James Sturgis was shift supervisor for most of his 21 years at the Augusta Chemical Co., directing the use and production of something called beta-naphthylamine. Sturgis could barely pronounce the name when he left in 1967, but he knows it very well now.
Five years after Sturgis left, federal inspectors made the plant stop using the chemical, which is a powerful skin-penetrant used in leather dyes. At least 30 percent of the people exposed to it develop bladder cancer, and some studies put the cancer rate as high as 70 percent.
"We found workers standing up to their hips in tanks of the stuff, shoveling it," said Dr. William Johnson, a former inspector with the National Institute for Occupational Safety and Health (NIOSH).
That was in 1972. But the federal inspectors never notified James Sturgis that he might be in danger. Neither did the company.
A joint effort to remedy that by the government and an educational arm of the AFL-CIO, the Workers Institute for Safety and Health, started quietly here last November, but it ran into trouble: the prejudices of a conservative southern town, the uncertainties of northern organizers, bureaucratic delay. It only began to get off the ground this week, and for James Sturgis, now 50 and disabled, it is nine years late.
"My trouble started in '69, '70. My water would lock on me, you know," he said. Sometimes his urine was orange, and sometimes there was blood, and pain. He put his gnarled hand on his lower abdomen. "The doctor said it puzzled him . . . I been in and outta the hospital ever since. The company wasn't paying. I was thinking it was me."
Sturgis is one of perhaps 200,000 workers listed in files that NIOSH has collected over the past decade while tracking down hazardous chemicals in the nation's workplaces. Until this week, none of the people listed had been notified that NIOSH found something dangerous at their job sites.
NIOSH argued that proper notification would require vastly expensive medical screening and followup for everyone until they died. Another 21 million workers whose names are not known have been exposed to regulated hazardous substances, and the agency didn't even want to think about notifying them.
But congressional hearings in 1977 extracted a promise from NIOSH that it would try to do something about the situation.
This week, Sturgis and 1,100 other former Augusta Chemical Co. workers are getting letters from NIOSH about beta-naphthylamine and will get a free physical exam, courtesy of Uncle Sam. It is the government's first tentative effort to share its information on job-site dangers with the people most concerned, and the bureaucrats hoped it would become a model for notifying the rest of the people on their lists.
If that is the case, future projects can expect months of delay and roadblocks thrown up by community suspicions. The program has had a hard time getting started in Augusta, and the problems are likely to plague other notification efforts nationwide.
Augusta was chosen because the group is relatively small, the chemical has been known since 1895 to cause bladder cancer, and bladder cancer responds well to early treatment. These are also the years, 20 to 25 years after exposure, when the cancers will show up. The plant bought and used beta-naphthylamine from 1946 to 1955, and manufactured it from 1955 to 1972.
Sturgis and 50 other former workers, many very ill and tired of waiting for help, have filed a lawsuit charging the company with negligence and fraud. The company denies liability, arguing that its safety precautions were thought adequate at the time.
There is a lot of hard feeling in Augusta over the situation. "It's a real mess," said Dr. Fairfield Goodale, dean of the Medical College of Georgia School of Medicine.
Augusta is a cautious town on the banks of the Savannah River, proud of its small plants that make paper cups and chemicals and pulpwood and worried, like many American cities, about its decaying downtown area. The 50,000 residents are accustomed to halting traffic and conversation while clanging Southern Railway locomotives chug back and forth across Broad Street, the main thoroughfare. The Confederate flag still stands beside the Stars and Stripes at public meetings, and the town supplies the audience with free cookies and orange juice. Augusta is 53 percent black.
Sturgis and most of the other chemical company workers are among the black poor, living in the ramshackle Bethlehem section south of the area where several people were killed during two days of riots in 1970. More than 75 percent of the former workers still live within 50 miles of Augusta.
The Augusta Chemical Co. plant is still here, too, just two miles from the huge medical complex that is the pride of the state: the Medical College of Georgia, the Eugene Talmadge Memorial Hospital and the Veterans Administration hospital. More than 350 doctors serve Richmond County.
Most of the problems have centered around the doctors, according to Paul Schulte, the NIOSH epidemiologist directing the notification project, and Knut Ringen, the project director for the Workers' Institute, called WISH.
NIOSH and WISH wanted to enlist the Medical College to provide physical exams for the workers. But the town powers, including the doctors, suspected that the notification project really aimed to launch a unionization drive in the overwhelmingly non-union area. "We had signed the basic agreement and suddenly we got this intense wave of anti-labor feeling," Schulte recalled.
WISH had planned a large community meeting, but rumors circulated that it was to be a union and black-power demonstration. "Whether it was a labor organizing effort or not, it was seen as one," recalled Dr. Maurice Patton, director of the Richmond County Health Department.
The meeting last Jan. 27 was peaceable enough, and Jenny Munro of the Augusta Chronicle planned a story on it and on the notification program. That was the next problem. WISH, NIOSH and the doctors were in accord that it was too soon for publicity, that the program wasn't ready and a newspaper story would simply upset the workers.
"I've never been under such pressure for anything as I was not to run that story," Munro recalled. It ran Jan. 30.
Nearly everyone involved in Augusta agreed that Munro's story caused the establishment to dig in its heels, slowed the project down and prompted the workers to file their lawsuit.
Schulte of NIOSH, Ringen of WISH and all the doctors contacted argued then and argue yet that workers should only be told of their danger when doctors, psychologists and other social supporters are ready to catch them if they collapse under the shock.
The only dissenters from that view are the workers themselves, who would like to have been told in 1972, and the determined woman who represents the Bethlehem community on various city boards, Addie Powell. She says the newspaper stories are the only thing that kept the project moving.
"We're not holding up that clinic," she said. "We could have raised hell a long time ago but we've been waiting for them to get going. Everybody has their own angle on this . . . They let us sit here 'til we had no recourse but to go to court. It's just like desegregation all over again."
Last March, the medical college wrote Schulte that it would participate only if WISH were out of the picture and if the county medical society endorsed the project.
"That letter was reprehensible," Schulte said. He shifted primary contracting to the county public health agency, making the college a subcontractor. Ringen and WISH withdrew from most visible efforts in Augusta so as not to jeopardize the program, and that slowed community contact. "We've been trying to pick up the pieces ever since," Schulte said.
Finally, in May, with Jenny Munro continuing to write about delays in the program, W. P. Copenhaver of the local Chamber of Commerce laid it on the line to the doctors. "Frankly, this has all the makings of another documentary for '60 Minutes,' " he wrote to the medical society, Patton and the college. He pleaded with them to resolve their problems "at the earliest possible moment and move ahead with the notification of those exposed."
The medical society endorsement followed 10 days later. Since then, NIOSH and the various medical units have been bouncing contract language back and forth, with the screening clinic targeted to open for business Sept. 11. Goodale expects 650 workers to show up Fridays and Saturdays over the next 10 weeks for physical exams. If the urinalyses are negative, the worker will be told to get regular checkups. If positive, sophisticated diagnoses will be done until the worker knows what the problem may be.
That will cost NIOSH $300,000. The agency has already spent that much getting going, and the program ends with a diagnosis. The workers then return to whatever medical services they were using when they got the letter from NIOSH. That worries many people.
"Screening isn't enough," said Addie Powell. "You tell me I'm dying and you're not going to help me? Morally that's wrong, it's just dad-gum wrong."
But the bureaucrats look at their lists of 200,000, knowing maybe millions more are exposed to toxics, and they don't know what else to do. "That's one of the reasons we haven't done this sooner," said Schulte. "The problem is as much political as it is scientific."