TAYLORSVILLE, N.C. -- Sheri Farley walks with a limp. The only job she could hold would be one where she does not have to stand or sit longer than 20 minutes, otherwise pain screams down her spine and up her legs.
For about five years, Ms. Farley, 45, stood alongside about a dozen other workers, spray gun in hand, gluing together foam cushions for chairs and couches sold under brand names like Broyhill, Ralph Lauren and Thomasville. Fumes from the glue formed a yellowish fog inside the plant, and Ms. Farley's doctors say breathing them in eventually ate away at her nerve endings, resulting in what she and her co-workers call "dead foot."
A chemical she handled -- known as n-propyl bromide, or nPB -- is also used by tens of thousands of workers in auto body shops, dry-cleaners and high-tech electronics manufacturing plants across the nation. Medical researchers, government officials and even chemical companies that once manufactured nPB have warned for over a decade that it causes neurological damage and infertility when inhaled at low levels over long periods, but its use has grown 15-fold in the past six years.
Such hazards demonstrate the difficulty, despite decades of effort, of ensuring that Americans can breathe clean air on the job. Even as worker after worker fell ill, records from the Occupational Safety and Health Administration show that managers at Royale Comfort Seating, where Ms. Farley was employed, repeatedly exposed gluers to nPB levels that exceeded levels federal officials considered safe, failed to provide respirators and turned off fans meant to vent fumes.
But the story of the rise of nPB and the decline of Ms. Farley's health is much more than the tale of one company, or another chapter in the national debate over the need for more, or fewer, government regulations. Instead, it is a parable about the law of unintended consequences.
It shows how an Environmental Protection Agency program meant to prevent the use of harmful chemicals fostered the proliferation of one, and how a hard-fought victory by OSHA in controlling one source of deadly fumes led workers to be exposed to something worse -- a phenomenon familiar enough to be lamented in government parlance as "regrettable substitution."
It demonstrates how businesses at once both suffer from and exploit the fitful and disjointed way that the government tries to protect workers, and why occupational illnesses have proved so hard to prevent.
And it highlights a startling fact: OSHA, the watchdog agency that many Americans love to hate and industry often faults as overzealous, has largely ignored long-term threats. Partly out of pragmatism, the agency created by President Richard Nixon to give greater attention to health issues has largely done the opposite.
OSHA devotes most of its budget and attention to responding to here-and-now dangers rather than preventing the silent, slow killers that, in the end, take far more lives. Over the past four decades, the agency has written new standards with exposure limits for 16 of the most deadly workplace hazards, including lead, asbestos and arsenic. But for the tens of thousands of other dangerous substances American workers handle each day, employers are largely left to decide what exposure level is safe.
By contrast, OSHA has two dozen pages of regulations just on ladders and stairs.
"I'm the first to admit this is broken," said OSHA director David Michaels, referring to the agency's record on dealing with workplace health threats. "Meanwhile, tens of thousands of people end up on the gurney."
Royale Comfort Seating disputes that Ms. Farley's health problems and those of some other workers were linked to their jobs. Company officials also say that while they have sought to safeguard their workers, they have also feared losing jobs to foreign competitors, as many of their industry counterparts in North Carolina have.
Royale has not switched away from the nPB glues, managers said, because alternatives did not work well, were sometimes more dangerous and were almost always more expensive.
"We, as a company, are also in a tight spot," said William Lee Isenhour, Royale's director of personnel and safety.
Chronic ailments caused by toxic workplace air -- black lung, stonecutter's disease, asbestosis, grinder's rot, pneumoconiosis -- incapacitate more than 200,000 workers in the United States annually. More than 40,000 Americans die prematurely each year from exposure to toxic substances at work -- 10 times as many as those who die from the refinery explosions, mine collapses and other accidents that grab most of the news media attention.
Occupational illnesses and injuries like Ms. Farley's cost the U.S. economy roughly $250 billion per year because of medical expenses and lost productivity, according to government data analyzed by J. Paul Leigh, an economist at the University of California, Davis, more than the cost of diabetes or chronic obstructive pulmonary disease. Roughly 40 percent of medical expenses from workplace exposure, or about $27 billion a year, is paid by Medicare and Medicaid.
Both government officials and employers weigh the costs and benefits of protective measures. Many studies show that investing in workplace safety saves money in the long run, but economists say that does not prove true in every case. This, of course, raises the most difficult calculus of all: comparing the worth of a dangerous job versus no job at all. How should companies and regulators put a dollar value on workers' quality of life -- indeed, on their very lives?
While the number of inspectors has grown under the Obama administration, OSHA still has just 2,400 responsible for overseeing roughly 8 million work sites -- roughly 1 inspector per 60,000 workers, a ratio that has not changed since 1970. The federal budget for protecting workers is less than half of that set aside for protecting fish and wildlife.
Mr. Michaels, whose tenure leading OSHA since December 2009 has been characterized by more aggressive enforcement than that of his most recent predecessors, cites a deeper problem: the small amount that OSHA can levy in fines. The maximum penalty for a violation that causes a "substantial probability of death -- or serious physical harm" is $7,000. The highest fine for a willful and repeated violation is $70,000.
This, Mr. Michaels said, pales in comparison with fines of up to $130,000 that the Department of Agriculture can levy if a dairy company refuses to pay fees that help the federal government advertise milk products, or the $325,000 that the Federal Communications Commission can fine a TV or radio station for indecent content.
"If the cost of compliance to our rules outweighs the penalties for breaking them, companies just take a 'catch me if you can' approach to worker safety and health," he said. And serious violations of the rules should not be misdemeanors, he said, but felonies, much like insider trading, tax crimes and antitrust violations.
But Jeff Ruch, the director of Public Employees for Environmental Responsibility, a public health advocacy organization, said that, on average, OSHA now conducts health inspections and collects air samples less than half as often as under the Reagan administration.
"You can't hit someone with a fine," Mr. Ruch said, "if you aren't on site looking to find the violations."nation