This article originally appeared in Southern Exposure Vol. 6 No. 2, "Sick for Justice: Health Care and Unhealthy Conditions." Find more from that issue here.
When a hand truck filled with yarn smashed Jesse Hawkins’ rib last year, his employer, J.P. Stevens & Co., did not even send him to the doctor. The fifty-five-year-old black man had to go on his own. Hawkins’ personal physician, Dr. R. E. Frazier, was also designated by J.P. Stevens to examine any of its Roanoke Rapids workers hurt on the job.
Dr. Frazier told Hawkins to wear a ladies’ girdle and wrote him a medical slip saying he could do a full day’s work. Hawkins, who was spitting up blood, went to the local hospital for an x-ray. The results were sent to Dr. Frazier who told Hawkins, “Jesse, I'm glad you didn’t have a broken rib. Go back to work. Tough it out as best you can.”
Hawkins, still coughing up blood and getting no satisfaction from either his doctor or the company, stopped by the local union office of the Amalgamated Clothing and Textile Workers Union. The union made an appointment for Hawkins at Duke University Medical Center, where doctors found Jesse Hawkins had a broken upper rib and bone cancer. “At J. P. Stevens, they put people back to work that is sick and they know that they’re sick,” Hawkins said. “If you can’t do nothing but sit around, they let you sit around to keep from paying compensation. And all Dr. Frazier was interested in was that big sign they have outside the mill saying ‘three million man-hours with no lost-time accident.’”
In terms of cost to the company, accidents such as Hawkins’ represent miniscule outlays of cash compared with the costs of occupation disease. Both J.P. Stevens and its workers’ compensation carrier, Liberty Mutual Insurance Company, know the bald statistics: the average occupational disease case is fifty percent more expensive than the average accident case.
Jesse Hawkins is filing a claim against Stevens and Liberty Mutual to get workers’ compensation for his broken rib. He is filing another claim as well, for Jesse Hawkins has only fifty-nine percent of his breathing capacity. Hawkins has the classic symptoms of byssinosis or brown lung, a disease caused by excessive exposure to cotton dust, a crippling respiratory illness that has stricken some 35,000 cotton mill workers.
Most Wednesday afternoons, when weekly meetings take place, Jesse Hawkins can be found at the sunny offices of the Roanoke Rapids chapter of the Carolina Brown Lung Association. In joining the CBLA, Jesse Hawkins has joined forces with other disabled mill workers in the organization’s three-year-old fight to clean up the mills and win compensation for workers disabled with brown lung. The CBLA has ten chapters in North and South Carolina.
One of them is in Erwin, North Carolina, “the denim capital of the world,” where nearly everyone in town has worked in the giant red brick Burlington mill that spews America’s favorite cloth round the clock.
The Erwin mill, the largest single maker of denim, also produces a lot of brown lung victims. By Burlington Industries’ own count, 141 workers in this mill had the classic symptoms of byssinosis in 1971. In a company-wide survey that year, Burlington found that 460 workers in 19 Burlington-owned mills had symptoms of the disease.
The Denim Capital of the World
Unlike J. P. Stevens, which is the target of a nationwide consumer boycott because of its anti-union, anti-worker policies and practices, Burlington Industries leads the textile industry not only in profits but in reputation. Burlington is particularly proud of its medical surveillance program, instituted in December, 1970, after Dr. Harold (“Bud”) Imbus came to Burlington to head its medical department. No other textile company has come close to Burlington in studying byssinosis among its workers.
Burlington built its public image as a combatter of byssinosis largely on its 1971 study of 10,133 employees exposed to cotton dust. The Burlington study established that 18 percent of the 1,266 workers in the preparation departments, the dustiest mill areas, had “classic byssinosis symptoms.” The study also showed that 4.5 percent of all the workers tested had byssinosis. A 1976 Burlington study, according to Dr. Imbus, showed that out of a sample of 12,519 employees, 1.09 percent had byssinosis. Dr. Imbus explained the reduction: “A number of employees have been compensated, a number have left and a number who had the symptoms have been transferred.” He also accounted for the drop by saying, “the number who have the symptoms has gone down, quite simply because of a lowering of the dust levels.”
