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Emergency calls from US Magnesium workers show disorganized response

Callers seemed confused about how to interact with dispatchers and often lacked crucial information.

The following story was reported by The Utah Investigative Journalism Project in partnership with The Salt Lake Tribune, with support from the McGraw Center for Business Journalism at CUNY’s Craig Newmark Graduate School of Journalism.

The urgent call came into the Tooele County 911 dispatcher just after 9:30 one night last November. A young woman, possibly 30 years old, was having seizures. She was an employee at US Magnesium, a sprawling chemical facility near the shores of the Great Salt Lake, an hour from the nearest hospital, across 50 miles of mostly unpaved roads.

“She’s got blood coming out her nose, I’m the only EMT on staff, I gotta go!”

The EMT then handed the phone to another US Magnesium employee and raced back to the injured woman.

As crucial seconds ticked down, the dispatcher began asking the man questions about the situation to prep emergency responders.

“Do you know the phone number?”

In between panicked breaths, he admitted he didn’t know it.

“Is she awake?” the dispatcher asked.

After a pause, he said that she had been but that he was not with her currently.

“Is she still jerking?”

“It seemed to have stopped when I ran up here, I had to run up to the front, it’s probably a couple hundred feet away,” he gasped. “It seemed like she was still breathing but she either bit her tongue or the side of her cheek because there is just — blood.”

Like most people who work at US Magnesium, according to former employees, he was not allowed to have a cellphone with him on site. He answered questions as best as he could but was stuck on the landline, with no clear view of his injured colleague.

“Uh, I can see if I can find a different phone real quick and call my lab and see if she’s still there,” he said.

After a tense delay he reported back that she had stopped seizing and was awake. Then the connection suddenly became distorted, only every other syllable coming through. Not until the connection stabilized was the dispatcher able to tell him that ambulances were on their way.

That mid-November call was one of 37 emergency calls involving physical injuries or health issues at the remote chemical processing facility over the past decade. The Utah Investigative Journalism Project reviewed audio from four 911 calls that came from the facility in 2023 (dispatch does not hold onto audio for more than a year).

In every case, callers seemed confused about how to interact with dispatchers and often lacked crucial information, despite the urgency of many situations. Indeed, in one case last July, a foreman made an emergency call requesting an ambulance with no information at all. “I don’t know exactly the nature of the injury,” he told dispatchers. “I have not been told anything other than we do have one.”

When reached for comment, US Magnesium said it takes worker safety very seriously. In a statement, the company said that most of the reported injuries were not work-related.

“Over the last five years, we have had only three cases where county dispatch was contacted for assistance regarding a work-related injury,” the company said noting the facility had lower injury rates than comparable industries.

When asked about training for coordinating with 911, US Magnesium responded that security guards, who are trained EMTs, are the main point of contact for emergency services. “They have received training on communication methods and protocols regarding various emergency situations.”

The Utah Investigative Journalism Project also gathered call detail reports made by dispatchers going back to 2013. These written records, as well as interviews with experts and former employees, paint a picture of a work site where poor communication has hampered emergency responses.

All this in a workplace where workers can face exposure to highly dangerous chemicals such as chlorine gas, the same gas used as a chemical weapon during World War I.

Nic Wurzer worked at the US Magnesium facility for eight months between 2022 and 2023. He recalled getting “gassed out” by an accidental release of chlorine. He needed to be put on oxygen at the facility, but no ambulance was called. Instead, when his oxygen levels stabilized, he was required to go back to work, he said.

“They don’t send you home for nothing,” Wurzer said.

Alpha to Delta

Emergency dispatch is a highly disciplined and organized system meant to respond to moments of chaos and uncertainty. All codes are flagged by severity from Alpha — representing non-life-threatening events — to Delta and Echo, the other end of the spectrum. These are the most severe incidents, where the danger is highest.

Of the 37 emergency calls that 911 received from US Magnesium between 2013 and 2023, fully one-third were of the highest risk. A dozen were Delta-level emergencies, most of which were for workers experiencing chest pains. One Echo dispatch in 2015 came for an employee who died from a heart attack.

In two major incidents, dispatchers struggled to get crucial information from employees at the facility reporting explosions.

