Document 65O9gRDB84Dp9BeBjkYq0ZG44

FILE NAME Cape Asbestos CAPE DATE 2003 DOC CAPE010 DOCUMENT DESCRIPTION Journal Article - Cape Asbestos Barking Health & Environment 1928-1946 American Journal of Industrial Medicine AMERICAN JOURNAL OF INDUSTRIAL MEDICINE 109-119 2003 Historical Perspective Cape Asbestos Barking Health and Environment 1928-1946 Morris Greenberg MB FRCP FFOM RCP Background The mining of chrysotile began in the province of Quebec in the late 1870s Twenty years later while annual exports were still measured in hundreds of tonnes serious and lethal effects were being reported in England and shortly after in France In 1913 after a number of years of operating in South Africa Cape Asbestos Company established a factory in Britain in Barking Essex Some 15 years later in 1929 the local Medical Officer of Health was seeing their asbestotic workers at his Chest Clinic the local Chest Hospital was investigating them and publishing their findings and the Coroner began what was to be a long series of inquests Methods Documents from the Institute of Mining and Metallurgy The Royal School of Mines Central Library of Imperial College The Porton and Barking Archives and documents obtained by legal discovery were utilized in preparing this historical perspective Results Despite complaints from the local authority Parliament was assured that there was no special incidence of disease at Cape Barking and that its exhaust ventilation was quite up to the general standard and constantly being improved Reports on the factory environment and information on the health of Cape's workforce that are available for the years 1928 193p4rovide a less sanguine view of the situation as was confirmed by subsequent health reports on its workforce Conclusions The case of asbestos is considered as a paradigm for the economic considerations that are considered to justify the perpetuation of unsafe and unhealthy occupations decisions with which medical opinion can be found to concur Am J. Ind Med 109-119 2003. '2003 Wiley Inc. KEY WORDS asbestosis United Kingdom history of medicine environmental hygiene respiratory protection INTRODUCTION Cape Asbestos began to manufacture asbestos products at Barking East Ham in 1913 it was not by accident that Boroughs to the east of London came to house hazardous and Extramural United Kingdom Contract grant sponsoThre Joseph Rowntree Charitable Trust Correspondence to Morris Greenberg 74 North End Road London NW11 7SY UK mail Gill Morris.Greenberg@btinternet.com Moris.Grenberg@btinternet.com Morris.Greenberg@btinternet.com Accepted 27 August 2002 DOI 10.1002 ajim.10147 Published online in Wiley InterScience www.interscience.wiley.com noxious processes In the latter part of the 19th century these enterprising local authorities would advertise in continental newspapers alerting manufacturers to the advantages of setting up locally these included a plentiful labor supply cheap local authority housing and as a special inducement freedom from the restrictions of the London County Council outside whose administrative boundary they were situated As a consequence they succeeded in attracting toxic and sweating industries yielding an unenviable legacy of human and environmental blight to be enjoyed by succeeding generations Cape did not come new to the field of asbestos when it set up in Barking but had the benefit of experience derived '2003 Wiley Inc. 110 Greenberg from its earlier activities in South Africa Further while manufacture of asbestos products had begun in the UK since about 1880 and annual imports of raw material were still measurable in hundreds of tonnes its severe adverse health effects on the workforce were not long in being reported there Deane 1899 Murray 1907 in France Auribault 1907 and in Italy Scarpa 1908 No useful lessons would seem to have been learnt by Cape or if learnt put to good effect From the inception of the UK asbestos industry to the first reporting of disease took 18 years 1880-1898 from the start up of Cape to the reporting of disease in its workforce took 15 years Cape was not operating in a vacuum even in the days before the trade associations were established For example it was in regular contact with Turner Brothers Asbestos Company TBA of Rochdale at Trade Meetings and by correspondence sharing health reports and experience On the 8 April 1932 the Company Secretary of Cape wrote to W.W.F. Shepherd one of the directors of TBA discussing the vexed problem of perceived misdiagnoses at death by asbestosis in workers who happen to have had pulmonary tuberculosis and whom he considered did not have asbestosis at all He felt that this ought to be taken up formally with the Home Office Shortly after on 2 June 1932 R. H. Turner another director of TBA sent Cape a copy of a report by a Dr. Pooley which Cape not surprisingly did not consider very helpful as it consisted of 48 lines of typescript only 11 of which dealt with asbestosis nevertheless they asked if they might be informed of any further information that came to hand at Turner and Newall Asbestos T & N With the publications arising from studies of their workforce and the American Courts throwing open the archives of T & N Chase 1990 their apologists have maintained that the company has been victimized as a result of its superior record keeping and openness implying that it was no worse than other asbestos companies and better than many While such pleas are no excuse for acts of omission records available for Cape Asbestos were reviewetdo see how it dealt with its responsibilities towards its workforce THE MEDICAL OFFICER OF HEALTH FOR BARKING URBAN DISTRICT COUNCIL UDC REPORTS In minutes of Barking UDC for the period 1927-1928 Page 72 approval was noted for the appointment of Dr. C.L. Williams as their Medical Officer of Health MOH who seems to have wasted no time in writing in his first annual report for 1928 to the Council under the heading