy tools. Much needed personal protective gear was scarce and badly used. With rare exceptions, supervisors had not built ships before. and certainly not at a pace or style which soon emerged.
158
FORREST
E.
RIEKE
Fortunately, the Kaiser management contained skilled safety engineers and construction supervisors with long experience in use of heavy materials and equipment. They were knowledgeable about accident prevention and care of the injured but faced an immense task to teach the rest of us who were new in heavy industry. The first months were bloody, but within a year the mayhem diminished; workers were better instructed and equipped. machinery became adequate to demands of the job, and unsafe practices had been defined and isolated or eliminated. In a period of war, emergency problems are born almost full grown. In 19411942 the demand for hard hats, goggles, lifting equipment, and ventilation fans could not be met. We had to treat thousands of injuries which subsequently were soon prevented; lessons were quickly learned about heat stroke, scalp wounds, electric arc burns of the eyes, cornea1 foreign bodies, metal fume fever, and finger amputations in riggers. This was the period just before effective antibiotics. tetanus toxoid. and television; infections were common and serious; soap and water and teaching about hygiene were major weapons. One serious labor/management oversight greatly complicated our work by adding to the occurrence of serious injury. Regrettably, the problem is still operative in West Coast shipyards--the interdiction against doctors’ physical examination as a part of the employment process. As a result of abuse of employment examinations in the 1930s. metal trade unions were adamantly opposed to their inclusion in the hiring process in war industry. A 1940 Pacific Coast Master Agreement for shipbuilding and ship repair firms and metal trade unions barred doctors’ physical examinations and age limits, except as required by law. Subsequent failure to medically screen the seriously impaired. the cardiacs, those with seizure patterns, and a welter of other problems permitted high risk workers to be employed in processes and locations of high hazard. All too frequently I was called to attend seriously injured or dead workers, men or women who were trapped by their need to work and unable to survive at totally inappropriate job assignments. I shall leap ahead of myself to point out that this same malignant agreement governs today’s shipyard employment practices. Obviously it bothers me and those workers I try to serve; fortunately the Occupational Safety and Health Act of 1970 (OSHA) will increasingly require wise use of medical examination to assure that workers are afforded work which is safe and appropriate to their capabilities. As war deepened, the young, healthy males were siphoned into the armed forces leaving a work force of so called 4-F’s and those of middle age and above. In the winter of 1942, women began to fill “men’s” jobs and at peak employment in 1944. of 90,000 workers in three local Kaiser shipyards 35.000 were women. Workers came from household duties. clerking. sales. and many other occupations and moved outdoors into a harsh winter environment; some thrived but many did not. Respiratory infections were a serious problem from the outset. In the first and second winters. deaths from pneumonia and complications of cardio-respiratory disease were common. Many of these deaths were blamed on the work environment, especially on inhalation of welding fumes, and several immense legal actions were brought for alleged neglect of the health and safety of employees. Most of these were settled on a nuisance basis; as time permitted. studies were made of morbidity among welders which seemed to show that welders and other workers were about equal in health and illness.
WHAT’S
BOTHERING
TODAY’S
SHIPYARD
WORKERS
159
During these 4% war years at the Oregon Shipbuilding Corporation, 40 deaths were charged to on-job injury; at the same time, there were nearly 200 who died at work of natural causes. Autopsies were performed in most of the job-connected deaths. I have no recollection of any discussion about excessive lung cancer or mesothelioma. but pathologists were not then alerted to occupational causality in malignancies of the lung. In the history of medicine, many obvious bodily insults have been overlooked until a disease process or stigma is clearly defined by its “discoverer.” Early in the war, mass chest X-ray screening was introduced into war plants as a method of case finding in unsuspected tuberculosis. Chest films were the size of postage stamps, designed primarily to show scarring of lungs. They revealed some but not all of those with TB, workers with scarred lungs from other healed infections or inhaled silica dust, and those with relatively advanced lung cancer or distinct changes in heart size. X-ray changes associated with prolonged inhalation of asbestos dust would not have been recognized even if visualized. In the latter 2 years of the war, preventive strategies were working and violent personal injury became the exception. In-plant medical work became less surgical, and personnel were freed to teach a better adjusted adult clientele. With cessation of hostilities, U. S. ship construction literally melted away. Most of the privately operated shipyards soon closed, and workers scattered to thousands of more usual pursuits. Although anticipated, there was no flood of postwar accident claims for care of persistent disability. Accident insurance funds were embarrassingly solvent. Those who had learned to provide health and hygiene services to war workers quickly scattered to governmental agencies and private industry. Only a few physicians transferred their skills and energies to provide communitylevel occupational health services for those who remained in ship repair and ship dismantling. to OSHA (1970): A PERIOD OF NEGLECT World War II, ship repair and a small segment of boatbuilding devolved upon smaller companies, most of them products of the war effort. They had engaged in small vessel construction, in ship modification, and in subcontracting with the giants. Since 1945 their work has been episodic, with varying periods of weeks, months, and even years between major contracts. Through grim necessity. operating companies. local unions. and port authorities have learned to cooperate and to share docking facilities and major equipment. This has been a sharing of scarcities with some of the following shortcomings common to all: (1) Workers are migratory, finding employment with many different employers in the course of a year. (2) Skilled and knowledgeable work supervisors have tended to drift away to more permanent employment. (3) Swift movement of workers and pressure on supervisors result in failure to instruct new workers and to ensure that safe procedures are understood. (4) Environmental safety has been neglected by rapidly rotating crews of employers and workers: staging may be poorly built; cranes and jitneys are inappropriate to burdens within “dead” ships: ventilatory equipment is not in place or 1945
Ship repair. Following
160
FORREST
E.
