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LAURENCE FUORTES A faculty member and his team track down former munitions workers who have been exposed to toxic materials, helping them get the compassion and compensation they deserve.

During and after World War II, national defense was a priority. The health of workers who designed and assembled nuclear weapons in labs and factories was not.

Thousands of employees who worked at the Iowa Army Ammunition Plant near Burlington and the Ames Laboratory at Iowa State University were exposed to toxic materials. Many suffer from lung disease and cancers. Some have died.

Admitting more should have been done to protect the workers, the federal government offers them free medical care. The workers or their survivors are also eligible for compensation. Laurence Fuortes leads a team at the University of Iowa College of Public Health that is committed to helping thousands of former workers through the complex process.

Since 2001, the professor of occupational and environmental health has directed the UI-based Former Worker Program. Funded by the Department of Energy, the program provides medical screenings to workers who may have been exposed to toxic substances.

When there is evidence of an occupational illness, Fuortes and his team help former workers track down records required as evidence. They guide individuals through the cumbersome process of applying for compensation from the Department of Labor.

“It’s much harder than doing your taxes if you own two businesses and a home,” Fuortes says. “The typical 80-year-old is stymied. Some are physically unable to go through the process because of impairments such as blindness. Each of us has adopted a number of people in dire straits to provide social support and help them through the system.”

Former workers who are sick are eligible for up to $150,000 under one program and $250,000 under another. Survivors could receive as much as $150,000 from one program and $125,000 from the other. But getting that money isn’t easy.

The first step is to track down the workers or their survivors and let them know they may have inhaled dangerous dust from beryllium, uranium, or thorium. That includes 13,000 workers or their survivors from Ames and 3,500 from the Burlington area. Fuortes and his colleagues hold meetings in the communities and work with the media to spread the word.

Screening involves a chest x-ray, general blood work including a test for beryllium exposure, and a lung function test. Fuortes examines patients and reviews test results with two other physicians. They come to a consensus on which lung x-rays are concerning and require additional tests, such as CT scans.

Most are grateful for a free screening—sometimes it’s the only medical care they’ve had in years. But compassion is essential because some of the former workers are afraid.

In some cases, they’re scared to find out what might be wrong with them. Or, they’re nervous about discussing their work at the plant because they were sworn to secrecy. Fuortes and his colleagues assure the former workers that it’s ok to discuss work history with their doctors—as long as they leave out specifics on how to make nuclear weapons.

Some former workers, Fuortes says, are reluctant to “bite the hand that fed them.”

“The sense of patriotism that people have regarding the work they did is real,” he says. “There is a sentiment that pursuing screening for disease and filing claims for occupational illnesses might be anti-patriotic.”

To date, the Former Worker Program has screened more than 1,000 individuals from the Burlington area—about half of the exposed individuals who are still living—and helped hundreds of survivors there submit compensation claims.

They are in the process of screening the 2,000 Ames Lab employees who worked at the plant during the highest-risk period, 1942-59. Former Ames Lab workers are harder to locate because the workforce includes a mobile population of students and researchers.

“The compensation program for these workers may not have been implemented if not for the dedication of Dr. Fuortes and the Iowa Congressional Delegation,” says James Merchant, the former College of Public Health dean who selected Fuortes for the job. “He deserves enormous credit for his devotion to seeing that each of these workers was given a right to compensation for any medical injury suffered as a result of their Department of Energy work. He has represented them with compassion and professionalism every step of the way.”

Fuortes takes significant pride in his work, saying “public service is what public health is all about,” but stresses that he’s just one member of a team of UI employees and students committed to helping the former workers.

He points to Christina Nichols, a project assistant who hops in the car and drives to homebound former workers’ houses to screen them for work-related illnesses. And Marek Mikulski, a project assistant known for his detective work tracking down medical files and personnel records from offices and hospitals that may have closed decades ago.

Still, those who know Fuortes say the Former Worker Program wouldn’t have helped as many people without his leadership. For his work, he received the College of Public Health’s inaugural award for faculty achievement in community engagement.

Outside the University, he volunteers for the Johnson County Crisis Center Food Bank and as medical director to the Proteus Migrant Health Project, which provides healthcare to Iowa migrant workers. He also serves as faculty advisor for the UI Peace Foundation and has served as a board member for the Iowa City Free Medical Clinic.

“He could easily fill a 36-hour day with his work schedule, but still he finds time to participate in every single screening and community meeting event,” Mikulski says. “He is also always available by e-mail, phone, or fax to help and advise workers in need.”

Fuortes is known as a confidante and advocate for the workers. He even organized a picnic so former Iowa Army Ammunition employees could gather and reminisce.

“The gratitude these people have for Dr. Fuortes and all he has done for them is overwhelming, to say the least,” Nichols says. “He’s one of the most caring individuals I have ever met. He continuously inspires all of us to a higher level of kindheartedness.”

Story by Nicole Riehl; photo by Tom Jorgensen.

February 23, 2009