of Asbestosis During the year my work at the Chest Clinic has drawn my attention to a particular disease which while resembling consumption in many ways is not due I feel sure to the germs of Tuberculosis that is consumption As Medical Officer of Health the possible asso- ciation of this disease with industrial life has had my attention and certain steps have been taken in the matter I am hopeful that our experience in Barking when correlated with that in other similar towns may help clear up a somewhat difficult and serious problem In the general introduction to his 1929 report to Council he noted 66 I have had the greatest help from my colleague Dr. Burton Wood and also from Dr. Gloyne is a pathologist at the Victoria Park Chest Hospital and we have established that many people in Barking are suffering from the disease of the lungs due to the inhalation of asbestos dust Somewhat late the Home Office on the 17th March 1930 issued a memorandum on the subject after you on the finding of our personal experience had made representations to them Williams devoted three pages of the main text of the 1929 report to the subject of asbestosis which included the following In June 1929 an interim report was circulated to members of the Council at the request of the Juvenile Employment Committee In this interim report a table was given showing that of nineteen cases of persons suffering from some pulmonary disability and who had been exposed to asbestos dust there was sufficient evidence to warrant a diagnosis of asbestosis in eight no sufficient evidence to warrant a then diagnosis in nine whilst there were two cases at the time in question awaiting further examination The same report included five conclusions that in William's opinion had been established up to that time 1 That people working in asbestos factories inhale asbestos dust which can be found in the substance of the lung proper and in the sputum which is exuded from the bronchi of the lung 2. That the presence of this asbestos dust in the lungs produces a definite disability adversely affecting earning capacity and decreasing the expectation of life Cape Asbestos Barking 1928-1946 111 3 That is possible for an exposure to asbestos dust over a period of six months to produce a definite disability lasting over many years 4 That there is not sufficient evidence to warrant an opinion on the question of the possible increased incidence of tuberculosis in persons who are suffering from asbestosis 5. That these conclusions indicate that the conditions under which certain of these cases have been working have been such as to permit the inhalation of asbestos dust with consequent pulmonary disability He concluded with the observations << we have at the end of the year 23 cases investigated 9 of which show sufficient evidence to warrant a diagnosis of asbestosis 10 of which showed no sufficient evidence at that time to warrant a diagnosis of asbestosis and 4 of which were waiting further investigation ... During the year 1929 there have been three deaths in Barking attributed to asbestosis ... Another case of asbestosis died during 1929 and the cause of death was given as Bronchitis Of course this notification is quite correct but in my opinion it does not represent the whole truth In his 1930 report to Council Williams expressed high hopes for the asbestos regulations stating The passing of the Workmen's Compensation Silicosis and Asbestosis Act 1930 should in time do much to mitigate the lung trouble from which many persons in Barking suffer and which is provoked by the inhalation of asbestos dust It will however take many years for any substantial improvement to be felt It is not unreasonable to suppose that for the next fifteen years we shall be getting deaths from asbestosis among people whose lungs are already affected In 1931 Williams restricted himself to reiterating his opinion that insufficient time had elapsed for the 1930 Act to make itself seriously felt and in succeeding years his reports were silent on the subject of asbestosis and he observed The work I have been carrying on in this connection in relation to asbestosis convinces me more than ever we shall never get an efficient complete medical service in England until the whole of the public medical services are united under one Ministry The fact that the health of workers in the factories is under one Ministry and the health of these same workers outside the factories is under another Ministry is essentially bad By that year a total of 57 cases of asbestosis were reported as having been diagnosed at the Victoria Park Hospital 12 complicated by pulmonary tuberculosis 2 qui- escent and 10 active Wood and Gloyne 1931 A study of the minutes of Barking UDC and its various committees over the years 1927 193t6hrew up no further references to asbestos other than a request from Cape Asbestos for permission to use asbestos cement soil pipes to which they responded We recommend that this type of pipe be not approved LOCAL GOVERNMENT CENTRAL GOVERNMENT AND CAPE ASBESTOS Apart from the implied criticism in their comment of how late the Home Office asbestos memorandum had been issued official reports of the Council provide no evidence of friction between a Council alarmed by its perception of the severity of the asbestos problem and the official sanguine attitude of the Factory Department of the Home Office as characterized by their Minister's assu- rance to Parliament The London Borough of Barking and Dagenham archi- ves do not contain either Dr. Williams or the Council's or its committees papers and correspondence personal communication Heritage Services Manager however some unpublished papers relating to Cape Asbestos Barking at that period have survived providing evidence that all was not sweetness and light between Barking UDC and the Factory Department over Cape In 1928 The Factory Department in the persons of Dr. E.R.A. Merewether