Cadmium Spiked at Lead Factory, Workers Didn’t Get Help

By Rebecca Woolington, Corey G. Johnson and Eli Murray | September 28, 2021

TAMPA, Fla. (AP) — In June 2014, an air monitor strapped to a worker inside a Tampa lead factory picked up an unmistakable red flag.

The level of cadmium, a toxic metal known to cause cancer, had soared to more than 100 times the federal limit.

It happened again the next winter, with the level reaching 75 times the limit. Both times, the amount of cadmium in the air far exceeded the capability of most workers’ protective equipment.

The high readings should have prompted Gopher Resource to meticulously track and document the risk to employees. But records obtained by the Tampa Bay Times show no evidence of any tests for cadmium in the year that followed.

It wasn’t the only time. The documents, which the company provided to employees, show two other gaps in cadmium testing over the past decade, each lasting about two years.

The federal government regulates worker exposure to cadmium, setting rules for how much is allowed in the air, how data must be recorded and disclosed, and how companies must evaluate the health of workers who are possibly exposed.

For years, Gopher broke those rules, putting dozens of workers at risk of serious health consequences, the Times has found.

A Times investigation earlier this year chronicled Gopher’s persistent problems with the neurotoxin lead and other poisonous chemicals. Cadmium has long been present inside the factory. But in the rare instances when regulators showed up, they focused mostly on lead or gases like sulfur dioxide.

This story demonstrates for the first time how the company and government regulators mishandled another dangerous chemical inside Florida’s only lead smelter.

Reporters analyzed data measuring the factory’s air quality and reviewed medical records for 26 employees who worked in various locations around the plant. The records depict a company that left workers in the dark about cadmium exposure, despite federal rules requiring they be given comprehensive data.

The documents and interviews also show that Gopher’s contracted doctor repeatedly failed to follow up on lab tests designed to protect the health of workers. It is the same doctor who the Times found had cleared employees to work despite health problems that could be tied to lead.

Gopher executives did not agree to an interview for this story and did not answer questions in writing. In a statement, Gopher said it believes the company is in compliance with federal rules on cadmium exposure and that the Times’ reporting appeared to be based on incomplete records.

But Gopher told multiple employees in writing that the records reviewed by the Times represented all of its testing for cadmium. And when asked by reporters to provide additional information, Gopher declined.

Company officials said they were busy working with the Occupational Safety and Health Administration on a review prompted by the Times’ earlier reporting.

“Gopher Resource is focused on cooperating with the ongoing OSHA investigation and addressing their inspectors’ questions and requests as they continue that effort,” the company said in a statement.

Cadmium is a naturally occurring metal that exists in zinc, copper and lead ore. People are mainly exposed by smoking cigarettes or eating certain foods grown in cadmium-contaminated soil.

At Gopher, cadmium can be found in scrap metal and in the lead that workers extract from used batteries. The lead is liquefied in furnaces, purified in the refinery and forged into new blocks, which are sold to companies. Cadmium exposure occurs from inhaling metal fumes and dust.

Cadmium can build in the body over time, and even low levels are considered dangerous. Chronic exposure can cause lung cancer and can damage the kidneys and bones. It has been associated with increased risk of prostate cancer and heart disease.

The Centers for Disease Control and Prevention recommends that companies keep air levels as low as possible and equip workers with the most protective respirators around any detectable level of the metal.

OSHA has its own rules, which limit the amount of cadmium workers can have in their blood and urine. The rules require companies to measure the amount of a specific protein in workers’ urine to assess possible kidney damage. When elevated levels are detected, the company physician must provide a written medical opinion, “clearly and carefully” explain all results and follow up with more testing and exams.

Gopher has a history of not providing that follow-up, the Times found.

Anil Eglais worked at the plant for more than 25 years, mostly in the furnace and refining departments. He had poisonous metal in his blood for decades, his medical records show. For two straight years, he had enough of the protein in his urine to require additional medical care.

He didn’t get it _ despite having other company lab results indicating problems with his kidney function. The company-contracted physician, Dr. Bruce Bohnker, didn’t mention signs of kidney damage in a letter to Eglais or in a separate medical opinion.

The Times found at least four additional instances when the doctor didn’t document other workers’ need for follow-up. The most recent example occurred in 2020.