RIEKE
won’t move sufficient air; environmental hygiene tests are rarely done. (5) Coordination between multiple subcontractors is the exception: sand blasters share air space with unprotected welders and painters; asbestos workers raise dust in the presence of those without respirators; excessive noise is common and inescapable. (6) Most metal trade and union members have been aging without benefit of persistent surveillance by informed doctors and nurses. Prohibition against employment examinations has prevented monitoring of general health and detection of occupational disease. In many instances workers have deteriorated but continued on hazardous duties. (7) Casualty insurance is handled in many offices, and epidemiologic analysis has been poorly attended. 196&l 971 (pre-OSHA)A START TOWARD PREVENTION
The situation began to improve in 1960 when the regional labor commissioner implemented new federal statutes on maritime and waterfront safety. Personnel were added who strengthened portwide safety inspection and enforcement. Better education and enforcement stimulated formation of both a management controlled Shipyard Safety Council and a labor/management Safety Coordinating Committee. Availability and utilization of safety equipment increased, and serious injury diminished. I am not aware of efforts to increase medical monitoring for better placement and for return to work after injury or illness. My informants advise that managers and occupational nurses are still haunted by lack of attention to and consideration for those with underlying hypertension, coronary heart disease, diabetes, arthritis, seizure patterns, and other debilitating conditions. 1945-1970
SHIP DISMANTLING
(SHIP SCRAPPING)
What began in 1945 as a tiny and temporary adjunct of the secondary metal industry has turned into a large and permanent industry in many parts of the world. Hundreds of mothballed or obsolete civil and military ships have been dismantled for their valuable scrap metal, fittings, equipment, and reusable hulls. These are dead ships, without ventilation, suitable cranes, or accurate descriptions of hazardous contents. Workers who have drifted to dismantling work are a motley crew, relatively unskilled, frequently aging, and in various stages of desuetude. Many of them tolerate abominable conditions in order to support a drinking habit, or because other more observant employers will not employ them. Until OSHA. no medical surveillance was countenanced. Lead intoxication has been prevalent for 30 years, heavy accidents have been all too frequent, and callousness toward workers has been common. Owners and managers have been aware of occupational disease potentials for years; they have failed to respond to complaints of unions, treating doctors, insurance carriers, and state hygiene officials. Those employees who made too loud an outcry have been discharged. As recently as last week a scrapburner was referred with blood lead level of 0.09 mg; two others were not sent because levels were not then quite that high. The employer plays games with
WHAT’S
BOTHERING
TODAY’S
SHIPYARD
lead levels but does not send workers for regular medical bothers me inordinately. OSHA-THE
TOOTHLESS
TIGER:
161
WORKERS
surveillance.