H.M. Medical Inspector of Factories and Mr. C.W.Price H.M. Inspector of Factories started clinical and environmental studies of the asbestos industry In 1929 their seniors tried to speed up the reporting of their conclusions from the study in response to Barking's alarm about the health of Cape workers The Education Committee on Barking Town Council which included in its concern obtaining employment suitable for young persons had passed a resolution on the Employment of Juveniles and was proposing to send a deputation to wait on the Secretary of State The MOH alerted the Home Office to the sequence of inquests that had taken place on Cape workers and Price was recalled from Christmas leave to accompany a Medical Inspector to an inquest on 23 December 1929 Williams met and discussed his Cape Asbestosis data at length with Merewether who reported to the Senior Medical Inspector 112 Greenberg ...the impression I gained during this long interview This impression is that he is obsessed with the subject especially from the compensation point of perhaps because of pressure from his Labour Council However there is no mention of compensation in Williams annual report for 1930 in which he informed the Council We still continue to keep the dossiers of these patients up to date in order intensively to study the progress of the diseases with the object of finding out everything possible It will readily be recognized that it can only be by finding out everything possible that we can hope to build securely a scheme for preventing the future incidence of asbestosis In the event Williams appears to have discontinued surveillance of asbestosis in East Ham which was anyway the remit of HM Factory Inspectorate His MOH responsibilities were onerous as he was responsible for an overall population of 47,620 with pressing problems including maternal and infant health the health of schoolchildren running a diagnostic and treatment clinic for tuberculosis and the diagnosis treatment and control of infectious diseases With the district having attracted a young population from the East End of London the MOH would have been fully occupied with their immediate care and in planning for the demands of a population increasing by year In contrast to those physicians who successively were persuaded that the measures adopted by the asbestos industry would virtually eradicate disease Murray 1907 Lanza 1939 Wyers 194610 Williams concluded that the 1931 regulations would only mitigate the health problem and that it would be many years before improvement would be seen In 1930 he could list 27 cases that he had investigated for asbestosis of which sufficient evidence was found to warrant a diagnosis of asbestosis in 12 cases with further examination awaited in 5 cases This occupational health problem serious as it was has to be seen in the context of his priorities for Barking's other public health problems In that year while four persons were certified as having died of asbestosis among 486 hospital admissions for infectious diseases 17 died from diphtheria and scarlet fever and there were 36 deaths on his Tuberculosis Register of 737 cases Registrar General 1931 Although Williams made no further comments on the subject of asbestosis in his reports for a number of years he continued to assist the Victoria Park Hospital with their investigation of the diseases of asbestos workers and his contributions were duly acknowledged by Wood and Gloyne in their publications After Williams ceased to tabulate deaths at Cape the Factory Inspectorate proved very attentive to mortality at the factory for several years Table ) THE FACTORY INSPECTORATE AND CAPE A question had been put to the Home Secretary on 12 December 1929 asking him whether he was aware of yet another inquest on an employee of an asbestos factory at Barking who had died of asbestos poisoning and whether he was aware that asbestosis is prevalent especially at Barking The reply prepared for him concluded with the reassuring statement,,that " the investigation did not disclose any special incidence of the disease at the Barking works where the exhaust ventilation which is TABLE I. From a Manuscript Entitled Fatal Cases of AsbestosiastCape Asbestos Co. Barking Which Have Com to te he Knowledge of the Factory Department Duration of No. death Name Sex Age Occupation employment years 1 30.11.29 WH M 47 Weaver 14 2 19.12.29 BS F 22b Spinner 14 3 30.12.29 MP F 50 Asbestos worker 19 4 27.6.30 ES F 37 Spinner 5 11.10.30 FB F 30 Mattress maker 6 13.10.30 SF M 42 High pressure jointing Dept 7 2.2.31 EL F 31 Mattress maker 8 4.2.31 ES F 46 Spinning room 12 6.10 93 525 15 Anonymized by author Probably a clerical error for 32 internal evidence and checking against Dr. Williams notes Interval between cessation of employment & death 1 year 6 months 3 years 3+ 3+ years 6years 6years 4 8 years 2 years Ceased work May 1928 Ceased workin1926 Ceased workin Nov. 1926 Ceased work Nov. 1929 Ceased work Nov. 1929 Ceased work on 2 Feb. 1923 Ceased work Jan. 1929 Cape Asbestos Barking 1928-1946 113 the chief means of prevention is quite up to the general standard and is constantly being improved This may have been based in part on a visit some three months previously 15 August 1929 by the Manager of Cape Asbestos Barking to Dr. Middleton a distinguished Medical Inspector and an expert in the pneumoconiosis who informed him of proposals for localized ventilation for some of the machinery including opening spinning and weaving as well as innovation to reduce the dustiness of bagging asbestos The reassuring ministerial reply was quite at variance with the evidence The Factory Inspectorate and others were to pay a lot of attention to Cape over the next few years and to find it seriously wanting The order of Cape's problem can be inferred from a dust count survey carried out on 23 September 1930 which revealed an unsatisfactory situation Table II A weaver under best