Some of the Burlington employees examined by Dr. Imbus in his 1971 study think the issue is not that simple. One is Linnie Mae Bass.
On April 26, 1977, the second anniversary of the CBLA, Linnie Mae Bass, president of the Erwin CBLA chapter, and a delegation of fifty CBLA members traveled to Washington, DC, to testify at public hearings held by the Department of Labor’s Occupational Safety and Health Administration (OSHA) on the proposed cotton dust standard.
As the phalanx of old and disabled mill workers began their slow procession to the witness table, cameras whirred and ranged over the lined faces, the two wheelchairs, the denim overalls, the respirator, the two oxygen tanks. And still cameras snapped at the buttons each member of the delegation wore: a large brown one reading “Cotton Dust Kills” and a smaller yellow one which said “And It’s Killing Me.”
When it was her turn to speak, Linnie Mae Bass cleared her throat and said, “The denim that made blue jeans for you has made brown lung for us. I worked for Burlington Industries for twenty years in the spooling and warping department until I was forced to retire because I couldn’t get my breath. I had to come out of the mills seventeen years earlier than I should have. Right now my breathing is only twenty-eight percent normal.
“Mill workers are scared. They are scared of losing their jobs. They are even scared to admit that they are sick because I was myself until I knew.
“We never knew about our rights to compensation for an occupational disease. Definitely the companies have never told us about this disease. You cannot trust the company to do their own education of the people. They cannot be trusted to do their own medical tests. Even Dr. Imbus, Burlington’s famous company doctor, cannot be trusted. It has been the Brown Lung Association and not the company that has been educating the people about this disease.”
As she talked, Linnie Mae Bass was oblivious to her photogenic attraction to the cotton industry, but Jerry Armour, a photographer for the National Cotton Council of America, dressed in a synthetic blue jean suit lined in red, white and blue, snapped her picture again and again. Asked why he had been flown from the Cotton Council’s Tennessee headquarters to take pictures of the CBLA members, Armour answered, “To show what we’re up against.” He added, “We’re using stills, color slides and sixteen millimeter film. We’re going to put together a presentation and show it at the Cotton Growers Association, various board of directors meetings, the National Cotton Council, of course, and to textile manufacturers. We’ll probably show it to people like Burlington Industries.”
Several months after the CBLA testified at the cotton dust hearings. Dr. Imbus submitted to OSHA a rebuttal of the testimony of disabled Burlington workers on behalf of the American Textile Manufacturers Institute, Inc.
According to Imbus, the testimony of the Erwin chapter of the CBLA “contains distortions, half-truths, and outright falsehoods.” Imbus came down hard on Linnie Mae Bass. “It is clear that the individual was advised of the results of every single examination and evaluation that was made regarding her breathing problems.”
Few reporters were present in the makeshift courtroom in the small North Carolina town of Lillington when Linnie Mae Bass had her workers’ compensation hearing for brown lung.
The hearing was held during the one week in July that the Erwin mill is closed, and the courtroom was filled with mill workers, many of them disabled with breathing problems. And Linnie Mae’s fellow CBLA members had traveled from Roanoke Rapids and Greensboro to attend the hearing.
Dr. Imbus, subpoenaed by Bass’s lawyer, took the stand. Before the lawyer for Liberty Mutual, Burlington’s compensation carrier, moved to strike it from the record, Dr. Imbus verified his signature on a 1971 document stating that Linnie Mae had irreversible byssinosis.
“Did you tell Mrs. Bass she had byssinosis?” her attorney, Charles Hassell, Jr., asked the doctor.
“No,” replied Dr. Imbus.
“I did not tell anyone they had byssinosis. I have assiduously avoided making a diagnosis of byssinosis for anyone. I have relied on outside consultants to make the diagnosis.”
