Blog by Christine Pich
One of the stories that I followed in the media while doing my doctoral research was the situation at the General Electric (GE) Peterborough plant. Since 2004, former GE Peterborough workers have filed over 650 occupational disease claims to Ontario’s Workplace Safety and Insurance Board (WSIB) for diseases such as brain cancer and lung cancer. Initially the majority of these claims were not accepted, but there has been another push by retired workers to get these claims compensated. Despite evidence from workers’ experiences, journalistic investigations, and a research report that demonstrate long-held knowledge about worker exposure to hazardous substances, when former Premier of Ontario Kathleen Wynne was asked about the GE occupational disease problem she replied that the situation is “tragic” but that “there was no malicious intent – people just didn’t know” (see Kovach, 2017 August 3).
With a focus on occupational disease as a sociological object of inquiry, my doctoral research examines knowledge contestations in relation to the challenges of recognising occupational diseases in the context of Ontario’s workers’ compensation system. I do this through a multi-method qualitative approach that incorporates archival methods, in-depth interviews, participant observation, extensive document analysis, and Freedom of Information requests. I also draw on theoretical insights from ignorance studies, sociology of knowledge, and new materialism. A central aim of my research is to problematize simplified claims to unknowns - such as the claim that “people just didn’t know” - by examining the complexities that different processes of unknowns bring into decision-making procedures about occupational disease recognition. More specifically, I identify three processes of unknowns (uncertainty, absences, and closure), each of which take up their own chapter in my dissertation.
Occupational disease is highly contentious due to the many challenges embedded in recognising the occupational factors that contribute to the development of a disease. Many diseases have long latency periods where the ill-health effects from an occupational exposure can take decades to manifest. A worker can be exposed to asbestos, for example, and develop lung cancer twenty years later. Coupled with other factors, such as multi-factorial disease aetiologies, synergistic effects between exposures, a lack of exposure and/or occupational histories, and contestations over standards of proof (e.g., scientific versus legal), the recognition of occupational disease is filled with numerous obstacles. Divergent economic interests and values, along with an array of social actors who come into these processes with various epistemological perspectives, further complicate the recognition process.
A key finding of my research is that multiple dimensions of unknowns play a pivotal role in knowledge contestations over occupational disease recognition. Generally speaking, unknowns can encompass positive (such as a pleasant surprise) and negative (for example, being manipulated through withheld information) components. In the context of my research, I observe that unknowns tend to operate in negative forms for those seeking to obtain compensation as they complicate and obscure connections between occupational factors and the development of disease. Absence, for example, can become misinterpreted by decision-makers as being complete rather than partial. Epidemiological evidence tends to hold a significant amount of evidentiary weight in decisions about occupational disease claims. Even if other forms of evidence are presented as the best available evidence, a lack of a certain types of epidemiological studies may result in the denial of a claim based on the erroneous assumption that there is an absence of evidence to support a probable connection between occupation and disease. In other words, absence of (particular types of) evidence can all too easily become translated as evidence of absence.
The problem of occupational disease is not that “people just didn’t know”. While the configurations of who knows and to what extent they know may vary in different circumstances, historical and contemporary struggles to recognize occupational diseases in Ontario demonstrate that people knew about occupational hazards and their ill-health effects. To be sure, more knowledge could always be produced and my research discusses the importance of increasing attention to occupational factors in health-related research and medical education and practice, as well as a (re)establishing a specialized research body dedicated to studying occupational disease (there was, for example, an Occupational Disease Panel that existed for a few years until it became abolished by the Harris Conservative government in the mid-1990s). However, the lack of certain types of knowledge should not be mobilized as a way to stall or prevent the recognition of how occupation impacts one’s health. In addition, more consideration needs to be paid to knowledge and evidence that does exist and is available for decision-makers, since a key issue is what kinds of knowledge is granted evidentiary weight and whose knowledge is deemed sufficient and legitimate enough to demonstrate a probable connection between an occupation and a disease.
In deciding to focus on occupational disease for my doctoral research, I did so as an outsider to the field. The topic of occupational disease, as well as the focus on knowledge and unknowns, was new research terrain for me. Unravelling the complexities of unknowns was a challenging process, as was developing an understanding of the shifts in how workers’ compensation operates in Ontario in relation to occupational disease – both historically and contemporarily, as well as in theory and in practice. I aimed to practice reflexivity in many respects, including how I was understanding other disciplinary fields and their epistemological paradigms, as well as the ways in which I was presenting my research more generally. In emphasizing the complexity of unknowns, for example, I do not want to be misinterpreted in saying that knowledge about diseases is too complex and therefore nothing substantial can be done about it. Indeed, that argument has been used to mobilize unknowns as a strategy to forestall the recognition of occupational disease.
As I progressed through the research process, the importance of studying occupational disease and workers’ compensation became increasingly salient to me, especially considering the lack of sociological attention this social problem has received. Continued struggles to obtain recognition for occupational diseases illuminate the ongoing and contemporary relevance of the problem of occupational disease, and the multi-faceted ways in which unknowns become mobilized to evade sufficient legitimization of, and response to, this social justice issue. It also demonstrates how occupational disease is not simply a problem of a lack of knowledge, but one that is highly contingent on social and political factors.