conditions was exposed to 406 particles which in terms of particles per cubic foot is several orders greater than those were to be reported for miners studied by McDonald et al 1980 and for weavers studied by Dreesen et al 1938 Merewether after he completed his studies at asbestos factories in Lancashire and in London returned to his office in Glasgow but continued to take an interest in Cape On 23 October 1930 he wrote to Mr. Field in the Home Office referring to two named Cape employees and asking whether either had since died he also inquired whether there was any further information on three other Cape cases The letter was passed to Middleton who replied that he only had information on one of the cases Table I No. 6 and enclosed a copy of a report on the inquest held and drawing his attention to the work history of the deceased the only constantly heavy exposure occurred 9 years ago namely 4 months in the fiberizing department Probably his trouble was determined there and then and subsequently the dust from the cards about 10 yards from which he worked would aggravate his condition ... On 25 February 1931 Mr. H.J.Muggeridge a LabourMember of Parliament wrote to a Labour Home Secretary Dear Clynes Referring to your letter of the 19th I am sorry to trouble you again but the matter of this Barking factory is so urgent that I want to put a few more facts that have come to my knowledge before you rather than ask a question in the House TABLE II Copy of Typescript 00000351 0881 Asbestos Committee Dust counts at Cape Asbestos Coy 23/9/30 Emptying chamber 712 particles 575 particles 1,448 particles c.c = sweepings Average = 912 particles c.c Burst of dust through sack as shovelful of asbestos was dropped in 2,356 particles Cardroom Breathing level of Card Tenter condenser 563 particles Weaving cloth exhaust off 1,057 particles Weaving cloth exhaust on same loom as No. 4 406 particles c.c Spinning record not identified with 50 c.c. sample McDonald et al 1980 approximated 6.6 millions of particles foot to 20 fibres c.c. While the conversion from cubic foot to c.c is simple deriving the equivalent of particles per c.ct.o fibres per c.c. has not been attempted as it is fraught with consider- able uncertainties arising from different environments different sampling strategies and methods of measurement I am assured by a very credible witness that special preparations are made when your Inspectors go to the factory to conceal from them some of the worst features of the dust evil from which so many of the employees suffer I am told for instance that as soon as the office there knows that your Inspectors are coming instructions are given to stop the machines so as to lay the dust and three men with the aid of a vacuum cleaner are put to the work of removing all the signs of it from the girders and principals in the machine shop The firm informed your representatives that they spent 2,000 on a dust removing plant But this is only in one section of the building There is for example a carding department where many girls are employed where the dust is even worse than in the actual machine room but where no dust- removing plant has been installed Mouthpieces are issued to the girls and other employees but I have seen one of these and it consists only of a piece of calico with two pieces of tape for tying round the head So far as I can see it would make breathing after a time prac- tically impossible would not act as a filter and 114 Greenberg in the case of girls whose lungs have already been affected some times only half left it is impossible for them to use it Furthermore the company even now has several employees away affected by asbestosis and pays them no part of their wages One man named deleted who has been in their employ for 7 or 8 years and has when specially requested worked late in the unhealthy atmosphere of the factory has now become so affected that he has been away for 6 months certified as suffering from the disease and is getting not a penny from the Company but is left with his family to subsist on the sick illegible I am convinced from all that I am told that your Inspectors do not know the real facts about this place and I hope you will send one or two down with special instructions and perhaps will allow me to accompany them to satisfy myself as to the condition of things there There have been eight of these painful deaths in the last 14 months as well as a long list previous to that period while the health of the whole staff appears to be in a bad state Please let me know what can be done to take prompt steps to deal with this firm which I am sure is putting off as long as it can the action your department will want them to take This letter was passed to Merewether by the Chief Inspector for his observations which he gave promptly in a memorandum on 3 March On the matter of the Company preparing for Inspectorate visits he replied It is true that on special occasions and in order to make the visit an effective one notice has been given to the firm that a Technical Inspector Medical or Engineering proposes to visit On other occasions visits have been paid without notice and I can state from my own experience that the time spent in the office would not in any way permit preparations of the character suggested to be made in the Works operation for many years and is not up to modern standards I am not clear what is meant by the machine room but it may refer to the disintegrating and settling plant At these the exhaust system is in use and while to some extent efficient and in advance on old methods it is realized that improved arrangements can be made and these will have to be effected to meet the requirements of the draft regulations ... I am afraid I am not by any means satisfied that the general standard of dust suppression is sufficient to prevent cases of asbestosis developing This is not in any way belittling the extensive and