Toxic warrior

Oct 4, 2000 at 12:00 am
There’s a classic picture hanging on the wall of Dr. Michael Harbut’s clinic in Southfield. Grinning construction workers munch sandwiches and mug for the camera — while sitting on a narrow iron beam hundreds of feet above New York City’s 1932 skyline. It’s a giddy, dangerous-looking shot, but at least those men knew exactly what their risks were.

It’s much more complicated today. People are still getting hurt and killed on the job, but the causes are harder to prove. In particular, workers sickened by industrial poisoning face a daunting gamut of courts, governmental agencies and corporate lawyers arguing over things more complicated and subtle than the effect of gravity on girders and people.

There’s certainly plenty for all of those lawyers, experts and workers to argue about these days. The National Institute of Occupational Safety and Health says that, on average, 137 workers die from work-related diseases daily. That human cost almost trivializes the financial costs—$26 billion per year, according to NIOSH. (For comparison, that’s more than two-thirds what AIDS costs the country annually.)

Some of these stealthy dangers can lurk in the home as well. Household cleaning compounds, weed-killing chemicals, lead-based paint, asbestos-impregnated insulation, arsenic-laden drinking water, radon-fumed basements: It sometimes seems as if there are invisible, dangerous intruders around every corner.

Harbut has chosen to live and work in the middle of this riot of science, mystery, misery and litigation. An assistant professor of internal medicine at Wayne State University and a section chief at Providence Hospital, he’s a gentle, soft-spoken man on the verge of 50 who radiates an energy typical of someone half his age.

“I’m often accused of being pigheaded,” he says, “but what I think is right and wrong hasn’t changed since I was a kid: It is wrong to do things that hurt people.”

Most patients come to Harbut’s Center for Occupational and Environmental Medicine hurting and desperate. Today he’s seeing former assistant school principal Mary Smith, in her fifth year of recovery from what Harbut diagnoses as “sick-building syndrome” contracted while she was an assistant principal at Cass Technical High School. (See box.)

“I knew I had to find somebody in environmental health,” she says, “and I bumped into Michael while I was with a loved one at Providence Hospital. There’s no question about it; he has saved my life. He works with his patients; he’s not arrogant. He identified the problem and developed a medicative approach. He was gutsy enough to certify that I was genuinely sick and was willing to go to court and say so. That willingness to go on record was very important in my case.”

Harbut not only treats toxic illnesses; he also works to prevent them. He’s petitioned agencies, unmasked unhealthy factories and quarreled publicly with his own professional association about its ethically questionable politicking. In another bold stance, he urges doctors to test patients’ blood arsenic levels much as they test cholesterol levels. Particularly, Harbut says, patients who drink well water should be tested, which would cover some 23 million households, according to U.S. Census data.

Dr. Jeffrey Zaks, who taught Harbut during his internship at Providence and who is now that hospital’s chief medical officer, says the toxicologist is like few other doctors he knows.

“He is an unbelievably passionate guy about issues that are larger than, say, pneumonia and the medical treatment of it,” Zaks says. “He advocates for patients, for the disadvantaged, for those that don’t have an organized voice. I admire him for that. He’s a very single-minded, very determined young man. I think that he sometimes has unpopular views, and he’s not afraid to express them.”

Cakes with Walesa

Harbut rarely takes “no” for an answer. When no decent American medical school would admit him at the ripe old age of 27, he finagled a scholarship from UNESCO and headed for Poland to study medicine there. Two years later he had to flee when Polish communist authorities were about to arrest him.

“They were going to accuse me of being an anti-communist,” he chuckles, “even though I had a Red Squad file on me back in Michigan.”

He finished medical school at the American University of the Caribbean in Montserrat, interned at Providence, and then specialized in occupational and environmental medicine at the University of Michigan. After a year as a full professor at Wayne State University, he returned to Poland in 1989 as the U.S. Agency for International Development’s (USAID) chief medical policy adviser for that nation’s newly triumphant Solidarity government. (He has a picture of him and Lech Walesa sitting at a table happily contemplating a plate of cakes.) Ever since his return to this country, he’s been trying to heal “the system” almost as much as he’s worked to help his patients.

In 1991 he angered Ford Motor Company when his research team screened workers at the Rouge Plant and discovered many were suffering from exposure to asbestos. In a subsequent suit, some 100 ailing workers won a multimillion-dollar settlement out of court.

He thinks his persistent screening of workers at Ford (“I hear they have meetings there about me,” he says), Dow Chemical, Great Lakes Steel and other industrial companies in the early ’90s earned him the occasional tapped phone — there were signs, he says, though no proof — and outright harassment. In an 18-month period that began soon after he’d conducted the worker screenings, he says he endured two Medicare audits, a Blue Cross Blue Shield inquiry, and questions from a federal grand jury, the Michigan Employment Security Commission and even his erstwhile sponsors at USAID.