This
1970-l 973
For 3 years OSHA has loomed on the horizon. Formulated and legislated by labor, it has been the law of the land since December 29, 1970. From its implementation in April 1971 through September 1973, OSHA made 98.852 inspections resulting in 63,270 citations alleging 315,049 violations. with proposed penalties totaling $8,441,911. Of that amount $5.863.589 has been collected, an average of $18.60 per violation. It is more painful to exceed the speed limit or miss a stop light. Employer associations continue to complain that OSHA is unconstitutional. unnecessary. unwarranted, and a heavy burden on member companies. The U. S. administration has failed to expedite the vital work of OSHA and NIOSH by withholding funds for staff, for training, and for necessary studies on occupational environmental hazards. Congress and state legislatures have been intimidated by industry’s lobbyists and state functionaries are moving with less than due deliberate speed to implement state plans. My management consultant advises me that OSHA and its accompanying federal/state laws and regulations are his biggest bother. He seems most troubled that OSHA tells the employer to clean up and to enforce the rules. that employees refuse to live by these rules, and that the employer is then subject to heavy penalty. The man has a very cogent point. There is clear and continuing evidence of human failure, by managers and workers. with resultant costly damage to both. COMMENTS
AND CONCLUSION
This conference will identify physical and social factors that are bothering shipyard workers. Some are implicit in weather and plant location, others in materials and dangerous products. All hazards are compounded by lack of understanding, by the constraints of small size and inadequate funding, and by workers and managers who treat danger with contempt. Experience in shipyards in war and peace shows that identification of causes, teaching, and enforcement are the most effective tools to reduce injury and conserve health. Some managers are callous and uncaring; they need to be chastened, converted or eliminated. Organized labor has been allowed to cop-out. by failure to insist that members make full use of protective equipment, and through insistence that medical safeguards not be used. Both managers and labor need to be persuaded, by carrots or a stick, to demand and support studies, research, and the widest sharing of knowledge that will protect and prevent. In conclusion, it cannot be overemphasized that ignorance kills and failure to bother multiplies our losses. There are constructive uses of bothersome rules. regulations, inspections, and enforcement. Our task is to generate incontrovertible knowledge, to blend curiosity and wisdom, and to bother workers and supervisors sufficiently that they will act in their own behalf.
REStARCH
(1976)
11,156-161
What’s Bothering
Today’s
FORREST E. Industrial
Clinics.
Shipyard
RIEKE,
Portland.
Workers?
M.D. Oregon
Shipyard workers of my acquaintance in the Pacific Northwest of the United States engage in new construction, in ship repair, and in ship dismantling (ship breaking). They may work in loft buildings, outdoors under a hot sun or in cold, clammy rain, and occasionally, in ice and snow. Ship repairs are often an emergency. performed under pressure. night and day with long hours of overtime. The employer may be the U. S. Navy operating in a huge, old establishment or a small private builder with one or two marine ways. Or he may be an erstwhile scrapdealer who drags ragged components onto an open field for sorting and salvage. Equipment and environmental controls may be excellent or abominable. used skillfully or not at all. Those I work with and those I serve are men and women of all ages and from widely differing stations in life; they may be owners, managers, nurses, office workers, leadmen. or laborers. Most are experienced craftsmen, electricians, carpenters. boilermakers, titters, and move-men, but they may be casual drifters and drunks with no skills and very little interest in safe performance. Some are young, athletic. and unmarked, but many are aged, hard of hearing, emphysematous. arthritic, or diabetic. Because of union insistence none has been medically examined to ascertain that they are placed in work commensurate with their physical capabilities. Despite these disparate circumstances. common personal and environmental problems can be identified. but the manager is bothered by different problems than the construction leadman or the scrap metal burner. Certainly the scruples and concerns which agitate occupational physicians, nurses, or hygienists often appear unrealistic and bother managers and workers hardly at all. In an international convocation, language may be a barrier to communication and even skilled translation may miss the point. A few years ago I attended a radioman from a Spanish ship who had suffered a shattered leg in a traffic accident. It took a number of days to work out simple words and sign language with agreed upon meanings. “Do you have pain?” drew a blank. I tried “dolor;” he a word connoting a troublesome. continuing nuifinally suggested “moleste,” sance without great pain. As the days passed “moleste” assumed different coloration and meaning; a brief ache after turning in bed; a concern for the future, about whether he would ever walk comfortably; and fear that his slightly deformed leg would alienate his intended bride back in Malaga. Webster’s Collegiate dictionary defines “bother” variously: “to annoy, worry, perplex; vi to feel care or anxiety; n one who, or that which, bothers; state of perplexity or annoyance: embarrassment. worry.” It says nothing about sickness or health, frequency, severity or chronicity. Nor does it even suggest that some bothersome nuisances shade into the lethal. Welding smoke is a bother to metalworkers; breathing of the smoke from melting zinc causes a transitory illness; but 1.56 Copyright All rights
Q 1976 by Academic Precs. Inc. of reproduction in any form reserved.