In the first, a magnesium refining cell, a kind of oven-like structure where magnesium is superheated and refined, exploded in February 2014. According to a Tooele County Sheriff’s report, the explosion covered two workers with thermal burns. One employee said, “the explosion was so intense it picked him up and threw him backwards.” In that incident, the callers were unable to let dispatch know if injured parties were safe and out of danger, alert and responding appropriately, having breathing problems and the extent of their injuries.

In an even more serious event, a mobile boiler exploded at the company’s magnesium facility in March of 2022, knocking a contractor unconscious. Dispatchers could get few answers to their initial questions and did not know if everyone was out of danger, if the area was on fire, or the extent of injuries. Eventually, word came back to dispatchers that the contractor had a massive laceration on his head.

In a statement, US Magnesium noted that since the deceased, Robert Self, was a contractor, they could not comment on that separate company’s safety policies. Nor would they address the Sheriff’s report, which noted that Self’s hard hat was in his truck.

“We cannot provide verification of safety helmet use by Mr. Self,” the statement reads. “In either event, there was no correlation between helmet use and the injuries sustained in the incident.”

This doesn’t match with emergency dispatch records, which showed the last communication from US Magnesium employees to dispatchers was that Self had a massive head wound, and every time they tried to give him oxygen through a respirator, they saw it exit through his injury. In a Tooele County Sheriff’s report, an officer noted that the contractor’s hard hat was not at the scene of the explosion but was on the floor of his truck.

In its statement US Magnesium stressed that the company “does require employees and contractors to wear approved hard hats.”

Another death occurred in April 2015, when an employee suffered a heart attack. Records of that call show a county ambulance arrived outside of the facility at 7:32 am only to report that “they have both sides of the road blocked coming into the plant.” Documents show ambulances were not able to pick the employee up; within an hour he was declared dead.

In a statement, US Magnesium said access was blocked because of a traffic accident on the road to the plant.

“USM cannot be responsible for all actions that occur on the public access road to our facility.”

A review of dispatch records, however, showed no call about a traffic accident before this incident took place. The dispatch records did note a train may have blocked the route. US Magnesium would not respond to questions about a train blocking the road and if they took trains into account in emergency planning. Tooele County did dispatch a helicopter, which was able to make a landing.

‘They’re really all about their money’

One of the most common and most dangerous risks faced by workers at the US Magnesium facility is exposure to chlorine gas, a byproduct of refining magnesium.

Yet two workers interviewed by the Project seemed untroubled by the risks and described what they felt were cavalier attitudes among their co-workers and the company over exposure. Wurzer started working there in April 2022 as a “brickie,” laying bricks inside magnesium refining cells. After a cell had cooked as much magnesium as it could, he would go inside the cell with a jackhammer, demolish the acid-corroded bricks and then rebuild it all over again.

When he got “gassed out,” he said he was so smogged in by chlorine he couldn’t see his own hand in front of his face. But that didn’t stop supervisors from putting him back to work, he said, as soon as his oxygen levels stabilized.

Flavio Zambrone is a public health specialist, founder and CEO of the Brazilian Institute of Toxicology and an expert on chlorine exposure. He says that one-time exposure to chlorine gas would not necessarily be life-threatening. But over a long period of time, repeated exposures can lead to chronic effects.

When asked about a major exposure like Wurzer described, he was quite surprised by how Wurzer said the company responded.

“Normally, when they have large exposure, you need to take them out from the exposure and they need to go to the emergency room,” Zambrone said.

US Magnesium pushed back on that analysis.

“USM follows the Chlorine Institute advisory recommendations for chlorine gas exposure,” the company statement reads. “This is consistent with nationwide practice and complies with OSHA requirements.”

According to the Centers for Disease Control, chlorine is very harmful in high doses or over long periods of time. It can also afflict individuals with a chronic type of asthma known as reactive airways dysfunction syndrome.

“It felt like little pins and needles in my lungs, the worst cough you ever had,” said Wurzer of the aftermath of the heavy exposure. “I was hacking for like a week straight.”

Not all the workers say they’re worried about conditions at the facility. Austin Bear worked as a mechanic at the company’s magnesium refining facility from January to August in 2022. He described it as one of the safest jobs he’s had, compared to the construction and refinery work he did in the past.

