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FILE NAME Industrial Hygiene Foundation IHF DATE 1995 DOC IHF035 DOCUMENT DESCRIPTION Journal Article - Workers Industry and the Control of Information Silicosis and the Industrial Hygiene Foundation Workers Industry and the Control of Information Silicosis and the Industrial Hygiene Foundation DAVID ROSNER and GERALD MARKOWITZ Gwweeraore N January 1933 Donald Cummings a research sci- entist at the Saranac Laboratory an independent re- search facility in upper New York State received a letter from M. D. Harbaugh the Secretary of the Lem 2 Lem State Zinc and Lead Ore Producers Association an industry trade group in Missouri Kansas and Oklahoma Harbaugh informed Cummings that the Association had decided to deny him the right to publish his study on Silicosis Oc- curring in the Lead and Zinc Mines of Ottawa County Oklahoma The data collected at a clinic organized by the mine owners in con- junction with the Metropolitan Life Insurance Company and the U.S. Bureau of Mines reported on the prevalence of this disabling and often threatening occupational lung disease among the area's miners Harbaugh's point was simple Cummings could not publish the results because they were potentially damaging to the lead and zinc mine operators of this district There are now pending suits for hundreds of claims for total disability for occupational diseases Harbaugh informed Cummings If these suits were lost the mining companies now in existence here would have to bear the burden of paying for disabilities Certainly Harbaugh wrote Cummings could see what a brief your paper would be . . . The industry would be entirely wrecked if it were saddled with the care of everyone who might be persuaded to take action against it on the grounds of dis- ability from silicosis Cummings was dismayed that his years worth of data on which Saranac Laboratory had spent several thousands of dollars was to be wasted He appealed to Anthony Lanza a prominent in- vestigator who headed the occupational disease program at Metro- 29 J. Public Health 1995 2P9o-l52i89c-y58 ROSNER & MARKOWITZ SILICOSIS 3I range of possible solutions and the control of scientific data How can technically trained individuals avoid real or perceived conflicts of interest At what point does the ostensibly disinterested goals of pro- fessionalism conflict with the interest of the sponsoring organizations How and under what circumstances does the sponsorship of research become important in evaluating the conclusions of technical studies The Industrial Health Foundation an sponsored group headquartered in Pittsburgh has played a critical historical role in shaping the nation's agenda regarding industrial disease It has been involved in a broad series of investigations into the causes results and policy implications of a wide range of occupational hazards From its start as the Air Hygiene Foundation during the Depression it has portrayed itself as an sponsored agency that depended upon detached disinterested professionals and experts to develop effective programs to address occupational disease As an organization that brought together professional industrial hygienists business groups government officials academics and researchers it serves as a way for understanding the intertwining of industrial and academic agendas Throughout its history it has sponsored colloquia monographs and research into a host of occupational hazards On the one hand it has presented itself as impartial seeking to develop policy and carry out research in the public interest On the other hand it was begun by and has been closely associated with industries directly affected by positions it has taken THE SOCIAL AND ECONOMIC CONTEXT OF THE SILICOSIS CRISIS During the early 1930s silicosis a chronic industrial disease caused by the inhalation of silica dust emerged as a serious crisis for American industrialists insurance companies and workers in foundries mines quarries and other critical American industries The disease had been recognized as an important occupational disease prior to the Depression From the teens to the late 1920s investigators from universities the U.S. Public Health Service some state departments of health and insurance companies documented the extent of silico- sis among workers in diverse industries But before the Depression it had never been portrayed as widespread and epidemic By the 1930s hundreds of thousands of American workers were said to ROSNER & MARKOWITZ - SILICOSIS 33 From the very first meeting the Konicide Club was to be a compatible gathering of representatives of insurance companies the sil- producing and using industries equipment manufacturers and academic and medical research institutes The Club chose as the site for its second gathering the annual meeting of the National Safety Council in Washington D.C. in October 1932 an organization that was involved in a controversy about its suppression of a report written by a prominent Yale professor C.-E.A. Winslow that suggested an extensive silicosis problem 13 This was perhaps the first large gathering from U.S. industry before which representatives of the small group of pneumonoconiosis specialists presented the dimensions of the silicosis problem and the needs for its control 14 The Konicide Club was among the first group of technicians who recognized the growing significance of the pneumonoconiosis problem in the 1930s In addition to silicosis they identified asbestosis as an important occupational condition 15 Yet members recognized that outside support from industry was essential in order to have an impact in this field Without such support it would be difficult for experts to gather information or find the means of financing studies into dust disease William P. Yant a member of the Konicide Club who also worked at the U.S. Bureau of Mines and later the Mine Safety Appliances Corporation stated that the Konicide Club's meeting in Washington on January 13-14 1935 in a large measure could be considered as a rehearsal of the discussions for the Pittsburgh meeting of what was to become the Air Hygiene Foundation 16 In addition to the Air Hygiene Foundation the Konicide Club sought to establish close contact with the insurance and mining industries 17 ORIGINS OF THE AIR HYGIENE FOUNDATION Initially the Konicide Club defined itself as a grouping of technical experts from a variety of public and private academic and industrial concerns But its interests were soon to become intertwined with the goals of the Air Hygiene Foundation In late September 1934 as the insurance crisis deepened Alfred Hirth an attorney from Toledo Ohio who had devoted the better part of the past two years to the emerging silicosis crisis approached representatives of the Mellon Institute of Industrial Research at the University of Pittsburgh for help in coordinating a response to the silicosis crisis 18 Organized in 1913 with funds from steel magnates and bankers Andrew W. Mel- ROSNER & MARKOWITZ - SILICOSIS 35 public health and legal experts 25 William P. Yant a member of the Konicide Club presided over the session characterizing it as a meet- ing of representatives of trade organizations 26 According to Vandiver Brown of the Manville Company who attended this first gathering the sense of the meeting was that there were four areas of common interest First among these was the menace of ambulance chasing lawyers in combination with unscrupulous doctors Brown observed that the group was worried that under the jury system of liability the uncertainties surrounding diagnosis of the pneumonoconioses allowed plaintiffs to sway lay juries against the manufacturer The second area of common concern flowed out of the first the desirability of making various dust dis- eases compensable under properly drawn workmen's