WHAT’S
BOTHERING
TODAY’S
SHIPYARD
WORKERS
157
the smoke produced from “burning” of cadmium scrap metal can kill those who cut the metal and those who are working nearby. In the field of ideation, ignorance is bliss while knowledge may be bothersome, indeed. For centuries asbestos dust caused no “annoyance, worry or perplexity.” In 1944, as an occupational novitiate, I wondered if the clouds of asbestos dust in ship construction might cause lung changes and suggested in-plant chest X rays of all those exposed. I was assured by experienced asbestos foremen that their dusty trade held no threat to health. I was unable to arouse any interest or concern; they simply could not be “bothered” to walk a hundred yards to get a free X ray during work hours. Times change, don’t they? New knowledge. intellectual curiosity, better epidemiology, and effective communication can arouse concerned leaders, managers, unions. workers, even politicians. Well directed “bother” can become an incitement to action. And corrective action usually bothers or means extra trouble for somebody. Through the years I have been fascinated by. and frustrated by, the variety of interpretations and reactions of well-intentioned people to extremely bothersome features of work processes and the work environment. In preparation of this communication I informally polled the views of personnel managers, a companyemployed safety director, several occupational nurses. an OSHA inspector, and a number of my patients to see what was bothering them at the shipyards. From this statistically nonsignificant poll I extracted an amazingly disparate list. over and above who gets paid too little for doing what. In the next few pages I shall editorially blend their ideas with mine. My views and opinions are drawn from 5 years of in-plant work at the Kaiser shipyards in World War II and from 25 intervening years of medical work with small plant operators and employees engaged in many pursuits, including boat building. ship repair. and ship scrapping. Some of my frustrating bothers will be better understood if placed in historic perspective. 1941-l 945: NEW SHIP CONSTRUCTION
Shipyard workers in World War II achieved production miracles in spite of great inconvenience at home and at work. Thousands of strangers from widely different states and socioeconomic origins flooded coastal cities, lived in hastily built housing projects, wrestled with shortages of food, transport, and medical services. and cheerfully learned new and dangerous trades. Major industries sprang up almost overnight, on vacant land, and in ill-prepared communities. In 1941, Portland. Oregon was a slow-paced agricultural trade center and the site of many lumber mills. Ship repair activity had employed a few hundred each year; within 2 years more than 100,000 were directly engaged in new ship construction. During these first years, builders divided their energies almost equally between construction of shelter. provision of other necessities of life. and erection of steel ships. Once the first keels were laid. inexperienced workers produced a plethora of injuries; falls, wounds, fractures, eye burns, and zinc-fume chills. Workmen were unaccustomed to scaffolding, noise, and heavy tools. Much needed personal protective gear was scarce and badly used. With rare exceptions, supervisors had not built ships before. and certainly not at a pace or style which soon emerged.
158
FORREST
E.
RIEKE
Fortunately, the Kaiser management contained skilled safety engineers and construction supervisors with long experience in use of heavy materials and equipment. They were knowledgeable about accident prevention and care of the injured but faced an immense task to teach the rest of us who were new in heavy industry. The first months were bloody, but within a year the mayhem diminished; workers were better instructed and equipped. machinery became adequate to demands of the job, and unsafe practices had been defined and isolated or eliminated. In a period of war, emergency problems are born almost full grown. In 19411942 the demand for hard hats, goggles, lifting equipment, and ventilation fans could not be met. We had to treat thousands of injuries which subsequently were soon prevented; lessons were quickly learned about heat stroke, scalp wounds, electric arc burns of the eyes, cornea1 foreign bodies, metal fume fever, and finger amputations in riggers. This was the period just before effective antibiotics. tetanus toxoid. and television; infections were common and serious; soap and water and teaching about hygiene were major weapons. One serious labor/management oversight greatly complicated our work by adding to the occurrence of serious injury. Regrettably, the problem is still operative in West Coast shipyards--the interdiction against doctors’ physical examination as a part of the employment process. As a result of abuse of employment examinations in the 1930s. metal trade unions were adamantly opposed to their inclusion in the hiring process in war industry. A 1940 Pacific Coast Master Agreement for shipbuilding and ship repair firms and metal trade unions barred doctors’ physical examinations and age limits, except as required by law. Subsequent failure to medically screen the seriously impaired. the cardiacs, those with seizure patterns, and a welter of other problems permitted high risk workers to be employed in processes and locations of high hazard. All too frequently I was called to attend seriously injured or dead workers, men or women who were trapped by their need to work and unable to survive at totally inappropriate job assignments. I shall leap ahead of myself to point out that this same malignant agreement governs today’s shipyard employment practices. Obviously it bothers me and those workers I try to serve; fortunately the Occupational Safety and Health Act of 1970 (OSHA) will increasingly require wise use of medical examination to assure that workers are afforded work which is safe and appropriate to their capabilities. As war deepened, the young, healthy males were siphoned into the armed forces leaving a work force of so called 4-F’s and those of middle age and above. In the winter of 1942, women began to fill “men’s” jobs and at peak employment in 1944. of 90,000 workers in three local Kaiser shipyards 35.000 were women. Workers came from household duties. clerking. sales. and many other occupations and moved outdoors into a harsh winter environment; some thrived but many did not. Respiratory infections were a serious problem from the outset. In the first and second winters. deaths from pneumonia and complications of cardio-respiratory disease were common. Many of these deaths were blamed on the work environment, especially on inhalation of welding fumes, and several immense legal actions were brought for alleged neglect of the health and safety of employees. Most of these were settled on a nuisance basis; as time permitted. studies were made of morbidity among welders which seemed to show that welders and other workers were about equal in health and illness.