Bohnker did not respond to emails or letters from the Times sent to his office and home.

Reporters also asked Gopher in February about the lack of follow-up provided to workers. The inquiries appeared to have prompted some change in practice. At least two workers with elevated protein levels, including furnace veteran Cliff Burnett, were called back to the office for further testing, they said.

Bohnker wrote Burnett a letter indicating that he would receive more frequent medical care until his levels returned to normal. The doctor also referred Burnett to a kidney specialist under workers’ compensation.

“I was shocked,” Burnett said. “Because, I’m thinking, he never did this before.”

`Astronomical’ levels

Gopher’s problems with cadmium date back more than a decade, records show.

Federal rules require companies to test the air for cadmium every six months when exposure reaches what’s called an action level.

The rules also set a worker exposure limit: 5 micrograms of cadmium per cubic meter of air averaged over a shift.

A higher limit of 50 micrograms per cubic meter applies in two of the more contaminated locations inside the factory: the furnace area and a place called the baghouse, where toxic gases and dust get routed through the ventilation system. Workers in both spots must wear respirators to lower their exposure.

Companies are required to keep accurate data on cadmium exposure levels and maintain them for decades. Current and former employees can obtain the records from areas where they worked. The Times’ analysis is based on records obtained by employees and shared with reporters.

In September 2010, Gopher recorded an air-cadmium level of 272 micrograms per cubic meter in the furnace department. The reading was several times above the federal limit and beyond what the standard company-issued respirators were equipped to handle.

At the time, Gopher was building a new plant with an intricate ventilation system. Construction was completed in 2012. But almost immediately, mechanical issues arose that increased dust levels inside the factory.

It is unclear how much cadmium was in the air. Data provided by Gopher to workers and reviewed by the Times show no testing in factory work areas for all of 2012 and 2013.

Problems continued. In the baghouse, equipment breakdowns left workers doing dangerous manual labor that could increase their exposure. Workers described regularly shoveling mounds of contaminated dust that looked like sand dunes. Some spaces were so dusty, they looked like they’d been coated with a blanket of snow.

In June 2014, records show, a baghouse worker was exposed to an air-cadmium concentration of 7,206 micrograms per cubic meter _ 144 times the federal limit and 29 times what the standard respirator could handle.

More testing was done in March 2015. The concentration of cadmium in the air reached 3,839 micrograms per cubic meter in the baghouse.

Mark Wilson, a toxicologist and director of the industrial hygiene program at Tulane University, called the levels “astronomical.” He and two other industrial hygiene experts said that cadmium levels shouldn’t exceed the federal limit of 50 micrograms per cubic meter.

In 2014 and 2015, 13 tests from the furnace had results that exceeded that limit, including two that also went beyond what the standard respirator could handle.

It is unclear if Gopher tested for cadmium in 2016 and the first five months of 2017. Records provided to workers do not contain any results for cadmium tests during that period.

In June 2017, elevated air-cadmium levels in the furnace prompted Gopher’s safety team to voluntarily review its procedures.

The internal review found that Gopher should examine its manual labor methods, such as shoveling debris, because the practices contributed to higher exposure and were discouraged in OSHA’s rules, a draft report shows. It also found Gopher should update worker training to include topics covered by cadmium regulations, such as the health effects of the metal and where and how prevalent it can be in the workplace.

What’s more, the review determined the plant did not have signs to warn workers about cadmium. Under OSHA’s rules, signs are supposed to be posted around certain work areas and include the following language:

Danger

Cadmium

May cause cancer

Causes damage to lungs and kidneys

Wilson, the industrial hygienist, said communicating dangers to workers is a critical part in keeping them safe.

“It’s just kind of a basic human right,” Wilson said.

The review further pointed out that Gopher needed to complete a written plan for reducing worker exposure to cadmium. The draft report referenced a Nov. 30, 2014 compliance plan that mentioned the metal, but didn’t include any data about exposure levels in the plant.

Gopher’s safety team concluded that the lack of data meant exposures likely were below the federal level requiring semi-annual testing. But an exposure level had actually reached more than 2,800 times that concentration earlier in 2014, an air-monitoring report obtained by the Times shows.

Gopher decided it should fix the problems and measure the amount of cadmium in the air on the same quarterly schedule it used for detecting lead.