compensation laws Brown reported that the representatives at the meeting believed that workers compensation would eliminate the jury and em- power a Medical Board to pass upon the existence of the disease and the extent of the disability In addition Brown noted in a two paragraph that the problems of ventilation dust collecting and elimination and respiratory devices were a common theme Finally the need for establishing of standards for dust counting the taking of rays for diagnostic use and the technical problems of film inter- pretation concerned the group 27 The executives elected a Temporary Organization Committee to establish a permanent organization to plan a coordinated industrywide program in research and evaluation into dust and its impact on workers health 28 Shortly following this initial meeting the Temporary Organization Committee met together at the Duquesne Club in Pittsburgh on February 1 1935 to discuss the development of a common agenda to meet the needs of the various producing industries The group discussed a working paper prepared by Weidlein that argued that industry had to both protect its financial interests from the dangers of unsubstantiated lawsuits and other claims as well as to coordinate research It is necessary that there be some organi- zation representing industries for the reason that no program of research investigation could be carried on without assurance of continuity and financial support 29 The organization must have a broad outlook a sympathetic understanding of the problem and wide contacts with all cooperating agencies and it must have the confidence of the industries and of the physicians engineers and all institu- ROSNER & MARKOWITZ SILICOSIS 37 Temporary Organizing Committee because he believed that there is now no one place where there is available all information on all phases of the problem and no concerted planning is being done either as to the present or future or as to all of many different phases 33 Recognizing that many of the industries that he sought to attract to the group were wary of publicity about dust Hitchens promoted the idea that such an Industrial Dust Institute would keep membership and contributions entirely confidential 34 On December 2 1935 the Foundation was incorporated in Ohio 35 Of immediate concern to its members was the looming congressional hearing regarding Gauley Bridge Because of recent misleading publicity about silicosis and the appointment of a congressional committee to hold public hearings the attention of much of the en- tire country has been focused on silicosis Their concern was that it was more than probable that this publicity will result in a flood of claims whether justified or unjustified and will tend toward improperly considered proposals for legislation As a result the Foundation almost immediately decided to emphasize its fact finding and evaluation of data in favor of a program to improve to practical limits the dust conditions in the industries Together with this program went a publicity campaign to place before the public their own perspective on the silicosis problem hrough articles and items contributed to technical and popular magazines trade journals and newspapers and through talks to interested groups at conventions and elsewhere and also by radio the Foundation hoped to shape public opinion about silicosis 36 At the same moment that they told their members that they would slow down their fact finding and evaluation efforts the Foundation added to the staff of the managing director a qualified public and industrial relations man John F. McMahon 37 The Foundation presented a public face of neutrality and objectivity But its private goal was to return the discussion of silicosis to the realm of science and medicine where experts drawn largely from the original members of the Konicide Club could assert their dominance over lawyers politicians and labor unions 38 THE NATIONAL SILICOSIS CONFERENCES A little over a year after the first organizing conference of the Air Hy- giene Foundation and in the face of growing concern about silicosis _ the United States Department of Labor's Division of Labor Standards ROSNER & MARKOWITZ SILICOSIS 39 decades 42 Vandiver Brown the General Attorney for the JohnsManville Asbestos Corporation had initially been suspicious of join- ing an organization that appeared little more than an interest group defending the narrow needs of silica industries After the first meeting of the Foundation in January 1935 Brown suggested that asbestos companies did not care to be associated in the minds of the public or of employees with those industries whose problem was silicosis 43 Two years later however after Brown had attended the Special Meeting of the Air Hygiene Foundation on November 24 1936 he changed his views recommending that Manville and all members of the asbestos industry support the Foundation By this time he was convinced that the Foundation had avoided the pit- fall of becoming known solely as an interest group of the silica industries and had gained a reputation for approaching the dust issue from an unbiased viewpoint He also believed that underlying the Foundation was a reliance on and sympathy for industry It the Air Hygiene Foundation is nevertheless the creature of industry and is the one institution upon which employers can rely completely for a sympathetic appreciation of their viewpoint Its aim is to make an honest effort to appraise the evil to advance scientific knowledge of many of its doubtful aspects and to suggest remedies both preventative and curative As such it deserves and should receive the unquali- fied support of all members of industries faced with the dust disease hazard 44 Within two years of its establishment the Foundation published two of the most influential reports on the medical and preventive engineering aspects of silicosis In April 1937 the Air Hygiene Foundation's Medical Committee chaired by A. J. Lanza published a 178page history and analysis of Silicosis and Allied Disorders as Bulletin No. 1 of its Medical Series The Foundation's committee was chaired by Anthony Lanza and had as its members Leroy U. Gardner of the Saranac Laboratory T. Lyle Hazlett of Westinghouse Electric and Manufacturing Company R. R. Jones then of Bell Telephone Company Dr. O. A. Sander an industry consultant and R. R. Sayers of the United States Public Health Service among others most of whom had been members of the Konicide Club as well It provided a history of silicosis in the United States and foreign countries reviewed the definition pathology and diagnosis of silicosis examined the roentgenological appearances of the disease as well as its pathol- ROSNER & MARKOWITZ SILICOSIS 4I dustry and the solutions were constrained by the economic decisions of individual firms Workers were to be protected through engineering methods that did not disrupt existing technologies or the continued use of sand in blasting A consensus developed that technologically feasible engineering and medical standards could be developed to prevent silicosis from shortening a person's work life The impact of silicosis was to be measured by its effect on workers ability to earn a living not upon their sense of being or the quality of their lives after retirement Although the Conference addressed questions about the definition and prevalence of the condition the Conference reports were primarily concerned with the implications of clinical legal and engineering decisions on industry liability through the compensation system Industry and its allied experts hoped that the workers compensation system could contain the silicosis crisis The Reports reflected the business and public health perspectives in general and the influence of the Air Hygiene Foundation in particular First the reports of the various