Affiliation: Gillings School of Global Public Health, Department of Epidemiology
Badin, North Carolina is the site of one of the nation’s first aluminum smelting facilities, operated by Alcoa 1917-2007. Residences and jobs were racially segregated. The plant and its dumping sites are in West Badin, the Black side of town. The Concerned Citizens of West Badin formed in 2013 to advocate for remediation of contamination in their community. Since then, they have voiced concerns that the worst jobs in the plant were most frequently assigned to Black workers. The first aim of this dissertation described differences in job characteristics by race and sex, using data from company records of workers employed at the Badin plant 1985-2007. Black males had the highest proportion of workers in high danger jobs at hire and persisting 20 years after hire. The second aim involved enumeration of a cohort of employees at the plant 1980-2007 from the United Steel Workers. We compared mortality rates in the cohort to North Carolina population rates using standardized mortality ratios, and mortality rates among ever pot room workers to those among never pot room workers using standardized rate ratios. All-cancer, bladder cancer, and mesothelioma were in excess. Workers in the pot room experienced higher all-cause and cancer-specific mortality rates than workers who never worked in the pot room. Finally, the third aim critically evaluated race-based clinical metrics in occupational epidemiology. Workers’ compensation for respiratory injury is determined by comparing raw lung output to race-specific, algorithmically predicted capacities. By estimating compensation using race-corrected and uncorrected algorithms, we found that race-based clinical metrics result in Black workers being under compensated for lung impairment related to work exposures. This research serves as a starting point to addressing concerns about disparities in this group of former aluminum smelting workers. It may inform interventions to make departments equitably safe for workers.