But it is not clear how often the company tested _ or what the results showed _ in the two years that followed. In 2018, a mistake at the lab rendered all of that year’s cadmium air readings indiscernible, according to internal records.

After that, air-monitoring reports don’t show cadmium test results again until the end of 2019.

`A problem’

While cadmium levels spiked and Gopher identified problems with its own procedures, the company and its contracted doctor failed to help some of the most vulnerable workers.

OSHA requires annual tests to see whether workers have been exposed to cadmium. That includes blood and urine screens, as well as the test for the protein indicating kidney injury.

Cadmium isn’t the only reason someone might have a high level of the protein in his or her urine. Kidney damage from other causes like lead exposure, diabetes or blood cancers can also result in higher-than-normal levels. But company doctors are required to investigate, determine the likely cause and decide whether to reassign the worker to a position where he or she will not be exposed to cadmium.

When a worker’s levels are elevated, OSHA’s rules require the company to provide additional lab tests and a medical exam within 90 days. If the worker isn’t reassigned, lab testing is required at least twice a year until the levels return to normal.

The rules apply to all workers, including those who inhale cadmium through cigarette smoking.

Sixteen of the 26 employees whose records were reviewed by the Times had cadmium in their blood or urine at least once during their time in the plant. Nine of those workers identified as current or former smokers.

None of the workers had levels high enough to require being removed from the factory under OSHA’s rules. But industrial hygiene and medical experts interviewed by the Times said no level is considered safe.

Nine workers had signs of elevated protein in their urine. Seven had other lab results indicating possible kidney damage.

At least six, including Burnett, required follow-up under OSHA’s rules. But Bohnker, the company’s contracted physician, did not note the requirement in medical opinions or letters to those workers before the Times started reporting on cadmium, records show.

Burnett’s test came back elevated in January 2020, according to his medical records. Parts of Bohnker’s letter to Burnett were not easy to interpret or understand. The doctor used medical jargon, included unexplained test results and omitted the elevated protein level.

“You don’t know what the hell that means,” said Burnett, who left Gopher in August. “You just see numbers.”

If something is wrong, he added, “you trust that they’re going to help you.”

Instead, Burnett was allowed to keep working without documented warning from the doctor.

Bohnker and Gopher missed other opportunities to alert workers.

When Bohnker started contracting with Gopher in 2013, his medical opinions directly addressed whether a worker could be sick from cadmium _ or too at risk to be around the metal. But by fall 2014, after cadmium exposure inside the plant had reached its highest levels, medical opinions filled out by Bohnker and reviewed by the Times failed to mention cadmium at all.

In addition, lab reports provided to workers from late 2014 through 2016 did not flag results indicating that the level of protein in their urine was above OSHA’s threshold.

Eglais, the longtime furnace and refining worker, regularly had measurable levels of cadmium in his blood or urine, a review of his medical records shows. He smoked cigarettes, but it is unclear how much of his exposure came from tobacco and how much was from work.

Eglais was born in Haiti and grew up speaking Haitian Creole. He moved to Florida and started at the plant in the late ’80s.

At Gopher, he drove a forklift in the furnace, unloaded used car batteries from trucks and worked to purify lead inside the refinery’s kettles. He described “plenty of dust all over the place” inside the plant. But on questionnaires for company medical exams asking about his exposure amount and duration, he left the answers blank or simply wrote he didn’t know.

Over his career, the amount of lead detected in his blood averaged more than six times what the Centers for Disease Control now considers elevated, putting him at risk of high blood pressure, cardiovascular disease and kidney damage.

Based on OSHA’s standards, Eglais had elevated levels of cadmium in his urine as early as 1998, when the plant had different owners. Over the next 10 years, the metal was detected in his urine two more times.

By 2015, Eglais had enough protein in his urine to require additional testing and another exam. His lab results also showed he was anemic and had other signs of kidney injury. But the letter he received from Bohnker after his checkup that year did not mention any need for follow-up.

The next year, Eglais had even more protein in his urine and continued signs of kidney dysfunction. His anemia worsened.

Again, Eglais went in for a checkup. In a letter to Eglais, Bohnker acknowledged that the anemia merited attention and suggested Eglais follow up with a primary care doctor. But he gave no assessment of Eglais’ kidney function or protein level. He wrote nothing about follow-up required by OSHA’s rules.

