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Authors: Dan Fagin

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Fifteen years later, Zavon had a change of heart and decided to update the case count among the twenty-five workers who had been exposed to benzidine in Cincinnati. He discovered four more bladder cancer cases, raising the total to thirteen out of twenty-five long-term benzidine workers. This time, Zavon and Richard Wendel, Arthur’s son, wrote up the updated results and published two journal articles, in 1973 and 1974.
23
By then, though, it was largely a moot point. The freight cars from Buffalo had made their last trip to New Jersey in 1971, when Toms River Chemical finally stopped using benzidine. The company had little choice. Animal tests had at last definitively shown that benzidine was a carcinogen, and the newly formed Occupational Safety and Health Administration was cracking down hard on its use.
24
Allied Chemical, the last benzidine maker in the United States, ceased production in 1976, the same year it finally revealed the bladder cancer toll from six decades of production in Buffalo: one
hundred and fifty one cases, and probably many more because record keeping in the early years was poor.
25

What about at Toms River Chemical? Benzidine was just one of many known or suspected carcinogens—including epichlorohydrin, anthraquinone, trichloroethylene, and naphthalene—used in huge quantities at the plant at various times during the 1950s, 1960s, and 1970s. Were cancer cases piling up there as well? No one tried to find out. After the shocking study results in Cincinnati, Ciba was not eager to stir up more anxiety by bringing in another set of outsiders to study cancer in its Toms River workforce. There was little interest from outside researchers anyway, since most of them were now focusing on lifestyle risks like smoking and diet. In the absence of authoritative information, younger workers like George Woolley and the Talty brothers gradually developed their own ideas about possible cancer hotspots at Toms River Chemical, but their theories were based solely on unsubstantiated chatter around the plant.

It was as if the events in Cincinnati had never happened—no stunning cluster of bladder cancer cases, no investigations, no irrefutable scientific confirmation. The workers and residents of Toms River were still on their own.

The realization that there might be a cancer problem at the Toms River chemical plant was slow to take hold among the workforce, but once established it could not be shaken. The tipping point came in the summer of 1985, after more than a year of ceaseless pummeling in the newspapers over the toxic content of the waste that the factory was sending into the ground and ocean. The level of anxiety among employees who handled those chemicals every day grew so high that George Woolley and other union leaders felt that they had to ask Ciba-Geigy for a health study—even at the risk of generating more bad publicity that could threaten the company’s future in Toms River. “We didn’t necessarily
demand
a study, but we felt it had to be done, even if it couldn’t prove anything one way or the other,” Woolley said.

Ciba-Geigy agreed to take the first step, authorizing a search of the plant’s personnel records to count the number of cancer cases. To interpret the results, the company hired Philip Cole, a predictable
choice. The Harvard-trained Cole was the chairman of the epidemiology department of the University of Alabama at Birmingham, where he was building a long roster of chemical industry clients for whom he consulted on health controversies and testified in court cases. Cole was a forceful critic of what he considered overreaching by researchers like Eula Bingham and Thomas Mancuso who were close to labor unions and believed, as Wilhelm Hueper did, that workplace chemicals were important causes of cancer. Instead, Cole endorsed Doll’s view that occupational exposures were responsible for just 4 percent of cancers. In fact, in an interview many years later, Cole said, “My estimate would be two or three percent.”

Cole had equally strong opinions on the
kinds
of studies that were scientifically meaningful. Like many of his peers, he believed that case series studies, such as the one Arthur Wendel conducted in Cincinnati, were of little value in identifying potential causes of workplace cancer because they lacked control groups for comparison. And even case-control studies were not very helpful, he believed, unless they included rigorous efforts to account for the confounding influences of luck and lifestyle. Philip Cole was, in short, an occupational cancer epidemiologist who was highly skeptical of the tools of occupational cancer epidemiology. One of his frequent antagonists, Richard Clapp of Boston University, called him “the father of the negative study.”

When Cole traveled to Toms River in the summer of 1985 to meet with the plant managers, he learned that the company had found a few anomalies in its search of employee medical records. While there was nothing as obvious or dramatic as the cluster of bladder tumors Wendel had found in Cincinnati in 1958, one number did leap out: There were five fatal cases of brain cancer—seven if you counted two men who worked at the Toms River factory but died in Europe. There also seemed to be a surprisingly high number of deaths from bladder cancer and lung cancer. Were those case totals truly high? It was not an easy question to answer. Lung cancers were not particularly rare, but brain and bladder cancers were. On the other hand, more than sixteen hundred men, and a few women, had worked in the production areas of the sprawling factory at one time or another since 1952. Among such a large group, perhaps those cancer totals were not so
high after all. “I told them that based on the information they had given me, it was not possible to decide whether or not Ciba-Geigy had a problem with cancer in Toms River,” Cole recalled years later. “The only way to find out would be to do a formal study.” Company officials told him that they would think it over.

Ciba-Geigy and its employees had yet another reason to be jittery that summer about cancers at the factory: A federal investigator was in town to scrutinize the safety of the azo dye operation. Bruce Hills worked for the National Institute for Occupational Safety and Health, whose research was frequently used by the Occupational Safety and Health Administration to set workplace rules. Hills was there because of two suspect chemicals: ortho-tolidine and ortho-dianisidine. Both were closely related to benzidine, and Ciba-Geigy had depended on them since the mid-1970s, after OSHA’s crackdown on benzidine. The problem was, the two benzidine derivatives appeared to be almost as carcinogenic as their parent compound, which is why OSHA in 1980 had urged dye manufacturers to stop using them.
26
In Toms River, that advice was not followed. By 1985, despite the overall decline of Ciba-Geigy’s dye business, the factory was still on track to make more than thirty million pounds of dyes, many of them black, blue, or deep red azos made from ortho-tolidine or ortho-dianisidine.

