The swelling and the numbness and the pain began in Phyllis Eavers' hands two weeks after she started as a heart-and-liver girl here at Marval Poultry.
It was February of 1981, and Eavers was working the night shift on the eviscerating line at the poultry processing plant with 104 other workers. Water ran constantly and steam clouded the room, the floor was slick with fat. Plucked and bloody turkeys, hanging by their necks, rode past on a conveyor.
Using a large pair of scissors, Eavers, 39, would cut the heart and liver out of every third turkey. Then she'd cut the heart and liver apart. Then she'd trim the heart and drop it down a chute. Three, maybe four cuts a turkey, 10,000 cuts a shift for $4.25 an hour.
Soon, Eavers' hands hurt so badly she was unable to sleep. She'd sit on the edge of the bed, smoking cigarettes and drinking diet soda. She couldn't hold her car keys or dress herself or pick up a skillet, so her husband, Wilbur, did the cooking. He also worked at Marval, as did their three children, Phyllis' mother, her sister and her uncle.
What Phyllis Eavers had was a common but little known occupational disease called Carpal Tunnel Syndrome, a degenerative nerve affliction of the lower hand caused by repeated and forceful motions of the wrist. After two operations last May and six months of recovery, she's back at work--and says she now has CTS again.
She hasn't decided if she'll have another operation. The pain during recovery wasn't worth it, she says, and neither were the six months of soup and sandwiches she ate for dinner because her disability payments were lower than her lost income.
Tens of thousands of workers like Phyllis Eavers get CTS each year. But because of frequent misdiagnosis and a paucity of research, experts say it is hard to say how many people suffer from it. What is clear is that it strikes those in low-paying jobs, people who even after the CTS operation have few options other than to return to work in the same plant.
Official figures from the National Institute for Occupational Safety and Health, as reported by industry, show that 23,000 production workers--garment, assembly line and upholstery workers, meat cutters, letter sorters and workers with hundreds of other manual jobs--get CTS each year. However, Dan Habes, an industrial engineer with NIOSH, estimates that 10 times that number--230,000 workers--may actually have the disease.
Yet in Virginia, where 312,000 people, or 13 percent of Virginia's work force, are employed in industrial manufacturing, there is little official recognition of CTS. The assistant commissioner of Virginia's Occupational Safety and Health Administration says he never heard of it. Neither have officials of the Virginia Bureau of Occupational Health.
The state's labor department keeps no records on CTS. And while Virginia Industrial Commission officials say that over the last five years they have awarded hundreds of compensation decisions in favor of CTS sufferers, commission records don't distinguish it from any number of other injuries and diseases.
Industry officials are wary of CTS. One of the first studies of the disease was conducted under federal sponsorship at a poultry plant here between 1976 and 1979, but only after the researchers and the union signed papers agreeing not to divulge the name of the plant. And officials at Marval, the largest poultry processing plant in this area, ask why no one claimed to have CTS five years ago, before the disease had been diagnosed as work related.
Marval officials point to research indicating that CTS is not caused exclusively by the workplace and to compensation and health benefits available to workers who prove to the state industrial commission that their symptoms were indeed the result of their job.
Although T.J. Armstrong, a University of Michigan professor of public health and an authority on CTS, says simple changes in tool and workplace design could virtually eliminate occupational CTS, industry and union officials say the research is far from conclusive. Employers have thus been unwilling to invest thousands or millions of dollars on the changes.
And in a right-to-work state like Virginia, where only 30 percent of the labor force is unionized, unions have little power to push for the necessary changes. "We're fighting with a toothpick when what we need is a bat," says Bill Wilson, safety director for local 400 of the United Food and Commercial Workers.
Workers here in the Shenandoah Valley are known as hard working and religious, traits that have attracted numerous industries in the last 20 years. Labor here also comes cheaply: workers earn an average of $220 a week before taxes.
In a recession when only 19 help-wanted ads, most of them for salespeople and skilled workers, appeared in the local Shenandoah Valley newspaper one day last week, workers here have little choice but to keep their jobs in the poultry plants, where 40 percent of Rockingham County's 12,000 industrial workers are employed. The county is called the "Turkey Capitol of the World."
For Eavers, a sturdy bleached blond with blue makeup on her eyelids, and for workers like her who come down with CTS, the decision to take off and seek help is a difficult one, even though industry and union officials agree that most people who apply for CTS compensation eventually receive it. "I'd been working full time since I was 18," Eavers says. "Never had no help, never been sick, never relied on anybody's money but what I made. But what could I do? I had to take off."