“Did you tell Mrs. Bass the results of her test?” her attorney asked.
“I told her that her breathing was abnormally low. To me that is making the results of her test available. I did not give her the detailed results.”
Hassell asked again why the company doctor, a recognized byssinosis expert, did not tell Mrs. Bass she had byssinosis when he first learned it in 1971. Imbus, flustered, answered: “Because that word was not known then nor was brown lung.”
“What exactly did you tell her?” the lawyer persisted.
“I said your breathing capacity was not what we would expect of a person of your height and weight. She was unable to move the air in and out of her lungs. I told her there was some question of the dust.”
Then Imbus testified that Linnie Mae’s breathing capacity in 1971 was “fifty-one percent of predicted normal.”
The mill workers in the courtroom, many of them coughing and wheezing, did not take their eyes off Dr. Imbus as he ticked off the results of Linnie Mae’s breathing tests in successive years: forty-eight percent in 1973, forty-four percent in 1974, and in 1975, the year she had to leave the mill totally disabled, forty-one percent.
One person not looking at Dr. Imbus was Linnie Mae Bass, who sat with her hand cupping her eyes, shaking her head as she listened to the Burlington doctor confirm under oath what she had contended all along.
I Thought This Was Fishy
Other Erwin mill workers tested and found to have “classic symptoms” of byssinosis in 1971 are making charges against the mill, and they have documentation for what they say.
Talbert Faircloth, one of these workers, received no compensation when he was forced to retire because of his breathing disability. Burlington did not even do the necessary paperwork that would make compensation possible.
Dora Faircloth spoke publicly about her husband’s case at a North Carolina Insurance Commission hearing on the insurance industry’s requested 28.4 percent rate hike on workers’ compensation.
She said, “About a year after Talbert came out of the mill (in 1971), the plant nurse and the personnel man came out to our house and wanted him to sign a bunch of papers. They said that there might be some money in it for him. They came to the house four times, but they never told him what it was for.
“I thought this was fishy, so (in 1973) 1 wrote to the Industrial Commission to see if Talbert might be eligible for workers’ compensation. They said that in order to get compensation, the mill would have had to turn in a Form 19 report on Talbert. The Industrial Commission said that they didn’t have any record of a report ever being turned in. Back when Talbert had to leave the mill, we never knew nothing about this Form 19.”
Dora Faircloth told the Insurance Commission that her husband learned this past summer that Burlington did not file the Form 19 until September 17, 1976, five years after Faircloth left the mill. The document was signed by the Erwin plant personnel manager directly above the bold print at the bottom of the form reading, LAW REQUIRES REPORT TO BE FILED WITHIN FIVE DAYS AFTER KNOWLEDGE OF ACCIDENT.”
Dora Faircloth, irate, asked North Carolina Insurance Commissioner John Ingram, “Did Burlington ever file a report on these (other) 140 people? We think that they didn’t. “They were covering up (in 1971) and they are covering up now. That is how they cover up brown lung and that is how they keep down their insurance rates by breaking the law.”
Unlike Dr. Imbus’ earlier blanket indictment of the testimony of the CBLA Erwin chapter, this time Burlington was more guarded in the statement it made about Dora Faircloth’s charges: “We can neither confirm nor deny the accuracy of these claims.”
The CBLA says that until cases like Talbert Faircloth’s came to light, the mill companies routinely shunted disabled workers with brown lung to Social Security, where disability only — and not the liability of the employer - is considered in determining that disability payments should be made.
When an ill or injured worker is paid through Social Security disability, the cost is borne by the American people, not the textile mill or the mill companies’ workers’ compensation carrier.
A few days after Dora Faircloth spoke publicly on her husband’s case, she was with her husband in court as Liberty Mutual continued its court battle against Talbert's compensation. Talbert Faircloth and Hubert West, brothers-in-law, both disabled former Burlington workers.
“I guess they are stalling and stalling until he dies so they won’t have to pay him a penny,” she said.
