Recognition of workers’ diseases

Former workers at an industrial glassworks in Givors in the Lyon region feel they are victims of an injustice: during their working lives, they were exposed to dangerous substances, which their employer could not ignore, and this exposure is the cause of serious health problems. In this committed book, sociologist and historian Pascal Marichalar seeks to shed light on an enigma, that of “the accommodation of a democratic society like ours to a situation in which women and men are exposed to known risks, which in many cases will cause significant damage” (p. 16). The author presents a social science investigation into the former workers’ feeling of injustice, by analyzing their quest for knowledge and their legal struggle. Through a process of mise en abyme, P. Marichalar’s investigation focuses on another investigation, conducted by Mercedes Cervantes (wife of Christian Cervantes, a glassmaker who died in 2012 from two cancers) and Laurent Gonon (retired printer and volunteer for the association of former glassmakers) to establish the link between work in the glassworks and pathologies. M. Cervantes and L. Gonon called upon activists and scientists, including P. Marichalar, to support them in their approach. The author’s analysis is based on materials collected between 2013 and 2016, which include archival documents (documents mainly provided by L. Gonon), interviews, and observations.

Quest for knowledge

P. Marichalar first offers the reader a detour through history, which allows him to highlight the conditions of possibility of the investigation. After several transmissions and acquisitions accompanied by changes of names, the management of BSN Glasspack closed the glassworks for good in 2003. This closure was part of a financial operation, at the cost of the disappearance of a historic factory that was nevertheless profitable. The factories of BSN were then bought by OI Manufacturing in 2004. While the closure threw the glassmakers into great mental distress, for P. Marichalar it marked the rupture of the moral contract that bound the glassmakers to their employers. At the same time, this closure would make possible the glassmakers’ quest for knowledge and justice a few years later.

The investigation began with M. Cervantes becoming aware of the link between working in the glassworks and the cases of cancer she observed around her. With the help of her daughters, she sent a two-page questionnaire to former glassworkers to collect information about their workstations and their state of health. Of the 208 questionnaires that were returned, almost 100 people reported having cancer. This exercise in “popular epidemiology” underlines that compared to a comparable population, the number of serious illnesses and premature deaths is extremely high among former glassworkers. L. Gonon then took the reins of the investigation by drawing up in a few months a list of the harmful products to which the glassworkers had been exposed (asbestos in particular). P. Marichalar highlights the cynicism and hypocrisy of the manufacturers of chemicals used in glassworks. In particular, the “safety data sheet” for a product used to grease molds (Kleemold 170) states that the product is not dangerous when not heated; but this product is precisely designed to be used on molds whose temperature is very high. The data sheet also states that when the product is heated, it is necessary to use a very good ventilation system; but the factory was not equipped with such a system.

Quest for Justice

The investigation shows that the workers were left in great ignorance about the dangers of the products they handled during their careers. The glassworkers who felt they were victims of injustice then began a quest for justice on several fronts (administrative procedure to request recognition of the occupational origin of the disease; collective action to request compensation for anxiety damage at the industrial tribunal; criminal complaint by C. Cervantes for injuries; etc.).

P. Marichalar emphasizes the gap between the expectations of glassmakers with regard to justice on the one hand and the possibilities left by institutions on the other. Indeed, while glassmakers have multiple and complex objectives, the State only offers one possibility: that of recognizing the occupational origin of the disease. For the author, from the point of view of institutions, the government of sick workers consists of limiting as much as possible the number of people who will obtain such recognition.

The recognition process is fraught with obstacles and highlights tensions between glassmakers on the one hand and the medical profession on the other. In particular, this process requires glassmakers to obtain an initial medical certificate (CMI) written by a doctor, who decides on the possible occupational origin of the disease. Glassworkers are faced with the refusal of a certain number of doctors to issue these certificates, a refusal that they justify by their incompetence on the subject or their fear of sanctions from health insurance. Similarly, glassworkers are subject to the refusal of the occupational health service of Givors to issue certificates of exposure to carcinogenic products. The author emphasizes that indifference, linked to the social distance that separates doctors and workers, is not unrelated to these refusals.

The book also highlights the heterogeneity in the way cases are handled by institutions, with rapid recognition when a worker’s problem originates from exposure to asbestos and his cancer appears on the official list.

Causal Reasoning vs. Probabilistic Reasoning

For P. Marichalar, the difficulties of the glassmakers in obtaining this recognition (and later the failure of the criminal trial of the Cervantes) can be explained by the causalist reasoning held by the institutions. More precisely, from the point of view of the institutions, it is necessary for the glassmakers to prove that there is a causal link between their professional activity and their individual pathology in order to obtain recognition (for occupational diseases not provided for in the tables). However, it is impossible to prove the existence of such a causal link at the individual level, because scientific proof is by nature probabilistic. Using the example of a judgment rendered in Italy, the author suggests that only a shift in focus, from the notion of causality at the individual level to that of exposure to dangerous substances, would allow the institutions to respond to the workers’ demand for justice.

The author also shows the interest of collaborations between workers and scientists. Indeed, the involvement of scientists from the Scientific Interest Group on Occupational Cancers in Seine Saint-Denis (Giscop 93), founded by Annie Thébaud-Mony, marks a turning point in the glassmakers’ fight. This research team has developed a method that allows exposure to products to be defined more precisely, based on the workers’ accounts (“curriculum laboris”). In addition, the participation of these experts leads to the addition of new scientific evidence to the files. On another level, A. Thébaud-Mony puts the glassmakers in contact with a renowned law firm. All these elements play a major role in the recognition of C. Cervantes’ two cancers in 2015.

However, the glassmakers only had mixed success. Despite their efforts, they lost a case before the industrial tribunal in 2016. This passage from the book highlights the ignorance of OI Manufacturing’s lawyer about the workers’ working conditions: she claims that some products are not toxic when in fact they are, and refutes the presence in the factory of other products that are nevertheless very present.

To highlight the importance of the glassmakers’ struggle, the book also describes the working conditions in other active glassworks, and in particular that of Puy-Guillaume, which the author visited in 2014. The similarities with the Givors glassworks are obvious: exposure to the same dangerous products (including asbestos) and high temperatures and noise levels. The situation of the Givors glassmakers is therefore not an isolated case.

While a vast quantitative literature has shown the existence of strong social inequalities in health according to income and education level and profession, the book gives substance to these differences, drawing on interviews, observations, and portraits of former glassmakers. The strength of this book is to describe the system of production of non-recognition and irresponsibility, based on indifference, negligence, and ignorance, which participates in the perpetuation of these inequalities.