Like her mother, Zola Higgins, who had her operation after she dropped an apple pie she had made especially for company, and Shirley Johnson, who had hers after she broke the ornamental ceramic meat plate her daughter had made, Eavers' decision to have surgery turned not so much on the pain she felt as it did on a single incident.
One day in March, she was babysitting for her granddaughter. Blonde like grandmother and 1 year old, the girl began to cry. "She was crying and crying," remembers Eavers. "There was this little baby laying there, holding out her hands for me, just wanting me to pick her up. But I couldn't do it. I tried, but I couldn't do it. I cried."
The operations, one on each hand, were simple outpatient procedures. The Carpal Tunnel is located at the base of the hand, just above the wrist. Made up of bones on three sides and a ligament on the fourth, the tunnel houses the median nerve, which is surrounded by tendons and slippery tissue called synovia or bursa.
Repeated flexing and extending of the wrist, pinching or other forceful finger and hand movements can make the synovial membranes and the tendons swell, damaging the nerve. In the operation the ligament is cut, allowing the nerve and synovia more room.
Though Eavers says her recovery period was painful, the economic hardship was worse. For a month before the surgery, she worked when she could, averaging about $60 a week. Following the operation she received $109 a week in compensation payments, compared to the $170 a week she earned at Marval.
Dinners of meat, salad, potatoes, gravy and vegetables became dinners of soup and lunch meat sandwiches. "We couldn't afford to go out or even to buy a bottle of liquor," she says.
"We got behind on the mortgage on the trailer, on the light bill, on the telephone bill, on everything. It was so embarrassing. They would call and say that if we didn't pay by the next day they would cut off the service, and we'd scrape our money together and run down and pay. We were always one step ahead of them. It was hard times. I felt like some kind of awful person on welfare."
Thousands of Virginia workers are believed to be suffering from CTS, yet little information about it is available through state channels. Clayton Dean, the assistant commissioner of the federally monitored but state controlled Occupational Safety and Health Administration says: "I'm not familiar with that particular type of disease. Maybe I should be but I'm not . . . Maybe you should ask the occupational health people about it."
"We've never heard of it right off hand," says a spokeswoman at the State Bureau of Occupational Health. "Maybe somebody's had it somewhere along the line, but right off no one here knows about it."
Officials at Marval say they are suspicious of CTS. "The problem wasn't much defined or advertised until the last three years," says Marval Executive Vice President Don Simon. "Once someone defined it and found a way to treat it, a lot more people seemed to come down with it.
"The work has always been there. We must have had some of it in the past if we have it now . . . Maybe people can't work with a little pain these days. I don't know."
"We're basically a people-oriented company," adds Marval personnel director Robert Wolfe. "We're not interested in ignoring a condition that takes away from a wholesome workplace."
Since the federally funded study at another Harrisonburg plant, researchers have recommended reconstructing work stations and designing knives with curved handles so that some of the pressure is taken off the workers' wrists. But Simon says Marval, like other poultry companies here, hasn't undertaken any major redevelopment. "I don't know that we've had enough instances in any one place to change anything," he says.
"We've been redesigning to increase our yield . . . as much to the comfort of the employe as possible . . . ," says Wolfe. "We want to eliminate turnover, make it easier for our employes and increase our yield."
But UFCW union official Don Cash says little, if anything, has been done to eliminate work conditions related to CTS. "I don't think the companies are dealing with the issue," he says. "Honestly, we haven't found a steadfast solution to rectifying it, either. And until one is found to be certain, and maybe not even then, the companies aren't going to spend millions of dollars redesigning."
But Cash also says that lean economic times, which have slowed job turnover, may speed changes in plant conditions. "Maybe with less turnover, more claims will be made and when the companies have to pay an arm and a leg for compensation insurance premiums, it will be cheaper to remedy the problem than to ignore it."
"They know they can work us until we drop," says Shirley Johnson, at age 56 an 11-year Marval veteran who has had two operations for CTS. "The company doesn't care about the people. All it cares about is product, product, product. As long as you get the birds out, they don't care how you get here or how much it hurts. People quit and go to another company and come back, quit and come back. All of them's the same."
There is, however, no bitterness in her voice or that of Higgins, Eavers and other Marval workers interviewed. They know that without plants like Marval there would be no work for them.
"It's just like, well, I wouldn't know how to explain it," says Eavers. "I'm not angry at the world. A person has to work. There's no one to blame."