Violation of the Safe Load Limit
As the CBLA’s membership swells and as more and more disabled mill workers are finding out that their lung problems were caused by their work, the Industrial Commission docket increasingly is jammed with byssinosis cases. The CBLA claims that of the 150 brown lung cases filed in North Carolina since 1975, less than a dozen have been settled.
Only one case has made it all the way through the North Carolina workers’ compensation system and resulted in an award. Otis Edwards, a black J.P. Stevens worker from Roanoke Rapids, was awarded $20,000.
Liberty Mutual originally appealed the Industrial Commission’s decision on Edwards, but later dropped it.
On May 23, 1977, when Otis Edwards had his workers’ compensation hearing at the Roanoke Rapids Municipal Court, upstairs from the Police Station, the courtroom was jammed with disabled workers, many of whom would face similar proceedings in their fight to win compensation. And Edwards’ fellow CBLA members, including Linnie Mae Bass and a delegation from the Erwin chapter, were there to offer their moral support.
Richard B. Conely, a Deputy Commissioner of the North Carolina Industrial Commission and the hearing officer, looked out at the crowded room and over to the notice posted on the wall reading, “Maximum safe load limit on second floor is seventy-two people. Do not exceed.”
“I think we’re in violation of the safe load limit,” Conely said. “I think we may be exceeding it. I don’t know if the floor will cave in.”
As pressure builds up, sooner or later it will.
Keeping Occupational Disease Out of the System
The statistics against Otis Edwards winning a compensation award for byssinosis were enormous. Although 100,000 Americans die annually as a result of occupational disease, not more than 500 cases a year are compensated through the workers’ compensation system. Peter Barth, Professor of Economics at the University of Connecticut, who with H. Allen Hunt authored a study called “Workers’ Compensation and Work Related Diseases,” found that “what is disturbing is the pattern to keep the occupational disease cases out of the compensation system. A shocking eighty-eight percent of compensated dust disease cases were contested.”
The crisis today in uncompensated and undercompensated occupational diseases is as severe as the situation at the turn of the century when an unconscionable proliferation of the maimed bodies and sundered limbs of American workers caused a national scandal that prompted passage of state workers’ compensation laws.
S.B. Black, a past president of Liberty Mutual Insurance Company, recalled the reform spirit of the early twentieth century in an interview he gave in 1950. “I think the philosophy back of workmen’s compensation laws was that injury was almost a normal by-product of work, and that perhaps there wasn’t very much that could be done about it. Therefore, industry should assume a fair share of the loss that the injured employee sustains.”
Liberty Mutual Insurance Company, today the nation’s largest workers' compensation carrier and the carrier for seventy percent of the textile industry, grew out of the 1912 Massachusetts law which made workers’ compensation insurance mandatory. The first stockholders of the company were the leading Massachusetts industrialists of the day, many of them cotton textile manufacturers.
The industrialists had another motive besides a humane response to the immense toll taken on the life and limb of American workers: they needed to protect their pockets from costly liability suits. The workers’ compensation system offered an orderly, no fault method of compensating injured workers through state industrial commissions.
In return, the workers’ compensation laws took away the worker’s right to sue the employer outside the state-administered system, thereby eliminating the possibility of enormously expensive liability suits. From the beginning, workers’ compensation was linked to wages earned. Today in North Carolina, in cases of total disability, disabled workers can collect only sixty-six and two-thirds percent of their weekly wages, not to exceed $80 a week. And textile mill workers are the lowest paid industrial workers in America.
Because the workers’ compensation law limits the worker’s right to sue an employer, many states protect the worker’s right to sue third parties. Omry Glenn of Columbia, South Caro- lina, a member of the CBLA and a diagnosed byssinosis victim, is the first brown lung victim to have filed a third party suit. In his million dollar suit, Glenn has sued the manufacturer of the mill machinery and ventilation system for “negligence, recklessness and willfulness” for designing equipment in such a way that it would “create dust and/or chemicals,” causing Glenn to become “permanently disabled.”