continuous efforts the firm has made to suppress dust but in my opinion having regard to the very high standard required if new regulation cases are to be prevented from occurring In response to Muggeridge's note on the mouth guards provided to the girls he avoided the issue and reported One very satisfactory point was the really ex- cellent use made of the Mark IV respirator REGINALD TAGE INVESTIGATES CAPE An enthusiastic amateur with no mandate succeeded in insinuating himself into the Cape factory to investigate the diseases of asbestos workers Signing himself Reginald Cosburn he wrote to the Trades Union Congress TUC on 23 January 1932 informing them that since 1929 autopsies had been performed on 11 persons who had worked at Cape Tage 1932 Their average length of employment he stated was 8 years and the average period between starting work and death was 11 years He reported that the average number of workers in 1930 were 218 and that the total of present and past employees known to be suffering from asbestosis to be 160 14 VICTORIA PARK HOSPITAL'S STUDY OF ASBESTOSIS On the subject of Ventilation his comments included In the process of spinning and weaving this firm has made greater progress in dust removal than any other firm and the plant which has been installed is most efficient The exhaust ventilation for the carding machines has been in Because of the strategic position of the Victoria Park Hospital from the late 1920s onwards Dr. S. Roodhouse Gloyne and Dr. W. Burton Wood were well placed to study and report on asbestos associated diseases at Cape and neighboring asbestos using enterprizes producing some of the classics of asbestos literature Their findings would also have been made more widely known from the proceedings of Cape Asbestos Barking 1928-1946 115 the local Coroner's Court that were regularly reported in the local newspapers and occasionally in the nationals CAPE AND PERSONAL RESPIRATORY PROTECTION By 1930 there were a number of dust masks in use which filtered air to varying degrees but they were recognized as being of severely limited value in protection being intolerable for prolonged use and inefficient against heavy concentrations of fine dusts such as asbestos REGINALD TAGE'S MASK The enterprising Mr. Tage having insinuated himself into the Cape factory in 1930 also established informal associations with the TUC and with its medical advisor Dr. Legge and with Dr. Gloyne at the Victoria Park Hospital inter alia informing them of cases of disease at the factory Wikely 1992 Greenberg 1993 In 1931 among his various initiatives was the design of a mask for asbestos workers which he did using a framework said to have been made by Siebe Gorman with a filter he had assembled using cellu- lose fabric foolishly testing it out on himself in the dust chamber at the factory This development was helped by the cooperation of the Assistant Works Manager who he said had asbestosis but he thought that the Manager would not give it a fair trial After providing further valuable and unsolicited service to the TUC Tage disappeared from the asbestos stage Porton In the period after the end of First World War and before the build up to the Second the Chemical Defence Experimental Establishment Porton while it had not been beaten into a ploughshare nevertheless responded to requests for assistance with civilian problems including protection against industrial dusts The physicians on the Medical Research Council's Committee on Industrial Pulmonary Disease notwithstanding Porton with its engineers physicists and physiologists were well equipped for the task and were to develop several models Their Mark IV respirator was to be tested at Cape and was used for a number of years widely in industry until it was appreciated that even when properly fitted and maintained and tolerated it was of limited value in exposure to high dust concentrations Dr. W.R. Jones Initiative On the 29 May 1934 Dr. Middleton wrote to Dr. Bridge that Dr. W.R. Jones had informed him that an air compressor had been installed at Cape and an apparatus ready to be worn by a man sawing insulation section This was referred to Mr. C.W. Price who visited Cape and reported to the Senior Engineering Inspector He was very approving of the efficiency of the mask and the fresh air supply reporting that when a pad of cotton wool saturated with eau de cologne was pressed against the wearer's cheeks the odor could not be detected by him He was however critical of the exhaust ventilation in use which he described as ill applied and inefficient Improvements should be possible but dissemination of fine dust into the atmosphere he considered almost inevitable Price reported Dr. Jones to advocate the widespread use of such masks to all workers subject to even low concentrations of dusts of silica asbestos etcetera and remarked that while the advantage to the worker in this particular department was indisputable he considered that it would be difficult to overcome the inertia of both employers and employed generally supposing the wearing of such masks were made the rule Dr. Jones was sceptical of the value of exhaust ventilation remarking that even where it is very efficient drawing air past the worker charges it with fine dust some of which must be inhaled Price considered that if the masks became relatively popular the effect might be to detract from the use of exhaust which he considered an effective safeguard Dr. Bridges wrote to the Chief Inspector on 16 July 1934 about the use of fresh air breathing apparatus at Cape agreeing Price's opinion that masks were no substitute for exhaust ventilation and asserting that they were more or less impracticable for factory processes He also mentioned that J.W. Roberts of Armley acting on his suggestion had designed a small facepiece with compressed air supply for the protection of workers spraying asbestos coatings on walls On 20 December 1934 