Instead, he noted, “I find no areas of concern from this physical examination related to occupational exposures with Gopher.”

Eglais himself, however, had serious concerns. He’d watched long-term colleagues and friends become ill and wondered when it would be his turn.

“All of us working at that place,” said Eglais, “you working there long, you ain’t gonna live long.”

A month after his 2016 exam, Eglais, then 58, collapsed inside his home from an infection-related heart failure. At the hospital, tests suggested he might have blood cancer. Doctors recommended he receive further testing from specialists after his discharge.

Dr. Steven Markowitz, an occupational physician and professor at Queens College, City University of New York, said Bohnker couldn’t have prevented Eglais from developing his illnesses. But had the doctor more thoroughly reported the abnormal findings to Eglais, Markowitz said, his prognosis might have been better.

Bohnker, Markowitz said, should have explained in his written assessment that Eglais’ lab results indicated kidney damage.

The doctor also should have acknowledged in writing that work exposure could contribute to Eglais’ problems or make them worse, Markowitz said. And he should have ordered follow-up tests as required by OSHA’s cadmium rules, which Markowitz likened to a cookbook recipe because the mandatory steps are so clear.

“This is a problem,” Markowitz said.

Eglais left Gopher in July 2017. That same month, the company finished its cadmium review, finding itself “substantially” in compliance with the medical requirements outlined in OSHA’s rules.

In an email to the company describing some needed tweaks to worker exams, Bohnker wrote he believed they were “basically okay.”

Eglais, meanwhile, watched his health decline. In 2020, he was diagnosed with severe kidney disease and an aggressive form of blood cancer called multiple myeloma.

Not long after, Eglais began talking to the Times. He said his health problems snuck up on him. He felt good until he didn’t, his body plagued by hidden changes. In recent months, a sense of impending death haunted him. He choked up talking about his outlook.

Times reporters planned to do a final interview with Eglais in July. But he lost control of his pickup truck the night Tropical Storm Elsa rolled into Tampa. He died after crashing into oncoming traffic.

He was 62.

Warning signs missed

When Gopher broke the rules on cadmium, it did so without consequence or notice from federal regulators.

Occasionally, OSHA inspectors visited the plant to assess workers’ exposure to lead and other toxic chemicals. But inspectors missed that the company repeatedly far surpassed the limits for cadmium in the air.

In December 2014, six months after cadmium was measured more than 100 times over the federal limit in one part of the factory, an OSHA inspector responded to a referral about lead exposure at Gopher. The inspector fastened monitors to workers’ uniforms to measure the amount of metals in the plant’s air, including cadmium.

A test in the furnace area recorded a cadmium level slightly above the federal limit. But the inspector wrongly referred to the metal in her report as zinc oxide.

The inspector’s report doesn’t say if she examined the company’s own air-monitoring data for cadmium levels or whether workers were equipped with proper respirators.

OSHA said the agency must have probable cause to broaden an inspection and examine conditions beyond those outlined in an original complaint. OSHA said the 2014 inspection did not include a record of the high air-cadmium level measured months before.

But the level of cadmium the inspector measured in the air alone should have warranted that Gopher regularly conduct air monitoring and place signs around the plant warning workers of exposure to the carcinogen. Her report doesn’t say whether the plant had the danger signs posted.

OSHA didn’t answer questions about why the inspector’s findings didn’t prompt a more thorough review.

“It is the agency’s policy not to discuss determinations beyond what is included in the case file,” OSHA said.

Inspectors who visited the plant in 2015 and 2016 didn’t address cadmium exposure or the contracted physician’s shortcomings in their reports, either.

The Times, in its initial investigation, reported that federal regulators had missed opportunities to hold the company accountable for breaking rules related to other toxic chemicals, including lead.

In April, OSHA began inspecting the plant for the first time in five years. The inquiry is ongoing.

Regulators have taken air samples and wiped surfaces to test for contaminated dust. They’ve interviewed workers and requested a year’s worth of medical records to examine.

This time, OSHA said, it will evaluate Gopher’s compliance with the cadmium rules.

About Rebecca Woolington, Corey G. Johnson and Eli Murray

Woolington, Johnson and Murray wrote this for the Tampa Bay Times.

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