Glenn’s attorney, Ronald Motley, said, “If the insurance carrier undertook to advise the company on safety, we're going to sue them, too.”
Dr. Arthur Larson - professor of law at Duke University, a leading authority on workers’ compensation and an Undersecretary of Labor in the Eisenhower administration - has written, “By failing to keep compensation benefits up to the standards and needs of the times, great pressure has built up for supplementing compensation benefits in other ways.” One of these ways is third party suits.
Discussing the nation-wide trend towards suing insurance carriers, Dr. Larson noted (in his Treatise on workers’ compensation) that “what really set off alarm bells” was the 1961 case in which the Illinois Supreme Court “upheld a judgement of $1,569,400 against a carrier based on a negligent performance of a gratuitous safety inspection. Perhaps the sheer size of the judgement added to the shock.” Larson also pointed out that the case stands as “a clear decision without dissent that a compensation carrier can be made liable as a third party in tort for negligence in safety inspection. After this case, suits against insurance carriers appeared in jurisdiction after jurisdiction.”
Of course, the insurance industry is not taking this lying down. In a countermove, in states like New Hampshire, the legislature has amended portions of the workers' compensation law so that insurance companies are exempt from liability as third parties. As Dr. Larson noted wryly in an interview, “When it comes to legislature, insurance companies are no slouches.”
In North Carolina, the insurance industry lobby, the largest and most effective in the state, spent $40,865 last spring on legislation to reduce Insurance Commissioner John Ingram’s power.
Not Supposed to Talk
Liberty Mutual’s vulnerability to third party suits stems from its participation in the 1971 Burlington byssinosis survey. The insurance company’s role came to light in testimony given at the cotton dust hearings by Dr. Moon W. Suh, senior operations research analyst for Burlington Industries. Dr. Suh testified that Liberty Mutual conducted the sampling of cotton dust levels in nineteen Burlington mills that “constituted the data base” for the study.
Russell Van Houten, Liberty Mutual’s director of field services, confirmed that the company had conducted extensive cotton dust testing “at least as far back as 1968.”
Liberty Mutual offered its services as safety inspector in testing cotton dust levels to other companies as well. About five years ago, Liberty Mutual did the “raw cotton dust testing” in Cone’s twenty-two plants producing cotton fabric. Dr. Theodore H. Hatfield, J. P. Stevens’ first medical director, appointed in 1976, said that “Liberty Mutual was instrumental in encouraging the company to bring me here.” Hatfield said that Stevens had “twenty-seven or twenty-eight plants that have significant exposure to cotton dust.”
And Samuel Griggs, who heads Stevens’ dust sampling program out of its Environmental Services Laboratory in Piedmont, South Carolina, said: “Before we were not encouraged and not required to do tests. We used to depend almost entirely on Liberty Mutual. We’d call them up and ask, ‘How do we get out of trouble?’ I mean, if we thought we had a problem.
“As far as cotton dust goes,” Griggs said, “we’d tell Liberty Mutual, ‘we’d like for you to come in,’ and they'd come in and survey the plant. They’d do an overall survey.”
Griggs stopped talking suddenly, then said, “This doesn’t connect with labor, does it? We're not supposed to talk about labor.”
If occupational health and labor relations are not linked in the mind of Stevens’ environmental safety personnel, top level Stevens management does make the connection.
Even as Samuel Griggs talked last spring, Joseph Jelks, Stevens Vice President in charge of Industrial Relations, was winging to Boston for a high-level meeting with Liberty Mutual. Jelks is on Liberty Mutual’s Advisory Board for South Carolina. Half the members of Liberty Mutual’s North Carolina and South Carolina Advisory boards are top textile executives.
Liberty Mutual president Melvin B. Bradshaw does not seem aware that his company is vulnerable to third party suits resulting from possible negligence in serving as a safety inspector in the mills.
Bradshaw said, “Our vulnerability is covered by law. It is totally unthinkable that the carrier that is asked to uncover hazards is then sued for it.”