Dr. Bridges wrote to the Chief Inspector of Factories about a visit he had made jointly with Dr. Middleton to Cape in connection with their use of air fed 17 respirators These had been installed by Siebe Gorman at the suggestion of Dr. W.R. Jones and had been in use by a certain number of operatives for the past 10 days Bridges appreciated the benefit if worn constantly but saw operatives disconnecting the line on several occasions even during his brief visit The light facemask was preferred to the cumbersome mask but there were problems of access at some sites due to tethering of the worker by the air line In his opinion the Manager was thought to be alive to the limitations of this form of protection and not regarding it as an alternative to dust removal plant Dust sampling was dis- cussed and a trial of the Mark III respirator from Porton Bridges concluded " would say that the firm have undoubtedly done a great deal of work in the removal of dust Unfortunately in carrying out experiments- some of which have been unsuccessful tion to some details have been overlooked For 116 Greenberg example an automatic plant designed for making slabs proved unsuccessful and on returning to the old plant the exhaust ventilation had not been connected up again This I am glad to say has now been remedied I understand that there is a question of taking proceedings against the firm for certain irregularities but I would submit that in view of the steps taken by the firm it would be undesirable to take such action Further we have received every assistance in testing out the various types of respirators submitted by Porton and they are willing to carry out future tests The textile departments were said generally speaking to be satisfactory though they found inadequate draught at one site a hood to be too far away in another and in front of one large loom the hood had been removed and not replaced Boiler compositions A fan had been removed from a mixer and moved to a new site with no replacement giving rise to very dusty conditions The hood was too high above the weighing machine to be effective the bag filter was not separated from the workroom and permeable sacks were in use Powder On the 12 December 1934 Mr. Price and Mr. Lowe conducted a day long inspection of Cape Barking as instructed by the Chief Inspector and reported on 24 December 1934 They found what they described as a number of somewhat serious irregularities which they presented in considerable detail including the following observations in a report for whose length they were apologetic Exhaust arrangements were crude and makeshift and a swivelled hood was turned out of the way when feeding material into the hopper There were accumulations of dust on floors and apparatus In view of the compliance disclosed by their visit a short report was sent to the Chief Engineering Inspector dealing with the past history of the matter and recommendations as to the action to be taken Slabs A POSTSCRIPT FROM Dr. WYERS Slabs were being made by hand with exhaust being provided by crude hoods under which workers often had to stand although at the time of the visit they wore respirators Paper lined sacks were placed on the floor but were not exhausted On further investigation they found that there was no exhaust as the fan had been disconnected a few weeks previously Sawing A new band saw had been provided with powerful exhaust at several hoods which while a distinct improve- ment on two older saws still allowed dust to escape near the breathing position The extraction at the older saws was still inadequate and one hood was missing Efficiency had been reduced by the neglect of the bag filter which had last been cleaned 3 days ago Debris had collected within the hoods and on the surrounding floor and plant Disintegrators All disintegrators were hand fed with some workers being stationed within the chambers At Mr. Lowe's previous visit on 7 December he found no exhaust operating at the feed opening and that blow outs occurred This had been remedied by switching to a more powerful motor but there was leakage of dust from joints of overhead trunking On the floor crude material was found in boxes and waste was in heaps In keeping with Dr. Williams prophesy the statistical 20 chapter of an MD thesis written some 10 years later shows the number of known deaths at Cape Barking from asbestosis alone or complicated by other diseases such as tuberculosis and carcinoma to have grown to 98 Wyers 1946 The mean age at death was 34.9 years and the average exposure to asbestos had been 7.6 years range 24.0 0.75 years which was not significantly different from Tage's observation in 1932. Three years later the total number of known fatal cases at Cape were given as 115 Wyers 1949 Unlike certain other physicians he did not make light of asbestosis noting that the diagnosis was ... ... in most cases a warning of dissolution in the not very distant future Further in the course of his thesis he wrote 66 evidence already accumulated seems to favor a causal connection between asbestosis and pulmonary cancer and humanitarian motives may decide the public conscience not to wait for scientific proof before insisting on more stringent safeguards against dust inhalation21 Nevertheless he concluded that much as it has been held that the treatment of tuberculosis was financial in a similar manner this was true for the treatment of pulmonary fibrosis The management at the time for tuberculosis involved expenditure for providing rest an equable and clean environment and a nutritious diet whereas in the case of asbestosis the grim reaper was not to be bought off Edward the Seventh Cape Asbestos Barking 1928-1946 117 asked of tuberculosis If preventable why not prevented In the case of asbestos Wyers was aware that with the limitations of engineering control prevention would require its use to be abandoned This he considered was not an option on two grounds 