Black Lung

Black Lung: Anatomy of a Public Health Disaster

ALAN DERICKSON
Copyright Date: 1998
Edition: 1
Published by: Cornell University Press
https://www.jstor.org/stable/10.7591/j.ctt1287f9d
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  • Book Info
    Black Lung
    Book Description:

    In the definitive history of a twentieth-century public health disaster, Alan Derickson recounts how, for decades after methods of prevention were known, hundreds of thousands of American miners suffered and died from black lung, a respiratory illness caused by the inhalation of coal mine dust. The combined failure of government, medicine, and industry to halt the spread of this disease-and even to acknowledge its existence-resulted in a national tragedy, the effects of which are still being felt.

    The book begins in the late nineteenth century, when the disorders brought on by exposure to coal mine dust were first identified as components of a debilitating and distinctive illness. For several decades thereafter, coal miners' dust disease was accepted, in both lay and professional circles, as a major industrial disease. Derickson describes how after the turn of the century medical professionals and industry representatives worked to discredit and supplant knowledge about black lung, with such success that this disease ceased to be recognized. Many authorities maintained that breathing coal mine dust was actually beneficial to health.

    Derickson shows that activists ultimately forced society to overcome its complacency about this deadly and preventable disease. He chronicles the growth of an unprecedented movement-from the turn-of-the-century miners' union, to the social medicine activists in the mid-twentieth century, and the black lung insurgents of the late sixties-which eventually won landmark protections and compensation with the enactment of the Federal Coal Mine Health and Safety Act in 1969. An extraordinary work of scholarship,Black Lungexposes the enormous human cost of producing the energy source responsible for making the United States the world's preeminent industrial nation.

    eISBN: 978-0-8014-7155-1
    Subjects: History, Health Sciences, Political Science

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. ILLUSTRATIONS
    (pp. ix-x)
  4. PREFACE
    (pp. xi-xiv)
    Alan Derickson
  5. ABBREVIATIONS
    (pp. xv-xviii)
  6. CHAPTER ONE THEY SPIT A BLACK SUBSTANCE
    (pp. 1-21)

    On September 14, 1881, H. A. Lemen, professor of medicine at the University of Denver and president of the Colorado State Medical Society, presented a paper at the society’s annual meeting. Lemen offered for his colleagues’ edification the case of his patient James McKeever, for thirty years a coal miner in Scotland, England, and Pennsylvania. He noted McKeever’s “harassing cough,” “care-worn expression,” and other nonspecific symptoms. In contrast to such vague indications of chronic respiratory disease, he also announced the less ambiguous finding that this patient sometimes expectorated more than a pint of black liquid in a day. After commenting...

  7. CHAPTER TWO TWICE A BOY
    (pp. 22-42)

    Coal workers had an acute sense of the perils of their industry. They came to the dilemma of dust disease with a pragmatism driven by concerns very different from those of the biomedical community. Explication of pathogenesis meant far less to them than estimation of future chances for subsistence. Above all, miners tried to fend off and to accommodate growing respiratory impairment. Translation of impairment into disability and lost wages dominated rank-and-file thinking. Some miners tried to warn their sons to avoid the industry. William Keating sang this ballad at the turn of the century:

    When I was a boy...

  8. CHAPTER THREE THE ATMOSPHERE OF THE MINE IS NOW VINDICATED
    (pp. 43-59)

    An amazing reversal occurred after the 1902 anthracite strike. The working environment in both hard coal and soft coal came to be widely regarded as relatively harmless. In the assessment of leading representatives of medicine and industry, the ailment known as miners’ asthma became a small problem or no problem at all. The voices of a few dissenters went virtually unheard outside the ranks of the miners. The production of misunderstanding took considerable exertion and even some contortions. Nonetheless, by 1930 denial of coal workers’ respiratory difficulties had triumphed in the United States.

    Physicians and other professionals led the campaign...

  9. CHAPTER FOUR SHEEP-LIKE ACCEPTANCE OF HALF-BAKED STATEMENTS
    (pp. 60-86)

    Governmental scientific expertise failed to reverse the exoneration of coal mine dust in the early twentieth century. Instead, public health authorities helped whitewash black lung. It could well have been otherwise. After 1900, both new and old public agencies generated much more knowledge of social ills. The Progressive Era seemed to offer a propitious time to examine such matters as occupational disease in the coalfields.¹

    Governmental experts pursued several avenues of inquiry regarding respiratory disorders among anthracite and bituminous workers in the first three decades of the twentieth century. Most importantly, the U.S. Public Health Service and the U.S. Bureau...

  10. CHAPTER FIVE TO BITS
    (pp. 87-111)

    After 1930, redefinition of coal workers’ respiratory disease became more openly political. Throughout the depression years, battles over workers’ compensation legislation raged in coal-producing states. Economic hardships on both sides intensified this conflict: displaced miners waged a desperate struggle for subsistence amid the Great Depression; mine owners felt it imperative to avoid taking on an onerous competitive disadvantage in an ever more ruthless market. The contest over redistribution shaped not just the application of biomedical knowledge but its generation as well.

    An altered balance of forces made possible a renewed drive for social insurance for industrial disease. The resurgence of...

  11. CHAPTER SIX FRIGHTENING FIGURES
    (pp. 112-142)

    The path toward understanding of the health effects of coal mine dust became especially circuitous in the two decades after World War II. Decisions to privatize and to ignore the pneumoconiosis plague stimulated a campaign to illuminate the problem. After much delay, labor forced the state to conduct the epidemiological research crucial to revealing that a dust-induced disorder other than silicosis plagued the coal industry. A small group of physicians associated with the UMW Welfare and Retirement Fund (WRF) played a pivotal role in pressing the federal bureaucracy to generate knowledge.

    By the forties, the United Mine Workers was left...

  12. CHAPTER SEVEN EXTREME SOLIDARITY
    (pp. 143-182)

    At the end of the 1960s, an angry insurgency overcame much of the ignorance and misunderstanding created by decades of denial and obfuscation. The insurgent movement mobilized not only masses of dust-disease victims but newfound professional support as well. This community of challengers transformed public policy on coal miners’ respiratory disease.¹ By 1970, federal responsibility encompassed not only compensation but also the emerging priority of prevention.

    The lack of provision for disease victims propelled the initial phase of the reform campaign of the late sixies. Just as their inability to obtain public benefits had pushed miners toward private arrangements in...

  13. ENDNOTES
    (pp. 183-228)
  14. INDEX
    (pp. 229-238)