Bradshaw appeared impervious to the suggestion that his company has a direct obligation to endangered workers. In a telephone interview in the spring of 1977, when asked if Liberty Mutual felt any obligation to inform endangered Burlington workers that it had found dusty conditions in Burlington mills, Bradshaw responded: “I don’t believe it is our prerogative to give employees this information. We do this work strictly as a consultant to the company. I’m sure we told Burlington.”
He added, “If they are working in the mills, they must know it’s dangerous. To what extent it’s dangerous, I don’t know.”
I’ve Got a Hurting All Across My Body
Some observers feel that the present workers’ compensation system can not deal with byssinosis claims in the Carolinas. One of these is Ernest Hollings, US Senator from South Carolina, where the state motto is “While I Breathe, I Hope.” Hollings has introduced a brown lung measure in the Senate. US Representative Phillip Burton introduced a byssinosis bill in the House in February, 1977.
A South Carolina delegation of the CBLA called on Senators Strom Thurmond and Ernest Hollings and the South Carolina Congressional delegation in April, 1977, after testifying at the cotton dust hearings.
Thurmond told the brown lung victims, “You all speak out now! We want to hear from you people!” The CBLA needs no prompting. Time is short for these people who are devoting their last days to cleaning up the mills and winning compensation for brown lung.
The South Carolina delegation of the CBLA told their Senators and Congressmen that J. H. (“Hub”) Spires, the first president of the Association, had been buried the day before, his lungs so riddled with disease that his doctors could not risk a necessary operation.
And Lonnie Moore, then president of the Spartanburg Chapter, got right to the point: “We want the mills to clean up or ship out. One of the two. If they had wanted to put in cleaner equipment, they would have done it by now. I’ve been in there for forty-six years, and they still haven’t cleaned it up.
“Now I've got a hurting all across my body. I just hurt all over. My last day in there, at Mount Vernon Mills, I got so sick I couldn’t stand up. The company wouldn’t even let me call an ambulance.
“The overseer wouldn't even call my wife for me. When I got on the phone to ask her to carry me to the hospital, my wife thought I was a child, my voice was so faint.
“When I got to the hospital, the doctor told me, ‘Your lung is full of fiber. Get out of that mill or make your funeral arrangements.’”
Looking at each of the politicians, Lonnie said, “Now you need our help just like we need your help. And we’re telling you, we need some help now."
Before the Senators and Congressmen could respond, the room was filled with shouts of “Amen!” “Amen, brother!” “Tell it like it is, Lonnie!”
Senator Hollings rose to his feet. “In old-time politics, you could always sneak into the mills and get the votes. I'd always come out coughing. And I had to carry a special campaign suit that wouldn’t pick up lint. I’ve always wondered how you all did it.
“Maybe we could bring this to a head. I'm going to introduce a bill. Maybe we should look at that black lung legislation and make a special bill like that for you. There may be some problems, but one way or another, I’m going to introduce a bill to deal with compensation benefits and this OSHA question.”
Interviewed after the meeting with the CBLA delegation, Senator Hollings said he had promised to introduce legislation because he was moved by what the CBLA delegation had said. Then he added, “But I want to emphasize that I can’t say I didn’t realize they had breathing problems before. I can’t say I didn’t know about conditions in the mills.
“But I’m tired of the indecisiveness. Something has to done for these people. If you work for fifty-three years in a cotton mill and end up on welfare, something’s wrong.”
I asked Hollings, the former Governor of South Carolina, about the current drive for unionization of textile mills in the South. “There’s no labor movement afoot in my state. But it seems to me that if these people don’t get remedial action on this [brown lung issue], that would be reason to organize and have a union.”
Mimi Conway has written about the Southern textile industry and brown lung for three years. The research for her article was made possible by a grant from the Fund for Investigative Journalism. (1978)
Earl Dotter is a free lance photo-journalist specializing in labor subjects with emphasis on workplace health and safety. Special thanks to the Highlander Center for helping to make these photographs possible. (1978)