Avian Bird Flu: When Second Class Workers Meet a First Class Hazard

February 7th, 2006 by

[Warning: This is not appropriate reading for bedtime.]
I’m not sure where the complacency about undocumented workers comes from, but I suspect that it’s a combination of racism and economics. We tolerate the presence of these second class workers because it results in cheaper products and services for us, and because we don’t really have to look at these struggling immigrants very often. They operate in the shadows of our culture. These undocumented workers are transient, unrepresented, and frequently unwilling to report injuries or illnesses because of real concerns about their continued employment or their immigration status. They work in substandard conditions, with few or no benefits. But that doesn’t impact us directly, does it?
Well, think again. Our colleague Peter Rousmaniere, who tracks the issue of immigrant workers, has posted a truly terrifying scenario where the second class worker becomes the carrier for an unstoppable disease.
It Cannot Happen Here…Can It?
Peter links to the Occupational Health Disaster Expert Network (OHDEN), a website run by Gary Greenberg MD. The goal of this well-documented and extensively linked site is to speed up transmission of time sensitive information on high profile occupational risks.
Dr. Greenberg tells us that the danger from a new influenza will begin when its DNA combines with the ordinary “flu” we experience every winter. If (or when) this strain develops, the public health fear is of a highly transmissible virus
with frequently fatal consequences. The resulting novel germ could then spread through our species unimpeded by any prior immunity, and would kill millions before effective vaccination and antiviral therapies might bring it under control. This would no longer be an”avian” influenza, but an accidental hybrid, an intensely lethal human
A Workplace Illness
Avian influenza is an occupational disease involving poultry workers. So it is in the poultry-processing workplace that the we find the intersection of two distinct issues: undocumented immigrant workers and flu pandemic risk. Poultry workers are largely foreign-born and poorly educated. They routinely work in horrendous conditions. (Again, that’s ok, as long as we can get a good price on chicken parts in the grocery store…) Even without viral dangers, Greenberg points out that these workers are exposed to intense levels of ammonia, organic dust, disinfectant, environmental cold, bird-specific fungi and bacteria, allergens, insect pathogens, and then the violent instruments and machinery required for the production of boneless filets and dressed, plucked fryers. Yikes!
I won’t go into the ergonomic horrors of chicken processing jobs. Again, we all know it’s bad, but no one forced these people to come here. No one made them take these jobs! And yes, we know that the pay isn’t great, but it’s better than these workers would find in their home countries. As for benefits, they are unlikely to be able to afford (or qualify for) health insurance, and if undocumented, they are also ineligible for Medicaid. Many are migrants, and so they have no medical records, no continuity of care, and no routine access to health monitoring. They are off the radar screen and beyond reach of our medical system. So what’s the big deal?
Here’s the point where the proverbial chickens may come home to roost. Greenberg tells us that the creation of a deadly new virus requires just one single transformation – a single virus in a single victim. Once this killer virus is set loose, the costs to humankind will be beyond the calculations of all but the most intrepid actuaries.
While many people apparently feel either cultural superiority or indifference toward the millions of immigrant workers in this country, our fates are inextricably joined. Their second class status, combined with marginal working conditions, may place them at greater risk for the initial development of the virus. But once developed, the virus will make no distinction between second and first class. There will be no reliable barriers to transmission. We’ll all face the same, irresistible force, much like the tsunami that tore through Asia in 2004.
Greenberg recommends a few practical steps to alleviate the risk of this unprecedented catatrophe. The steps are reasonable, relatively simple, and not all that expensive:
– All poultry workers need to be vaccinated against seasonal
influenza. This recommendation should be achieved worldwide. Urgent
action will be required for workers in the northern hemisphere (with
our own flu season already here).
– Free and urgent treatment of poultry workers’ respiratory illnesses
should be provided, regardless of immigration status and insurance
– Health status among these workers needs to be evaluated, monitored
and reported.
Greenberg’s recommendations are prudent and doable. But there is no way they will be implemented. Our national denial of the immigrant problem fatally extends even to a situation where we are all directly at risk. Greenberg will be viewed as just another “Chicken Little,” claiming that the sky is falling. Politically, it’s likely to prove impossible to elevate immigrant workers to the point where they are both acknowledged and accepted, let alone routinely treated for respitory illness.
If we’re really lucky, there may be few direct consequences. The pandemic might not happen. If, however, Greenberg’s worst case scenario takes place, we will finally be confronted with the real cost of our current indifference. Then, of course, it will be too late.
At that point, I imagine that someone will start a new blog called “Journal of the Plague Year.” Let’s just hope we are all around to read it.