WHAT’S
BOTHERING
TODAY’S
SHIPYARD
WORKERS
159
During these 4% war years at the Oregon Shipbuilding Corporation, 40 deaths were charged to on-job injury; at the same time, there were nearly 200 who died at work of natural causes. Autopsies were performed in most of the job-connected deaths. I have no recollection of any discussion about excessive lung cancer or mesothelioma. but pathologists were not then alerted to occupational causality in malignancies of the lung. In the history of medicine, many obvious bodily insults have been overlooked until a disease process or stigma is clearly defined by its “discoverer.” Early in the war, mass chest X-ray screening was introduced into war plants as a method of case finding in unsuspected tuberculosis. Chest films were the size of postage stamps, designed primarily to show scarring of lungs. They revealed some but not all of those with TB, workers with scarred lungs from other healed infections or inhaled silica dust, and those with relatively advanced lung cancer or distinct changes in heart size. X-ray changes associated with prolonged inhalation of asbestos dust would not have been recognized even if visualized. In the latter 2 years of the war, preventive strategies were working and violent personal injury became the exception. In-plant medical work became less surgical, and personnel were freed to teach a better adjusted adult clientele. With cessation of hostilities, U. S. ship construction literally melted away. Most of the privately operated shipyards soon closed, and workers scattered to thousands of more usual pursuits. Although anticipated, there was no flood of postwar accident claims for care of persistent disability. Accident insurance funds were embarrassingly solvent. Those who had learned to provide health and hygiene services to war workers quickly scattered to governmental agencies and private industry. Only a few physicians transferred their skills and energies to provide communitylevel occupational health services for those who remained in ship repair and ship dismantling. to OSHA (1970): A PERIOD OF NEGLECT World War II, ship repair and a small segment of boatbuilding devolved upon smaller companies, most of them products of the war effort. They had engaged in small vessel construction, in ship modification, and in subcontracting with the giants. Since 1945 their work has been episodic, with varying periods of weeks, months, and even years between major contracts. Through grim necessity. operating companies. local unions. and port authorities have learned to cooperate and to share docking facilities and major equipment. This has been a sharing of scarcities with some of the following shortcomings common to all: (1) Workers are migratory, finding employment with many different employers in the course of a year. (2) Skilled and knowledgeable work supervisors have tended to drift away to more permanent employment. (3) Swift movement of workers and pressure on supervisors result in failure to instruct new workers and to ensure that safe procedures are understood. (4) Environmental safety has been neglected by rapidly rotating crews of employers and workers: staging may be poorly built; cranes and jitneys are inappropriate to burdens within “dead” ships: ventilatory equipment is not in place or 1945
Ship repair. Following
160
FORREST
E.