“Eighty percent of the cases they audited were people with asbestos-related diseases,” he says of the Medicare and BCBS investigations. “They are entitled to it, because they were paying the bills, but when you add it all together it was a little weird. The grand jury was scary as stink. I am sitting in my office one day and a FBI agent shows up and subpoenas all of the records I had relating to the asbestos-screening project.

“I volunteered to cooperate with them,” he says. “There is crooked stuff that goes on with some of these asbestos screening projects, and I volunteered to help them find the bad guys. But they investigated me for a year.”

And if having the FBI nosing around was scary, the investigation by MESC, he says, was plain strange.

“MESC audited to see if I had paid adequate withholding taxes on my employees. My accountant said he had never seen that before. And when USAID audited me, the irregularity they cited was that I had sent them a Xeroxed copy of an airline ticket I used in Poland, instead of the original. But nobody ever found anything. I actually ended up getting some apologies. MESC sent me a letter that said they were sorry for putting me through the hassle and thanked me for my advice. It was a very nice letter.”

Fight ahead

Sometimes government agencies actually have responded positively to Harbut’s feisty advocacy, like this past spring when he filed an affidavit on behalf of the National Resources Defense Council (NRDC). The environmental organization was preparing to sue the Environmental Protection Agency (EPA) over its health standard for arsenic in drinking water, which is currently five times more lenient than the World Health Organization’s.

To Harbut’s surprise, the EPA responded to the threatened suit with a proposed quantum leap in its standards which would make them twice as tough as WHO’s.

If they stick, the new rules will have wide implications — arsenic-laced aquifers are not uncommon in the United States. In fact, the nation’s largest, the Marshall Sandstone Aquifer, underlies much of Michigan, including parts or all of Livingston, Washtenaw and Oakland counties.

Harbut predicts a huge catfight over the new rules because complying will be costly for some municipalities. It will also be very expensive for some large Western copper mining companies whose effluents contain significant levels of arsenic. Harbut predicts that, despite “hundreds of studies” confirming the dangers of arsenic in drinking water, the decision will be settled by politics, not science.

“What will happen depends on who the next president is,” he says matter-of-factly.

In the meantime, Archives of Environmental Health has published his peer-reviewed letter arguing that doctors can use a simple urine test for arsenic as an independent risk factor for many diseases (see box), just as high cholesterol is an independent risk factor for heart disease.

In particular, Harbut said in an interview, people who live over arsenic-laced aquifers or depend on wells for drinking water should take the roughly $18 test.

Breaking ranks

Harbut may eschew politics, but he’s not one to run from a fight. Last May he wrote a scathing letter of resignation as chair of the occupational and environmental health section of the American College of Chest Physicians.

The issue was AACP support of national legislation that many considered an outright bailout of the asbestos industry, a position taken without proper peer review and despite the opposition of hundreds of petition-signing members.

Harbut’s last straw was the discovery by the Seattle Post-Intelligencer that an AACP lobbyist was also working for GAF Corp. A major backer of the bailout bill, GAF itself faces potentially huge asbestos liabilities.

His letter must have hit home; the AACP has withdrawn its support of the bill.

“I couldn’t believe it,” he says. “About the same time the AACP president sent me a note and said if I ever wanted to put my name back on their membership list, just let him know. He didn’t say anything about the change in their position, though. It was a completely bland letter.”

Such activity has made Harbut something of a national figure. He’s been quoted in the Seattle Post-Intelligencer, the Washington Post, the Denver Rocky Mountain News, the New York Times, Associated Press and by four major TV news networks. But Harbut insists he is not permanently aligned with any one camp.

“The system that deals with this is fundamentally corrupt,” he says. “Both sides have their lists of experts that they buy. I once had someone send ten workers to my clinic for toxic testing. When I told their lawyer that eight of the ten were completely clean, he took me to lunch and explained to me that I wasn’t doing my job correctly.”

Harbut’s used to hearing such things. Even Dr. Zaks, his old teacher and one of his big admirers, says that at times Harbut may be going a bit too far out on a limb.

“Extreme?” Zaks says, mulling over a reporter’s question. “Yes, sometimes. There may be some controversy about, say, the tolerable level of arsenic in water and his position is ‘Hey, there shouldn’t be any!’ So while his opinions are sometimes volatile or extreme, they are always well intentioned.

“If you come in and your hair is falling out and it turns out to be arsenic from well water, he will not only treat you, he will try to find out how the arsenic got there, how the neighbors might be affected, what the resources are out there that can help you. Most of us tend to take care of the problem and then go home. He is not like that.”

Harbut says he only goes where the science takes him. It’s a simple philosophy, albeit in a complicated world.

“We no longer have corporate goons like Harry Bennett beating workers with ax handles,” he observes. “Instead we have an unknowing CEO who talks a good green game, a company attorney who is defending a law that’s already on the books, a plant manager concerned about maintaining his profit margins, and a plant physician untrained in toxicology. Together they do much more damage than Bennett ever did.”

Jim Dulzo is a veteran Detroit-area jazz broadcaster, critic and concert producer. E-mail [email protected]