1 No one would suggest the abolition of coal mining or deep sea fishing on account of their dangers because they are vital to the welfare of the nation 2. Indeed there is scarcely any industry which does not depend to a more or less degree upon asbestos take this valuable mineral away from a nation therefore would put back that nation's capacity by half a century a blow which this country at any rate could not survive This treatment of the problem of asbestos might be seen as a paradigm for how agents and occupations responsible for substantial burdens of disability and death were dealt with at that time Wyers was writing at a time before complete demobilization when the rationing of food clothes and furniture introduced in the Second World War was still in operation there were shortages of fuel and a flourishing peace economy remained to be restored Despite an awareness of the awfulness of death from asbestosis and from lung cancers and of the frequency of these conditions in his factory he justified the continued use of asbestos on economic grounds a sentiment with which the physicians examining his thesis That legislative measures have proved generally effective in the control of asbestosis presumably were in sympathy It was left to a later generation to find the hazard of asbestos unacceptable and its use dispensible ACKNOWLEDGMENTS The research on which this paper was based was sup- ported by a grant from The Joseph Rowntree Charitable Trust The author is particularly indebted to the following for their assistance Michael O'Connor in providing access to documents obtained by legal discovery librarians of the Institute of Mining and Metallurgy London for their help in identifying historic contributions to the transactions of their Institute to librarians of the Royal School of Mines and archivists in the Central Library Imperial College for searching their records Mr. G.B. Carter Consultant Archivist C.B.D.E.Porton for providing information on its early history Meredith Myers and staff at the Valance Park Library for access to Barking archives NOTES 1. Dr. J.S. Pooley was the Director of a clinical laboratory in Rochdale who presumably was commissioned by T & N to produce a report on asbestosis He sent to Mr. Turner on 24 May 1932 what he described in a covering manuscript letter as << a short statement of the present situation pathologically speaking in the group of dust diseases Much has of course been left out and only the bare facts are given still I hope it will serve your purpose Obviously there would be only needless expense in your initiation of private research to cover already known ground This was not the end of negotiations Dr. Bateman Turner's medical advisor arranged for Mr. Turner to accompany him to a meeting at Dr. Pooley's laboratory on 20 May 1932 Williams was not the only Tuberculosis Officer to make a mark in the early years of asbestosis Dr. Merewether who was to conduct the first industry survey had been one before joining the Factory Inspectorate as had Dr. C.L. Sutherland the first Chief Medical Officer of the Silicosis and Asbestosis Medical Board Although generally applied to pulmonary tuberculosis classicist physicians used the term phthisis to include other wasting conditions Before Koch's discovery keen observers discriminated between the toxic febrile phthisis of consumption and that fibroid phthisis associated with the inhalation of dust as by potters masons flint knappers and cutlery grinders The City of London Hospital for Diseases of the Heart and Lungs Victoria Park East had originally been established as a Chest Clinic in the City in the 19th century by Dr. Peacock a pioneer in the field of occupational dust diseases of the lung With the help of fellow Quakers he moved it to Victoria Park in the East End of London and developed it as a hospital Greenberg 1992 Inhabitants of East and West Ham fell into the City of London Hospital catchment area where their records contributed to the early knowledge of asbestosis though some of Cape's workers preserved an allegiance to The London Hospital and contributed to our early knowledge of mesothelioma in asbestos workers My attention was drawn by Dr. B. Castleman to a news story that appeared in the Barking Advertiser Mar. 15 1947 entitled The Tragic Toll of Asbestosis This cited Williams report for 1945 in which he noted that his 1930 prediction that there would be a lot of deaths from asbestosis for 15 years was borne out by the bad state of health of Cape workers in 1945 He further commented " am not in a position to assess the essential necessity of asbestos and its products to our national economy butI am firmly of the opinion that it is a deadly and dangerous commodity and that unless those who are charged with this responsibility of safeguarding the health of the people in the industry can give positive assurances that they have now after all these years removed every possible danger the processing of asbestos except in so far as its products are essential to our national economy should be barred 118 Greenberg This opinion was not peculiar to Williams At an inquest on a worker dying of asbestosis in Leeds Dr. H. De Carle Woodcock a lung specialist was reported as complaining that he had no opportunity to investigate cases of diseases reported in factories He was aware that the Factory Department can enter such factories but stressed that local organization should also share responsibility and have power of entry Manchester Guardian March 31st 1928 Today 70 years later the position is much the same as in Williams and Woodcock's time The use of these pipes is not specified but the descriptor soil a euphemism for human excrement is suggestive The reason for rejection of asbestos cement pipes for this purpose is not given but conceivably might have been based on uncertainty as to its technical qualities as compared with those of cast iron and glazed