Bruce Hills was not shocked by what he saw on his first visit to Ciba-Geigy. The production areas were cleaner than some other dye plants he had visited, where the air was so thick with colored particles that “you would think you were wearing tinted glasses.” He told company managers that he would return in a few weeks to test the factory air for ortho-tolidine and ortho-dianisidine, and he made a request: He wanted to collect urine samples from azo workers to test for dye chemicals. “I asked, and the company told me they’d talk to the union about it, and that it wouldn’t be a problem,” Hills recalled.

Word that a federal cancer researcher was visiting spread quickly around the factory, generating more anxiety for workers who were already upset about all the bad news of the previous months. Benzidine had already been taken away as a dye ingredient because of previous cancer scares. If they lost ortho-tolidine and ortho-dianisidine, too, there would be no way left to make azo dyes. Ciba-Geigy’s most
important remaining product—and all the jobs that went along with it—would disappear. Even more chilling than the economic threat was the sense that perhaps Greenpeace and the plant’s other critics were right. Maybe there really
was
a cancer problem at Ciba-Geigy.

Three days after Bruce Hills completed his first visit and left town, plant manager Victor Baker gathered the factory’s employees together and announced that Ciba-Geigy would cooperate with Hills and would also launch its own cancer study. Philip Cole’s protégé at the University of Alabama, Elizabeth Delzell, would conduct a case-control epidemiological study of the company’s past and present workers in Toms River, with a special focus on brain cancer, and the results would be published in a medical journal. Ciba-Geigy’s new official spokesman, Thomas Chizmadia, told reporters that the company’s actions were spurred solely by a desire to assure its workers and neighbors that the plant was safe. The company had not found “anything of an emergency nature,” he said.
27

The low-key news coverage of the decision belied its significance. For a company that had suffered through so many unwanted “firsts” since the discovery of the pipeline leak sixteen months earlier—protests, sabotage, a record fine, a criminal investigation, slashing news coverage, and public scorn—here was another one. For the first time in its thirty-two-year history in Toms River, Ciba-Geigy was acknowledging the legitimacy of the longstanding worries of its workers and neighbors. No one had ever done a health study in Toms River; talk of cancer had always been confined to anxious exchanges over back fences and lunchroom tables. Now, at last, modern epidemiology—with its blazing controversies, tantalizing ambiguities, and frightening implications—was coming to town.

There were limits to the company’s new openness, however. When Bruce Hills returned at the end of September to take air samples and collect urine, George Woolley told him that the union had instructed its members not to participate. “I was shocked and taken aback that the union said no,” Hills remembered. “I mean, if you were a worker, why wouldn’t you want this?” Woolley did not want it because the company had convinced him that the study design was flawed. Hills wanted to find out whether dye chemicals in the workers’ urine were
mutagens capable of altering DNA—an indication that they might also be carcinogenic. But company officials argued that if the urine tested positive for mutagenicity, it could be due to a chemical exposure from one of those “lifestyle” exposures Richard Doll and Philip Cole considered so important: smoking, alcohol, or even diet soda or barbecued meat. Since there would be no control group for comparison, there was no way to know if dyes were truly at fault.

Hills thought the objection was spurious—if the workers’ urine turned out to be mutagenic, then he could do a more extensive study to assess other potential causes. If it were not mutagenic, then the workers would have one fewer thing to worry about. But to Woolley, who knew how tense the workers were and how endangered their jobs were, the company’s objections made sense. “If we had been a part of that study, you’d wind up telling people they had mutagens in their urine but you wouldn’t be able to tell them why,” he recalled. “I just couldn’t see putting people through that, considering how much stress everyone was already under.” There was another reason, too, he acknowledged. “We didn’t want to have any more bad press and make the situation worse for the company and for the workers, especially for a study that wouldn’t prove anything.”

Hills went ahead with his investigation, producing an internal report that described what he saw inside the azo production buildings.
28
Even though dye workers generally wore respirators and other protective gear during the dustiest steps of the manufacturing process (at least while Hills was watching), his tests of the cassette filters the workers wore outside their respirators revealed airborne concentrations of dye particles as high as 1.64 milligrams per square meter—a result Hills later called “quite high, for something that’s a likely carcinogen.” But he dropped plans to publish his findings in the scientific literature because without urine testing there was no way to know how much dust the workers were actually inhaling. He tried to find azo workers elsewhere to test, but Ciba-Geigy was one of the last large factories in the United States that still used ortho-tolidine and ortho-dianisidine. Without the participation of the azo dye men from Toms River, Hills could not find enough workers to test to yield credible results, especially because so many were heavy smokers and thus
already had mutagenic compounds from cigarettes in their urine. Thanks to the success of Richard Doll’s huge population-based smoking studies, a factory-based study that was too small to take smoking habits into account seemed hopelessly unreliable by comparison.

Years later, Hills would look back and conclude that his abortive research effort had come too late. By the 1980s, production of ortho-tolidine and ortho-dianisidine was shifting to factories in Asia, just as benzidine had shifted overseas in the 1970s and BNA in the 1950s. Soon, Ciba-Geigy would give up on azos, too, in Toms River—and also epichlorohydrin, nitrobenzene, and all the rest. Then there would be nothing left to do but to clean up the messes, count the cases, and try to figure out who to blame.

CHAPTER TWELVE
BOOK: Toms River
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