RIEKE
won’t move sufficient air; environmental hygiene tests are rarely done. (5) Coordination between multiple subcontractors is the exception: sand blasters share air space with unprotected welders and painters; asbestos workers raise dust in the presence of those without respirators; excessive noise is common and inescapable. (6) Most metal trade and union members have been aging without benefit of persistent surveillance by informed doctors and nurses. Prohibition against employment examinations has prevented monitoring of general health and detection of occupational disease. In many instances workers have deteriorated but continued on hazardous duties. (7) Casualty insurance is handled in many offices, and epidemiologic analysis has been poorly attended. 196&l 971 (pre-OSHA)A START TOWARD PREVENTION
The situation began to improve in 1960 when the regional labor commissioner implemented new federal statutes on maritime and waterfront safety. Personnel were added who strengthened portwide safety inspection and enforcement. Better education and enforcement stimulated formation of both a management controlled Shipyard Safety Council and a labor/management Safety Coordinating Committee. Availability and utilization of safety equipment increased, and serious injury diminished. I am not aware of efforts to increase medical monitoring for better placement and for return to work after injury or illness. My informants advise that managers and occupational nurses are still haunted by lack of attention to and consideration for those with underlying hypertension, coronary heart disease, diabetes, arthritis, seizure patterns, and other debilitating conditions. 1945-1970
SHIP DISMANTLING
(SHIP SCRAPPING)
What began in 1945 as a tiny and temporary adjunct of the secondary metal industry has turned into a large and permanent industry in many parts of the world. Hundreds of mothballed or obsolete civil and military ships have been dismantled for their valuable scrap metal, fittings, equipment, and reusable hulls. These are dead ships, without ventilation, suitable cranes, or accurate descriptions of hazardous contents. Workers who have drifted to dismantling work are a motley crew, relatively unskilled, frequently aging, and in various stages of desuetude. Many of them tolerate abominable conditions in order to support a drinking habit, or because other more observant employers will not employ them. Until OSHA. no medical surveillance was countenanced. Lead intoxication has been prevalent for 30 years, heavy accidents have been all too frequent, and callousness toward workers has been common. Owners and managers have been aware of occupational disease potentials for years; they have failed to respond to complaints of unions, treating doctors, insurance carriers, and state hygiene officials. Those employees who made too loud an outcry have been discharged. As recently as last week a scrapburner was referred with blood lead level of 0.09 mg; two others were not sent because levels were not then quite that high. The employer plays games with
WHAT’S
BOTHERING
TODAY’S
SHIPYARD
lead levels but does not send workers for regular medical bothers me inordinately. OSHA-THE
TOOTHLESS
TIGER:
161
WORKERS
surveillance.
This
1970-l 973
For 3 years OSHA has loomed on the horizon. Formulated and legislated by labor, it has been the law of the land since December 29, 1970. From its implementation in April 1971 through September 1973, OSHA made 98.852 inspections resulting in 63,270 citations alleging 315,049 violations. with proposed penalties totaling $8,441,911. Of that amount $5.863.589 has been collected, an average of $18.60 per violation. It is more painful to exceed the speed limit or miss a stop light. Employer associations continue to complain that OSHA is unconstitutional. unnecessary. unwarranted, and a heavy burden on member companies. The U. S. administration has failed to expedite the vital work of OSHA and NIOSH by withholding funds for staff, for training, and for necessary studies on occupational environmental hazards. Congress and state legislatures have been intimidated by industry’s lobbyists and state functionaries are moving with less than due deliberate speed to implement state plans. My management consultant advises me that OSHA and its accompanying federal/state laws and regulations are his biggest bother. He seems most troubled that OSHA tells the employer to clean up and to enforce the rules. that employees refuse to live by these rules, and that the employer is then subject to heavy penalty. The man has a very cogent point. There is clear and continuing evidence of human failure, by managers and workers. with resultant costly damage to both. COMMENTS
AND CONCLUSION
This conference will identify physical and social factors that are bothering shipyard workers. Some are implicit in weather and plant location, others in materials and dangerous products. All hazards are compounded by lack of understanding, by the constraints of small size and inadequate funding, and by workers and managers who treat danger with contempt. Experience in shipyards in war and peace shows that identification of causes, teaching, and enforcement are the most effective tools to reduce injury and conserve health. Some managers are callous and uncaring; they need to be chastened, converted or eliminated. Organized labor has been allowed to cop-out. by failure to insist that members make full use of protective equipment, and through insistence that medical safeguards not be used. Both managers and labor need to be persuaded, by carrots or a stick, to demand and support studies, research, and the widest sharing of knowledge that will protect and prevent. In conclusion, it cannot be overemphasized that ignorance kills and failure to bother multiplies our losses. There are constructive uses of bothersome rules. regulations, inspections, and enforcement. Our task is to generate incontrovertible knowledge, to blend curiosity and wisdom, and to bother workers and supervisors sufficiently that they will act in their own behalf.