A big part of Bear’s job was flagging problems in the facility for preventative maintenance. He describes an exhaustive process used to check in with foremen and electricians to make sure everyone was accounted for in any particular work area. Employees in confined areas always had other employees nearby in case they got into trouble, he says, and supervisors were always quizzing them on safety protocols.

“You get questioned all the time, not because you are doing it wrong but to make sure you’re doing it right,” Bear said.

He also said everyone was equipped with sensors to warn them about chlorine levels throughout the facility.

When Bear was asked about 911 dispatch calls for chest pain and breathing problems, he said newer employees might have just panicked the first time they inhaled chlorine.

“Some managers that have been there a while, it doesn’t faze them one bit,” he said. The rule of thumb with chlorine, he added, was that “if it’s filtered and clean, it’s green.” If it was red, however, that was trouble, though he never personally observed any red chlorine clouds.

He admitted to feeling chest pains himself from chlorine, though he did not call for an ambulance.

Bear described the experience as “heavy,” as the gas settles into the bottom of your gut. “It does take your air away,” he said. More experienced workers told him that if he inhaled any, he had to bend past his waist and just cough it out as best as he could.

Despite the training sessions and safety discussions, he added, the work culture was something else.

“They’d say ‘it’s a dangerous job, if you don’t feel safe doing something, don’t do it,’” he said. “But no one does that, no one wants to look weak. They power through it. There was a lot of s— I didn’t feel comfortable about, but I did it.”

It was a grueling and dangerous job and Wurzer says he only really did it for the pay. But for that matter, he said, the company’s response after his exposure left him feeling that’s all US Magnesium cared about as well.

Workplace safety

Kenneth Solomon is a consultant and forensic scientist at the California-based Institute of Risk and Safety Analyses; he previously worked at the RAND Corporation in the Department of Engineering and Applied Sciences. He argues that a facility as remote as US Magnesium, given the risks inherent in its processes, should have its own helicopter available for emergencies. Moreover, he was surprised to learn that people calling emergency dispatch from the facility could seldom provide a number to dispatchers or up-to-date information on the nature of the injury.

“They need a better information flow from within the facility to advise people taking the call,” he said. “That could be easily addressed.”

The information flow has also been a problem between the company and regulators.

US Magnesium has been cited by the Utah Occupational Safety and Health Administration for workplace safety violations, as well as for failing to report incidents to the state regulator. In 2017 it was originally fined $5,000 when an employee was burned after being struck by molten magnesium and for failing to report the accident in a timely manner. The fine was later negotiated down to $500.

In that case, OSHA learned of the accident from the injured employee, a month after it had happened. US Magnesium claimed it was not a reportable workplace incident. US Magnesium also attempted to tell OSHA that the injured employee could not be contacted because the employee didn’t own a telephone; a claim belied by the fact that OSHA interviewed the employee over the phone multiple times, according to a 2017 OSHA investigation report.

According to the law, all work-related accidents need to be reported. But on multiple occasions, 911 was called for apparent work-related accidents that were not reported to OSHA. Following a 911 call in 2015, for example, dispatchers sent an ambulance to pick up an employee suffering a “traumatic injury” after smashing their finger with a hammer. OSHA was not notified of the incident.

That same year, another 911 call came in about an employee suffering “burns” identified as coming from “salt” on the back of their neck, while in 2016 dispatch records show someone experienced a “fall from a ladder.” OSHA has no records of either accident.

The 911 dispatchers also logged three calls for breathing problems and 16 reports of chest pains. The incidents include complaints of chest pains by a 20-year-old man in 2021 and a 32-year-old man a year later. The company says the two ailments weren’t caused by working conditions.

Both Bear and Wurzer noted chest pains and breathing problems were common reactions to inhaling chlorine gas.

Along with specific questions, US Magnesium was provided detailed 911 reports about these incidents.

In its statement, the company said that “personal medical problems and non-work related incidents” would not be reported to OSHA. In regard to the 911 cases of breathing problems and chest pains the company said only one was a “USM inhalation related case” that was reported appropriately to OSHA but would not address the others.

“USM cannot comment on specific cases due to privacy concerns,” the company said.

When it came to the dispatches of employees hurt by burns, falling off a ladder or injuries from a hammer the company also would not comment specifically.

“USM complies with all OSHA requirements regarding reporting and recordkeeping,” the statement read.