committees sought to reassure the public concerning the overall danger from silica on the job Silicosis it was argued was not as serious a problem as had been feared and the reports argued the vast majority of workers were not at risk Rather it was a threat in only a few select and scattered industries Second the conference participants sought to reassure both the public and industry that the problem could be addressed through existing regulatory and insurance mechanisms and did not require national legislation to control silicosis or a drastic reorganization of the system of compensation Rather the conferees argued silicosis should be integrated in the compensation system and medical boards should replace lay juries as the arbiters of compensable disease Third the conferees agreed that there were relatively straightforward technical solutions such as wet drilling ventilation and respirators It was agreed that these techniques could be applied to the few seriously affected industries and that their adoption could eliminate the silicosis hazard The report emphasized that the reduction in levels of exposure not the total elimination of contact could control the problem No fundamental alteration of industrial production would be required by the mining foundry stone cutting and other industries In light of the severe economic disruptions brought on by the Depression the conferees sought to allay fear and emphasize that work ROSNER & MARKOWITZ SILICOSIS 43 the broad public arena in which liability suits were fought Alfred Hirth and others in the Foundation had supported the inclusion of silicosis in state and federal workers compensation legislation The Foundation had provided information to its members but had avoided publicly endorsing any specific legislative plan Yet privately the AHF was quite active in trying to shape state legislation around silicosis In a detailed letter to the Board of Trustees Alfred Hirth the Chair of the AHF's Legal Committee proposed that the Foundation prepare a piece of workers compensation legislation that could serve as a model for individual states Hirth however believed that the AHF was not the best organization to publicly sponsor the contemplated move because it was on last analysis an employer organization As such any legislative proposal it may make is subject to the same scrutiny and criticism as is given proposals of organizations such as the National Manufacturers Association United States Cham- ber of Commerce etc. He reported that the Legal Committee agreed that some other organization free from the burden of appearing to represent industry be approached to sponsor such legislation The committee suggested the Committee on Legislation of the American Bar Association who because of their partisan character are ideally suited to appear publicly as the sponsor of this work He noted that the Foundation was rather fortunate in the fact that the present President of the American Bar Association has been associ- ated with both Mr. Theodore Waters also a member of the AHF Legal Committee and the writer in silicosis matters He will therefore appreciate the importance of this work and we believe that we can rely upon him to give us his active personal assistance 55 Despite its growing popularity among industry groups the Foun- dation wanted to shed its image as just another trade association Its leaders sought a broader legitimacy in the image of the National Civic Federation the Progressive era group that joined business labor and social reformers around a corporate liberal agenda Yet unlike the Federation the Air Hygiene Foundation sought only to in- tegrate business professional and governmental interests rather than those of labor or social critics Like the NCF however the Founda- tion also saw its responsibilities in the broadest possible terms It was not short profit that defined its mission Rather it saw longterm business success as closely linked to public attitudes toward business itself It sought to combine the success of the trade associa- 44 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 tions that flourished in the 1920s with the ideology of corporate lib- eralism From the vantage point of its organizers the silicosis crisis was symptomatic of a broader crisis for American capitalism and business needed to address both if it was to survive and eventually prosper As John F. McMahon the publicist for the Air Hygiene Foundation believed the employer's no 1 job today is not to sell his products but to sell the system that makes those products possible The Foundation saw itself as a collective effort by employers in be- half of employee health and therefore as a clear cut illustration of the assumption of greater social responsibility as advocated by progressive leaders of business Such activities could serve as antitoxin for the agitation against private enterprise 56 McMahon reiterated the broad social analysis that legitimated the Air Hygiene Foundation Viewed broadly the support of the Air Hygiene Foundation by industry is an investment in the American system of business and in the preservation of that system 57 The Foundation was a voluntaristic sponsored alternative to the threat of federal action Either employers will deal intelligently with industrial health through collective cooperation the Foundation is the only existing agency where they can do that they can continue their present disorganized course and await government inspection and enforcement of factory health standards 58 Through unified action the dusty trades had an opportunity to protect their own interests as well as to give structure to the silicosis debate But together with this broad outlook the original concern with the liability crisis did not fade As late as 1940-41 just as the Air Hygiene Foundation began to enlarge its focus and adopt a new name 59 appeals to its constituent members still emphasized protecting its members from liability suits In its annual Report of the Membership Committee C. E. Ralston safety director of the Pittsburgh Plate Glass Company outlined his rationale for joining the Founda- tion The Foundation's service of conducting plant surveys was pre- sented as a major benefit to member companies In case of claims you have a record showing what the health conditions actually were at the time of alleged injury . The report you receive from the Foundation removes the guess work and speculation as to whether there was or wasn't a hazard at the time in question Further as Mr. Fletcher pointed out here a year ago a survey report from an outside ROSNER & MARKOWITZ SILICOSIS 45 independent agency carries more weight in Court or before a compensation commission than does a report prepared by your own people In other words an outside party can talk with greater weight about you than you can talk about yourself 60 In addition to appealing to the technical aspects of dust measurement and control that would prove useful in protecting its members in liability suits Air Hygiene Foundation members were also instrumental in pressing for the inclusion of silicosis in workmen's compensation legislation This they understood would remove silicosis from the liability system and provide greater protection to the industries and insurance companies that constituted their corporate membership Before the 1930s industry had almost uniformly opposed the inclusion of disease into workers compensation systems but in light of the silicosis crisis industry positions changed 61 During World War II the focus of the Air Hygiene Foundation shifted dramatically from a concern about silicosis to an involvement in a wider range of industrial disease activities The most obvious manifestation of this shifting focus was the change in name to the Industrial Hygiene Foundation This was justified on a number of grounds