STATES OF EMERGENCY - Patrick Lagadec

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174 Technological crises and the actors involvedexpert, maybe we could review some of the cases you've been directlyinvolved in.L. ABENHAIM: Yes, I'd like to look at two examples. One is the earliestpublic health crisis I was personally confronted with, first in Canada(following the cluster at the Toronto Star I described earlier), and then inFrance. This taught me a great deal about the expert's role in such situations.The issue was pregnant women working on VDTs. The second example is thefire involving the PCB transformer at Villeurbanne, in 1986. I've chosenthese examples because they both represent decisions to be made in the face ofrisks about which science provides only scanty information. This meansscience and medicine offer no absolute truth at the time the decision has to bemade.Video display terminalsIn 1979, four women working on computer screens in the offices of thedaily Toronto Star gave birth - within the space of a few weeks - to childrenwith birth defects (a cardiac malformation, a cleft palate, a club foot, and amalformation of the eyelids). Of course this news was soon published by thevery same newspaper, and it rapidly became the subject of an importantdebate.It is easy to see what was at stake here. We were at the beginning of theoffice automation revolution, which many people were taking badly.Computers destroyed jobs, they were thought to be inhuman and hard to use.Some health effects of working in front of terminals (e.g. fatigue, eye strain,back pain) had been widely studied and were often used to support demandsfrom labor unions. The birth defects at the Toronto Star added a much moreserious source of worry, reinforced by the fact that the cases were notisolated.In light of the vigilance provoked by the Toronto Star cluster, twelveother clusters were identified in North America in the following months,involving unsatisfactory outcomes of pregnancy among women using videodisplay terminals, hi one case, among nineteen pregnant women working at ahospital, seven had miscarriages; elsewhere, among twenty female employeesin an agency of the US Department of Defense, twelve miscarried or gavebirth to abnormal children.These clusters triggered considerable action by employee and consumerassociations in Canada and the United States, who fought to have pregnantwomen removed from work involving computer screens. The question wentas far as the Congress of the United States and public health and occupationalhazard authorities in Canada (especially in Quebec). I can cite from memorysome of the questions that arrived every day at the IRSST in Quebec: "Mywife works with a VDT; she already had a miscarriage last year; should I askthat she be covered by the law on preventive removal of pregnant women?"(from a doctor at Saint-Luc Hospital in Montreal). "This young women wants
L. Abenhaim: Crisis and public health decision 175a baby; her only skill is word processing; she wonders if she should changejobs. Of course, unemployment being what it is..." (from a generalpractitioner in Montreal). "An employer wants to force all his secretaries towork on word processors; how can we make him understand that this isdangerous?" (from a labor union in Hull, Quebec).At the time, we had no data on the effects of computer screens on foetaldevelopment. Right away, we thought of the possibility that these screenswere emitting electro-magnetic radiation. Teams were sent out to measure theradiation produced by the terminals on the sites where clusters had beenobserved. The ionizing radiation they found was negligible, lower thanbackground radiation levels. On the other hand, fairly high levels of nonionizing(low-frequency) radiation were detected.We knew almost nothing at the time about the effect of these lowfrequencyelectro-magnetic fields (LFEMF) on pregnancy. This is why wewere impatiently awaiting the results of the first studies. And the earlieststudy published, done in Spain, demonstrated that this radiation causedmalformations in chicken embryos. The polemic, which had simmeredquietly until then, suddenly became much more heated.As a response to these worries, and to the demand for removing pregnantwomen (and those planning pregnancies) from work on VDTs, we saw severaltypes of reaction develop.The first attitude, encountered most frequently among employers, was todeny the danger outright. This denial without supporting argumentsreinforced the radical attitude of those who were worried or who wanted tohave the danger recognized. The second attitude consisted of denying the riskby applying what I call the poker player's logic. This is worth describing indetail, because it recurs systematically in this type of situation, sometimesrightly and sometimes wrongly. The poker player's logic goes like this: theodds are very slim of being dealt four aces in a five-card hand, but it'snormal that it should happen from time to time if you play often. By the sametoken, if large groups of women work with computer terminals, it's normalthat from time to time, some of them (four out of seven at the Toronto Star)will give birth simultaneously to malformed children.This logic recognizes that the probability of each cluster taken by itself islow, even infinitely low (we can calculate its rate), but since there are manyterminals in use (7 million in the United States in 1981), it is no surprise thatclusters occur from time to time. This explains how statisticians asserted, insome very reputed scientific journals, that clusters of birth defects like thoseat the Toronto Star could be normally expected to occur two or three timesper year, and that clusters of spontaneous miscarriages could be expectedmore than 100 times a year among women using VDTs.This argument wasn't convincing. As you can imagine, it was hard toaccept for the people who felt personally concerned, and furthermore, it wasonly valid if it could be supported by solid data. As it turns out, though thelogic was good, the calculations themselves proved to be totally wrong. Welater demonstrated, for epidemiological reasons that are difficult to explain
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STATES OF EMERGENCYTechnological Fa
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viiiContents- Edgar Fasel..........
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IntroductionIn recent years, a whol
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Introduction 3And what goes for maj
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Introduction 5It is not hard to mea
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Introduction 7Look for example at t
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PART ONETechnical Breakdown,Crisis
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12 Technical breakdown, crisis and
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Organizations with their backs to t
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3. In the thick of thingsThe most r
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MARC BECAMThe oil spill from the
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M. Becam: The "Amoco Cadiz" 47Trava
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M. Becam: The "Amoco Cadiz" 49quest
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M. Becam: The "Amoco Cadiz" 51M. BE
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M. Becam: The "Amoco Cadiz" 53way:
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RICHARD THORNBURGHThree Mile Island
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R. Thornburgh: Three Mile Island 57
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D.K Burrows: Mississauga 67We chose
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D .K Burrows: Mississauga 69look af
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D.K Burrows: Mississauga 71D.K. BUR
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D.K Burrows: Mississauga 73P.L.: No
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76 Technological crises and the act
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EDGAR FASELSchweizerhalleand the po
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PHILIPPE VESSERONThe case of the Se
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100 Technological crises and the ac
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Technological crises and the actors
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Technological crises and the actors
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Page 124 and 125: 124 Technological crises and the ac
Page 172 and 173: LUCIEN ABENHAIMUncertainty, the exp
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PART THREELandmarks for ActionQuest
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236 Landmarks for action. Questions
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6. Perspectives: the debate is open
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276 Conclusionsituations of excepti
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ReferencesIntroduction1. P. Lagadec
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References 281Chapter 21. Newsweek,
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References 28314. Interview with Lu
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STATES OF EMERGENCY - Patrick Lagadec

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