earthenware Murray on questioning about his case report stated that with the subsequent improvements made by manufacturers it is unlikely that many more cases would be seen Murray 1907 After a study of workers he claimed that asbestosis was clinically milder than silicosis and that there had been no fatalities Lanza et al 1935 and subsequently considered that with the dust control vigorously carried out by manufacturing companies there may be little opportunity for clinicians to become familiar with asbestosis Lanza 1939 17. Messers Siebe Gorman and Company were active in the design and manufacture of respiratory protection equipment As a result of being bombed out twice during World War II and moving to South Wales they have no records of their collaborative work with Dr. W.R. Jones personal communication Mr. S. Jones 18. Dr. W.R. Jones Reader of Mining Geology at Imperial College London while claiming no originality had advocated masks for gold miners exposed to silica dust with the provision of clean air under pressure either from a compressed line or from light compressed tanks There is no record of how he became involved at Cape 19. It would not be unreasonable to conjecture that this intended action might be civil servant for taking proceedings against the firm it may have been this action that Dr. Bridges advised against in his letter of 20 December to the Chief Inspector In common with the other major manufacturers for all the harvests of disability and death at Cape and the repeated findings of unsatisfactory environmental hygiene conditions up to the moment of closing of the Barking factory in 1968 Cape was to be little troubled by Factory Inspectorate prosecutions 20. There is no way of ascertaining how comprehensive these data were Wyers was aware of reasons why they might not have been definitive 10. In 1946 Wyers successfully defended his MD thesis entitled That legislative measures have proved generally effective in the control of Asbestosis 11 A copy of the reply given was shown to Merewether who merely acknowledged a sight of it Whatever reservations he might have had suggesting a correction to a Ministerial reply already given to a Parliamentary Question is not to be contemplated lightly 21. Although early in the 1931 asbestos regulations were recognized as being seriously flawed they were not to be reviewed until 1969. It was not until 1980 that the lung cancer hazard was taken into consideration in determining the hygiene standard REFERENCES 12 A copy of the reply given was shown to Merewether who merely acknowledged a sight of it Whatever reservations he might have had suggesting a correction to a Ministerial reply already given to a Parliamentary Question is not to be contemplated lightly 13. Reference to the use of the Mark IV respirator in 1931 seems anachronistic as late as 20 December 1934 the Senior Medical Inspector Dr. J.C. Bridges in correspondence with the Chief Inspector relating to Cape's use of respiratory protection devices refers to the Manager being asked to try out Mark III respirators when received from Porton 14. There is no evidence of where he obtained these data but when compared with Wyers 1946 they appear plausible 15. This opinion was given at the inquest on a worker dying of asbestosis in Leeds by Dr. H. De Carle Woodcock see footnote 3 16. There is no record other than Tage's reported assertions either in Siebe Gorman's archives or at the Patent Office Auribault M. 1907. Sur l'hygiene et la securite des ouvriers dans la filature et tissage d'amiante In Annual Report of the French Labour Inspectorate for 1906 Chase Manhattan Bank 1990. A large number of photomicrographs of documents obtained by legal discovery from the archives of Turner and Newall in the case of The Chase Manhattan Bank N.A. against and N plc United States District Court Southern District of York 87 Civ.4435 VLB KAR have provided information relating to other asbestos companies in England and America Deane L. 1899. In Annual report of the Chief Inspector of Factories and Workshops for the year 1898. London HMSO Dreesen WC Dallavalle JM Edwards TI Miller JW Sayers RR Easom HF Trice MF 1938. A study of asbestosis in the asbestos textile industry Public Health Bulletin No. 241. Washington US Government Printing Office Greenberg M. 1992. Thomas Bevill Peacock M.D. F.R.C.P Pioneer occupational and environmental physician Am J Indust Med 443 447 Greenberg M. 1993. Reginald Tage A UK asbestos prophet postscript Am J Ind Med 521-524 Lanza AJ 1939. Silicosis and asbestosis In Lanza AJ Goldberg JA Editors Industrial hygiene New York Oxford University Press Cape Asbestos Barking 1928-1946 119 Lanza AJ McConnell WJ Fehnel JW 1935. Effects of the inhalation of asbestos dust on the lungs of asbestos workers Public Health Rep 50 1 12 McDonald JC Liddell FDK Gibbs GW Eyssen GE McDonald AD 1980. Dust exposure and mortality in chrysotile mining 1910 7B5r J Ind Med 11 24 Murray HM 1907. In Departmental committee on compensation for industrial diseases Minutes of evidence Appendices and Index London Wyman and Sons Registrar General 1931. Registrar general's statistical review of England and Wales for the year 1930. London HMSO Scarpa L. 1908. The asbestos industry and tuberculosis In Lucatello L editor Proceedings of the 18th congress on internal medicine held in Rome October 1908. Rome Italian Society of Internal Medicine 1909 359. in Italian Tage RC 1932. Typescript copy of a letter to Mr. Smyth at the TUC dated 23.1.32 cited by Wikeley 1992 and Greenberg 1993 Wikely NJ 1992. Asbestos and cancer An early warning to the British TUC Am J Ind Med 449 454 Wood B Gloyne SR 1931. Pulmonary asbestosis complicated by pulmonary tuberculosis Lancet 954-956 Wyers H. 1946. That legislative measures have proved generally effective in the control of asbestosis A thesis presented for the degree of MD Glasgow Wyers H. 1949. Asbestosis Postgrad Med J 631 636831 638