First the Foundation's leadership believed that the silicosis crisis had passed and that the Foundation could not grow unless it moved on to new areas Second the demands of the war and especially the need for increased production while conserving domestic manpower led to a new emphasis on more acute conditions As Roger A. Hitchins Chairman of the Foundation explained at the Fifth Annual Meeting in 1940 the Air Hygiene Foundation's membership were now devoted to the defense program and the old focus on silicosis was no longer appropriate A handicap suffered by the Foundation in its earlier years but which could not be avoided at the time was the quite generally held opinion that it was in effect a silicosis institute . . . It is believed that this erroneous idea has been changed and that it is fairly well understood that the Foundation's work extends over the entire field of employee health 62 THE POSTWAR CONSENSUS The business community and especially the Industrial Hygiene Foundation were active in shaping a postwar consensus among professionals in industrial hygiene and medicine that silicosis was a disease ROSNER & MARKOWITZ SILICOSIS 47 berculosis and industrial dust When the silicosis crisis hit in the early 1930s it sought to expand its involvement in this potentially rich arena In 1932 for example Saranac's Director began an aggressive campaign to gain the support of the insurance industry and various mining companies In one such letter soliciting support they held out the prospect of information that might translate into direct financial value to the insurance companies writing industrial compensation policies 67 By the late 1940s they had succeeded in establishing important contracts with a variety of mining interests and had come to depend upon these contracts for their support The relationship became so close that even when their scientific experts such as Leroy U. Gardner sought to assert ostensible neutrality in management disputes few accepted his claims The attorneys for one mining company scoffed at Gardner's reluctance to testify in a silicosis suit We did not agree with him that his refusal to testify would help maintain Saranac as an independent research organization . because . . all of the mining companies were associated with Saranac and certainly in the eyes of everyone excepting Dr. Gardner Saranac was a mining company institution 68 While it is difficult to say with certainty that Saranac's work had been unduly influenced by its evolving relationship to the business community there is evidence to suggest that some of its clinical find- ings were used selectively One Finnish immigrant whose records were reviewed by Trudeau and Saranac worked as a miner from 1908 until his death in 1947 at the age of 61. His work history and rays going back to 1933 confirmed silicosis advancing from first degree in 1933 to third degree by 1936. But the immediate cause of death was a cerebral hemorrhage allowing the company to escape having to pay compensation The head of the Trudeau field office at Ironwood Michigan wrote to the research director It looks as if they may win this one as death was apparently caused by cerebral hemorrhage if successful a good sum of money will be saved 69 THE DEATH OF THE SILICOSIS ISSUE The Industrial Hygiene Foundation played a crucial role in the postwar years in the demise of silicosis as a serious public health problem The IHF's influence on the field of industrial hygiene was extended at this time when Theodore Hatch assumed the Presidency of the Amer- ; ROSNER & MARKOWITZ + SILICOSIS 49 Only growing attention to asbestos disease and coal workers pneumoconiosis seems to have reversed this declining interest Similarly the average number of articles on silicosis specifically declined from a Depression high of 35 per year between 1937 and 1940 to a mere 9 per year between 1953-1956 Furthermore the small number of articles on silicosis in the journals of the 1950s were in specialty journals rather than regional and local medical journals commonly read by local practitioners In 1933-36 1933-36 for example over II percent of articles on silicosis were in local journals By 1961-64 less than 1 percent were in these local organs One might conclude that local practitioners who make up the bulk of the readership of local medical society journals were no longer exposed to reports about silicosis in their regions and that the condition became the preserve of a specialty group This movement away from the generalists and toward specialization is reflected in the subject matter of the articles as well During the 1930s the articles were descriptive and therefore accessible to the generalists By the 1950s the articles were more technical appealing to specialists in the emerging fields of pulmonary and thoracic medicine The Chief of the Health and Safety Division of the U.S. Bureau of Mines summarized the recent amnesia regarding silicosis and lamented the apparently concerted effort to hide the facts regarding dust diseases in industry 74 Throughout the 1950s and 1960s sporadic reports of clusters of silicosis cases continued to be reported CONCLUSION During the early 1930s silicosis was perceived to be a widespread and potentially epidemic health problem among workers in a host of industrial operations Sandblasters miners quarrymen steel and foundry workers among others were perceived to be at risk of contracting this debilitating lung condition Yet less than a decade later it was said to be a disease of the past Significantly technical experts played an important role in this remarkably rapid turnaround a dis- ease whose symptoms often took decades to appear rapidly vanished from public view In part the growing inattention to this condition may be the result of dramatic improvements in ventilation But in part it appears that a central role was played by industries themselves through ostensibly neutral scientific studies Through the Air Hygiene Foundation common programs were developed to address the polit- ROSNER & MARKOWITZ SILICOSIS 51 3. Donald E. Cummings to Anthony J. Lanza January 24 1933 Plaintiff's Exhibit No. 5197 Wilentz 4 Donald E. Cummings to Anthony J. Lanza January 24 1933 Plaintiff's Exhibit No. 5197 Wilentz 5. M. D. Harbaugh Labor Relations in the State Mining District The Mining Congress Journal June 1936 20-21 In our book Deadly Dust we noted that although the government industry and insurance companies continued to study the area until 1933 none of the later data were published However it is now possible to suggest that the reason there was no further publication of data from the clinic was that the mine companies successfully suppressed them David Rosner and Gerald Markowitz Deadly Dust Silicosis and the Politics of Occupational Disease in Twentieth Century America Princeton Princeton University Press 1991 p 145 6. A review of the articles listed in Index Medicus between 1933 and 1942 reveals that Cummings did not publish an article on silicosis in the TriState area The following article does not address the State region D. E. Cummings Etiology of Silicosis Saranac Laboratory Symposium on Silicosis 1939 pp 20-34 another piece relates specifically to tuberculosis D. E. Cummings R. N. Downs M. Berg Tuberculosis Lesions in Male Industrial Workers Their Incidence and Significance as Disclosed by Stereoscopic Chest Reontgenogram American Review of Tuberculosis 39 April 1939 439-455 7. See David Rosner and Gerald Markowitz Deadly Dust Silicosis and the Politics of Occupational Disease in Twentieth Century America Princeton University Press 1991 for a more complete discussion of the social and epidemiological crisis of the 1930s 8. Andrew J. Farrell Silicosis in Certain of Its Legal Aspects Industrial Medicine Oct 1932 35 9. Quoted in David Rosner and Gerald Markowitz Deadly Dust Silicosis and the Politics of Occupational Disease in Twentieth Century America Princeton Princeton University Press 1991 p 75 10. For a broad discussion of the silicosis crisis of the 1930s see David Ros- ner and Gerald Markowitz Deadly Dust Silicosis and the Politics of Occupational Disease in Twentieth Century America Princeton Prince- ton University Press 1991 11. Theodore F. Hatch and Eugene P. Pendergrass The Konicide Club 1932-1940 A Brief History Journal of Occupational Medicine 19 May 1977 351 12. Theodore F. Hatch and Eugene P. Pendergrass The Konicide Club 1932 194A0 Brief History Journal of Occupational Medicine 19 May 1977 351-52 351-52 Drinker developeda list of individuals who might ROSNER & MARKOWITZ SILICOSIS 53 Konicide Club 1932-1940 A Brief History Journal of Occupational Medicine 19 May 1977 352 53 18. H. B. Meller to Dr. E. R. Weidlein October 9 1934. Courtesy of Joel Tarr 19. William Graebner Hegemony Through Science Information Engineering and Lead Toxicology 1925-1965 Rosner and Markowitz eds Dying for Work 145 20. Vandiver Brown Memorandum -Mellon Institute of Industrial Re- search Symposium on Dust Pittsburgh 15 1935 January 18 1935 Wilentz 2.1 H. B. Meller to E. R. Weidlein October 9 1934 courtesy of Joel Tarr 22. Just before the first meeting of the Temporary Organizing Committee in 1935 Philip Drinker wrote to the Konicide Club members calling them together for what he considered to be an unusually important meeting that would be entirely informal and private He noted that R. R. Sayers had organized a program that has a direct bearing on the forthcoming conference at the Mellon Institute See Philip Drinker Konicide Club Meeting Dec. 28 1934 NARG 70 U.S. Bureau of Mines Box 2429 1936 23. Report and Recommendation of the Temporary Organization Com- mittee which was Elected at the Symposium on Dust Problems Held at Pittsburgh Pa January 15 1935 Feb. 6 1935 and Roger A. Hitchens A Brief Outline of the Events Leading up to and Occurring at the Symposium of Dust Problems Held in Pittsburgh Pa Jan. 15 1935 both enclosed in W. G. Hazard to Dr. L. R. Thompson Mar. 21 1935 NARG 90 U.S.P.H.S. 0875-96-49 Pittsburgh PA 24. See for a complete discussion of this tragedy Martin Cherniack The Hawk's Nest Incident New Haven Yale University Press 1988 25. Roger A. Hitchens A Brief Outline of the Events Leading up to and Occurring at the Symposium on Dust Problems Held in Pittsburgh Pa January 15 1935 in W. G. Hazard to Dr. L. R. Thompson March 21 1935 National Archives Record Group 90 State Boards of Health 0875-96-49 Pittsburgh PA participants included Mr. A. C. Hirth a corporate lawyer from Toledo Ohio Dr. R. R. Sayers of the U.S. Public Health Service Dr. A. J. Lanza of the Metropolitan Life Insurance Company Dr. Eugene P. Pendergrass of the University of Pennsylvania Professor Philip Drinker of Harvard F. Robertson Jones of the Association of Casualty Insurance Executives Donald E. Cummings of the Saranac Laboratory and Dr. Samuel R. Haythorn of the Singer Memorial Labo- ratory in Pittsburgh 26. William P. Yant to Mr. Fieldner January 5 1935 NARG 70 Box 2201 File 437.4 1935 27. Vandiver Brown Memorandum -Mellon Institute of Industrial Re- ROSNER & MARKOWITZ * SILICOSIS 55 39. Zimmer to Secretary Perkins February 19 1936 National Archives Record Group 100 7-0-4 The National Safety Council the Casualty Insurers Underwriters the American Foundrymen's Association Union Car- bide and Sand and Gravel trade associations were among the groups that had to be won over 40. National Silicosis Conference American Labor Legislation Review 26 1936 60 41. H. B. Meller Silicosis Program of United States Department of Labor and Interest and Cooperation of Air Hygiene Foundation 1936 Carnegie lon Archives We are indebted to Joel Tarr for providing us with this document 42. History of Industrial Hygiene Foundation Pittsburgh PA Mellon Institute 1956 2 A3ir Hygiene Foundation of America Proceedings of Annual Meeting and Research Program Pittsburgh PA April 1 1937 12-14 For examples of the aggressive public relations campaign that the Foundation waged both within industry as well as in the popular press see Air Hygiene Foundation Progress Reports Mellon Institute of Industrial Research Carnegie Mellon University Archives Papers of the Mellon Institute 43. Vandiver Brown Memorandum -Mellon Institute of Industrial Research Symposium on Dust Pittsburgh 15 1935 January 18 1935 Wilentz 44. Vandiver Brown to C. J. Stover Dec. 4 1936 copy Wilentz 45. Air Hygiene Foundation of America Inc. Medical Series Bulletin No. 1 Silicosis and Allied Disorders History and Industrial Importance Pittsburgh PA April 15 1937 p 169. For an earlier statement of these same points see Air Hygiene Foundation of America Inc. Special Meeting of Members Pittsburgh PA Nov. 24 1936 46. Air Hygiene Foundation of America Inc. Medical Series Bulletin No. 1 Silicosis and Allied Disorders History and Industrial Importance Pittsburgh PA April 15 1937 p 169. For an earlier statement of these same points see Air Hygiene Foundation of America Inc. Special Meeting of Members Pittsburgh PA Nov. 24 1936 47. As early as 1930 interest grew in establishing a standard for silica The American Public Health Association's Committee on Silicosis composed of R. R. Sayers A. J. Lanza and Emery R. Hayhurst pointed out that traditional industrial standards of between 5 and 10 mppcf were not found to pre- vent the occurrence of silicosis Rather in the early 1930s they pointed out that standards were developed in part because they could be reached by the use of economically practicable ventilating devices See Effect of Dust on the Lungs American Journal of Public Health 20 April 1930 372 48. As early as 1930 interest grew in establishing a standard for silica The American Public Health Association's Committee on Silicosis composed of R. R. Sayers A. J. Lanza and Emery R. Hayhurst pointed out that tradi- 42 JOURNAL OF PUBLIC HEALTH POLICY - SPRING 1995 could go on as usual On this issue management and labor had es- sentially the same goal to reduce the hazard without undercutting the industries that created scarce jobs Another major impact that the Air Hygiene Foundation had on the silicosis issue in the 1930s and beyond was in its recommendations regarding the control and measurement of dust in factories mines and mills The foundation endorsed the use of protective equipment as a means of protecting the workforce from disease The use of such equipment should be the second step and not the first in the dust control project But protective equipment will always have a place in industry 50 The Engineering Committee of the National Silicosis Conference endorsed the idea that dust control methods had to be formulated with the costs to industry of any technological improvements in mind To be put into practice these methods must be economically feasible so that industries both large and small may utilize them in the solution of their dust problem The engineering group noted that safer substances were generally unavailable to most industries or if available were too costly and therefore the solution of the problem depends upon reduction of the concentration of the dust to safe limits The engineering group began with the assumption that workers would always be exposed to some silica dust 51 By the time of its annual meeting on April 1 1937 the Air Hygiene Foundation had further established its credibility among industrial leaders Its membership had grown during this time eight fold from 20 to 168 members Many companies and trade associations with a silicosis problem had signed on including Union Carbide HarbiWalker Refractories the American Mining Congress the Ameri- can Zinc Institute the Barre Granite Association the Foundry Supply Manufacturers Association the National Industrial Sand Association the State Zinc and Lead Ore Producers Association the United States Potters Association and the Lead Industries Association among many others 52 They had established research links with Harvard the Saranac Laboratory the University of Pennsylvania as well as the Mellon Institute itself 53 By the end of November 1937 the organization had 192 members 54 Addressing the biomedical and engineering issues was one part of the Foundation's attempt to deal with the broad liability crisis Another aspect was to find ways to remove silicosis from the courts and 40 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 ogy By and large this work did not break any new ground but summarized a diverse and immense literature framing the issue in med- ical engineering and largely technical language 45 One area where it had an impact in shaping the future of the sili- cosis debate was in its promulgation of the idea of permissible thresholds of dustiness to which workers could be exposed In re- sponse to the industry's needs for a benchmark that could be used as a defense in liability suits levels of permissible dustiness became a medicolegal issue of great importance As Weidlein had originally proposed two years earlier if the technical community would set safe limits that industry could meet companies would be able to protect themselves from liability suits for negligence In an analysis aimed at their own membership the Air Hygiene Foundation raised serious questions about the validity of the standard that they themselves were proposing as a mechanism for protecting workers lungs from disease They acknowledged that they did not have the knowledge upon which to base such thresholds of dustiness What they did have were bench marks . . . to indicate to the engineer the result to which he should strive Concentrations to which the dust must be reduced in order to be safe have not been absolutely determined they noted 46 Nevertheless Lanza's committee suggested a standard of 5 million particles per cubic foot of air for granite and other silica containing dusts 47 It is desirable to avoid concentrations of more than 5,000,000 particles of dust containing a high percentage of free silica in working places 48 This standard would have a major impact on all subsequent discussion of what would come to be called threshold limits and maximum allowable concen- trations 49 As the Air Hygiene Foundation was establishing itself as the pre- mier organization in the evaluation of the dangers in the dusty trades the Department of Labor held its Second National Silicosis Confer- ence to hear the final reports of the various committees This represented the real work of the Conference These committees were dom- inated by Air Hygiene Foundation members and other experts who developed a consensus that would define the silicosis issue in the coming years and even decades The agenda being developed was ostensibly a product of objective scientific and technical discussions But the discussions were framed by the very real social crisis facing in- 38 JOURNAL OF PUBLIC HEALTH POLICY * SPRING 1995 organized a National Silicosis Conference to try to air and to reconcile the divergent points of view about the social scientific economic and political implications of the silicosis crisis The Air Hygiene Foundation along with other industry groups approached the Labor Department's National Conference on Silicosis warily and pressed the Department of Labor to break down the reluctance on the part of employers ... ... ... and to allay suspicion of an ulterior motive 39 The conference convened in Washington on April 14 1936. Of the people present half were . . . representatives of employers in the dusty trades one quarter were public officials ten percent represented insurance companies and five percent represented labor 40 Despite the apparent diversity of the program participants the Air Hygiene Foundation tied together many of the key participants Of the three major papers read at the Conference two were by Foundation members A. C. Hirth was the Chair of the Legal Committee of the Foundation and presented a paper on the viewpoint of management to the Conference Dr. R. R. Sayers of the United States Public Health Service was also a member of the Foundation's Medical Committee He delivered the address on the engineering and med- ical aspects of the silicosis hazard In addition the Foundation was heavily represented in the four working committees that were set up to carry out the work of the Conference Five trustees three com- mittee chairmen and six members of committees of Air Hygiene Foundation are members of one or other of Mr. Zimmer's commit- tees three of them are . chairmen . It is plain the AHF reported to its members that the Foundation is being extended an opportunity to collaborate fully to aid especially in giving the views and attitude of the industries 41 By 1936 the Air Hygiene Foundation had established legitimacy in the fields of medicine law and engineering by attracting to its various working committees nearly all of the top names in the silicosis research and engineering communities They established research links with Harvard the Saranac Laboratory the University of Pennsylvania as well as the Mellon Institute itself In the midst of the Depres- sion with limited funds available and the federal government inca- pable of embarking on a major research effort the Air Hygiene Foundation and the public health researchers associated with it emerged as major forces shaping occupational lung research and the technical debate about silicosis in the United States for the next two 36 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 tions groups or individuals who might cooperate to advantage 30 There was no discussion of including workers or organized labor Industry could achieve major benefits by providing the funding for _ such an organization according to Weidlein The new organization could determine which specialists may not be properly qualified and whose results might therefore not be entirely acceptable . . ; to be in position to make reasonable grants to qualified individuals and agencies to study special problems or phases of problems Weidlein suggested that industry could retain some control over the dissemination of information if it were to support a permanent research organization On a more practical level such research could be important from both medical and legal standpoints in the preparation of court cases as well as assist in the preparation of safety codes and fair laws 31 Weidlein outlined a five point program by which industry could band together to both control their own members behavior as well as to set the agenda for silicosis in the nation as a whole In the medical phase of the effort Weidlein proposed to collect all existing information on dust diseases to focus attention on areas that demanded more research and finally to secure the cooperation of the American Medical Association in setting up authoritative and approved standards of diagnosis and correction In what he called the preventive area he maintained that the organization assume the role of establishing authoritative and approved standards By voluntarily establishing standards and pressuring industry to live up to them companies would be able to erect a defense against personal injury suits In the legal arena the organization could serve as a legal clearing house and advise businesses faced by liability suits while in the legislative arena the organization could help secure the enactment of state laws of a uniform character which when complied with will fairly and properly protect the interest of industry and those engaged in industry and of enlisting the cooperation of the federal government in that direction Finally the new organization would publicize what measures are being and should be taken in the direction of protecting both human life and property The sum of all this activity would be that industries most affected by the silicosis debate could collectively shape a research agenda legal framework and legislative program 32 Weidlein's plan appealed to Roger A. Hitchens Chairman of the 34 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 lon and Richard B. Mellon the Institute sponsored field and labo- ratory research on its premises and also functioned as an umbrella for organizations directly involved in the politics of industrial and environmental health 19 Even though its work was funded by industry the Institute had a good deal of credibility with the general public because of its early attention to air pollution in Pittsburgh The immediate initiative for the development of a dust program came from representatives of the sand and glass and refractories industries F. W. Sherwood President of Owens Glass Company and Roger Hitchens President of the American Refractories Institute met with Dr. E. R. Weidlein Director of the Mellon Institute about the need of some form of concerted action on the part of those industries presently or potentially involved with the silicosis crisis 20 While industry understood the need for concerted action the Mellon Institute saw its role as a coordinator of research and scholarship " ... ... A great deal of investigational work is being carried on by an increasing number of scientists most of it by medical men working more or less independently H. B. Meller of the Mellon Institute wrote to Weidlein He suggested that a more organized research effort was preferable and that it should be financed by the industries that stand to be affected 21 The goals of the Mellon Institute meshed perfectly with those of the Konicide Club 22 Shortly after this initial meeting Weidlein wrote at the request of a few of the industries in which the dust hazard ex- ists in an effort to determine whether sufficient interest existed to warrant having a meeting for a general discussion of this question He wrote to more than eighty industries and the response ... ... ... was immediate and represented a large percentage of the industries to whom the original letter had been sent 23 The political environment within which the Air Hygiene Foundation was organizing changed dramatically following widespread publicity regarding exposure of Union Carbide's attempt to cover up the deaths from silicosis of hundreds of tunnel workers in Gauley Bridge West Virginia 24 On January 15 1935 a day before the Congressional hearings on Gauley Bridge began over two hundred industries executives met at the University Club in Pittsburgh for a meeting called a Symposium on Dust Problems No reporters were present at this meeting and no stenographic notes were kept Attendance was by registration only and the group was addressed by industrial 32 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 have been exposed to potentially dangerous levels of dust and therefore to the disabling and often deadly disease 7 Thousands of workers in the dusty trades laid off during the Depression brought lawsuits against employers seeking damages for exposure to silica This led to a broad liability crisis threatening the closing of industrial plants and a vast economic loss 8 As Anthony J. Lanza who in the 1930s became head of Metropolitan Life's Division of Occupational Health said it was as if out of a clear sky and with dra- matic suddenness the insurance companies were faced with a situa- tion that was terrifying 9 By the early 1930s while numerous investigations were underway there was little coordination of this re- search There was also a great deal of confusion about the extent of the problem the mechanism by which silica affected the lung and the means by which to control the dust hazard 10 THE KONICIDE CLUB It was in the context of financial crisis and scientific uncertainty that a small group gathered at the Pittsburgh laboratories of the U.S. Bureau of Mines in January 1932 to exchange information create a research agenda and coordinate research into silicosis According to the recollections of two of the original participants Particular interest at the first meeting centered around methods for the standardization of atmospheric dust sampling and assessment of dust exposure and the parallel procedures for evaluating the respiratory injury found in exposed individuals 11 At the conclusion of this preliminary meeting one of the conveners Philip Drinker Professor at the Harvard School of Public Health suggested that the group call itself the Konicide Club which loosely translated meant killer dust club The club was important in that it was the first mechanism by which industry insurance and technical experts could begin to shape the silicosis debate In the coming years the members of the club emerged as the dominant experts on silicosis and the core of the technical commit- tees of the Air Hygiene Foundation the forerunner of the Industrial Health Foundation The club functioned as an informal and loosely organized mechanism for the exchange of information among a small group of colleagues interested in silicosis While Drinker assumed the duties of Secretary of the organization there were no other formal officers Each meeting elected someone to chair the session in an attempt to maintain an atmosphere of informality and collegiality 12 30 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 politan Life complaining that he had not realized when we entered upon this investigation the fact that it must be approved by the industry as well as by the Metropolitan Life Insurance Company and the U.S. Bureau of Mines He told Lanza that he could appreciate the companies reluctance to have any such data . . . used against the mine companies but that suppression presented him with a personal dilemma He had been collecting these data always intending to publish them in the American Review of Tuberculosis What harm could there be he wondered in presenting his findings in a journal with a small circulation of experts It would not reach the hands of any except those interested in the more or less technical aspects of this disease he promised Lanza 3 Cummings was clearly disturbed by the attempt of industry to in- terfere in the publication of his results But he was even more concerned that he had already exposed himself to possible legal action by the companies He might find himself investigating silicosis in the rock piles of the federal penitentiary in Atlanta in the course of the next few months he sarcastically noted because he had already submitted part of this evidence at a conference in Chicago and feared that his data were already incorporated in the report of that conference He told Lanza that he would write today in an attempt to delete this information from the record if it were not already too late 4 We do not know Lanza's reply to Cummings appeal 5 But we do know that whatever action was taken was inadequate to result in publication of the findings 6 This essay focuses on the early history of industry and professional relationships around silicosis the disease that was the focus of the lead and zinc owners and Cummings interest in the 1930s Specifically we will look into the development of the Air Hygiene Foundation later the Industrial Health Foundation an organization that would incorporate into membership both researchers such as Donald Cummings and industries and trade associations including the TriState Zinc and Lead Ore Producers Association the group represented by Harbaugh and Metropolitan Life the employer of Anthony Lanza We will explore some of the issues that arose when this industrysponsored group promoted public policy and scientific investigations We will ask Under what conditions is it appropriate for professionals and scientists to work in concert with industrially organizations What are the pressures that shape research questions the 58 JOURNAL OF PUBLIC HEALTH POLICY - SPRING 1995 76. See for examples of the literature on the 1970s silicosis epidemics Behzad Samimi Hans Weill Morton Ziskind Respirable Silica Dust Exposure of Sandblasters and Associated Workers in Steel Fabrication Yards Archives of Environmental Health 29 August 1974 pp 61-65 Austin Blair Abrasive Blasting Respiratory Protective Practices U.S. Department of Health Education and Welfare NIOSH Cincinnati Ohio April 1974 Phillip J. Landrigan Testimony before OSHA Concerning a Proposed Rule on Air Contaminants Aug. 1 1988 U.S. Department of Labor Docket Office 006 David J. Valiante and Kenneth D. Rosenman Does Silicosis Still Occur Journal of the American Medical Association 262 Dec. 1 1989 3003 300R7ecords of the Silica Safety Association 1975 1982 ABSTRACT This essay focuses on the early history of industry and professional relationships around silicosis the debilitating occupational lung disease through a study of the role of the Industrial Health Foundation an sponsored group which has playeda critical role in shaping the nation's agenda regarding indus- trial disease From its start during the Depression it has portrayed itself as an sponsored agency that depended upon detached disinterested professionals and experts to develop effective programs to address occupational disease As an organization that brought together professional industrial hygienists business groups government officials academics and researchers it serves as a means for understanding the intertwining of industrial and academic agendas We explore some of the issues that arose regarding public policy and scientific investigations asking Under what conditions is it appropriate for professionals and scientists to work together with industrially sponsored organizations What are the pressures that shape research questions the range of possible solutions and the control of scientific data How can technically trained individuals avoid real or perceived conflicts of interest At what point does the ostensibly disinterested goals of professionalism conflict with the interest of the sponsoring organizations 56 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 tional industrial standards of between 5 and 10 mppcf were not found to prevent the occurrence of silicosis Rather in the early 1930s they pointed out that standards were developed in part because they could be reached by the use of economically practicable ventilating devices See Effect of Dust on the Lungs American Journal of Public Health 20 April 1930 372 49. For a discussion of the formation of the TLVs see Gerald Markowitz and David Rosner The Limits of Thresholds Silica and the Politics of Science 1935-1990 American Journal of Public Health February 1995 50. Air Hygiene Foundation of America Inc. Preventive Engineering Series Bulletin No. 1 Measurement and Control of Industrial Dusts Pittsburgh PA Nov. 2 1936 p 11 51. United States Department of Labor Division of Labor Standards National Silicosis Conference Report on Engineering Control Bulletin No. 21 Part 2 Washington D.C Government Printing Office 1938 1 52. Air Hygiene Foundation of America Inc. Proceedings of Annual Meeting and Research Program Pittsburgh PA April 1 1937 53. History of Industrial Hygiene Foundation Pittsburgh PA Mellon Institute 1956 2-3 Air Hygiene Foundation of America Proceedings of Annual Meeting and Research Program Pittsburgh PA April 1 1937 12-14 For examples of the aggressive public relations campaign that the Foundation waged both within industry as well as in the popular press see Air Hygiene Foundation Progress Reports Mellon Institute of Industrial Research Carnegie Mellon University Archives Papers of the Mellon Institute 54. Air Hygiene Foundation of America Inc. Special Meeting of Members Pittsburgh PA Nov. 30 1937 55. Alfred Hirth to Board of Trustees Air Hygiene Foundation of America Jan- uary 31 1938 National Archives Record Group 70 Records of the U.S. Bureau of Mines Box 2534 022 1937 56. McMahon to Weidlein January 16 1939. Carnegie Archives courtesy of Joel Tarr 57. John F. McMahon Confidential Memorandum to Dr. Weidlein and Dr. Hamor April 5 1940 courtesy of Joel Tarr 58. John F. McMahon to Dr. Hamer March 5 1941 Carnegie Archives courtesy of Joel Tarr 59. In 1941 the Foundation took the opportunity of America's impending en- trance into World War II to change its name to Industrial Hygiene Foundation of America See Air Hygiene Foundation of America Fifth Annual Meeting of Members Pittsburgh PA Nov. 12th 1940 pp 1-5 Industrial Hygiene Foundation of America Sixth Annual Meeting of Members Pittsburgh PA Nov. 12-13 1941. See also John F. McMahon Progress Report for Week Ended June 29 1940 Mellon Institute of Industrial Research Carnegie Mellon University Archives Papers of the Mel- 54 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 search Symposium on Dust Pittsburgh 15 1935 Jan- uary 18 1935 Wilentz 28. Roger A. Hitchens A Brief Outline of the Events Leading up to and Occurring at the Symposium on Dust Problems Held in Pittsburgh Pa January 15 1935 in W. G. Hazard to Dr. L. R. Thompson March 21 1935 National Archives Record Group 90 State Boards of Health 0875 96 Pi4tt9sburgh PA The Committee was composed of a representative from each of seven types of dusty industries asbestos cork and metallic chemical abrasives alloy and ferrous metals foundries glass sand ground sand and glass manufacuturers iron steel and iron ore lime limestone cement and gypsum refractories ceramics and clays The Temporary Committee proposed that a new association tentatively called the Industrial Dust Institute be established in as- sociation with the Mellon Institute 29. E. R. Weidlein Plan for Study of Dust Problems in W. G. Hazard to Dr. L. R. Thompson March 21 1935 National Archives Record Group 90 State Boards of Health 0875-96-49 Pittsburgh PA 30. E. R. Weidlein Plan for Study of Dust Problems in W. G. Hazard to Dr. L. R. Thompson March 21 1935 National Archives Record Group 90 State Boards of Health 0875 96 Pi4tt9sburgh PA 31. E. R. Weidlein Plan for Study of Dust Problems in W. G. Hazard to Dr. L. R. Thomspon March 21 1935 National Archives Record Group 90 State Boards of Health 0875-96-49 Pittsburgh PA 32. E. R. Weidlein Plan for Study of Dust Problems in W. G. Hazard to Dr. L. R. Thompson March 21 1935 National Archives Record Group 90 State Boards of Health 0875-96-49 0875-96-49 Pittsburgh PA 33. Roger A. Hitchens The Industrial Dust Problem in W. G. Hazard to Dr. L. R. Thompson March 21 1935 National Archives Record Group 90 State Boards of Health 0875 96 Pi4tt9sburgh PA 34. Roger A. Hitchins A Brief Outline of the Discussion and Action Taken by the Temporary Organization Committee at a Special Meeting Held at the Duquesne Club Pittsburgh Pa on Friday February 1 1935 Hazard to Thompson March 21 1935 RG 90 35. Air Hygiene Foundation of America Inc. Annual Meeting of Members Pittsburgh PA Feb. 11 1936 p 3 36. Air Hygiene Foundation of America Inc. Annual Meeting of Members Pittsburgh PA Feb. 11 1936. pp 4-5 37. Air Hygiene Foundation of America Inc. Annual Meeting of Members Pittsburgh PA Feb. 11 1936 pp 4 5 38. E. R. Weidlein Plan for Study of Dust Problems in W. G. Hazard to Dr. L. R. Thompson March 21 1935 National Archives Record Group 90 State Boards of Health 0875-96-49 Pittsburgh PA 52 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 become members of the club They included Daniel Harrington F. B. Meriwether W. P. Yant and C. E. Brown of the U.S. Bureau of Mines C. O. Sappington of Chicago Illinois E. G. Meiter of Employers Mutual Insurance Company Philip Drinker and Theodore Hatch of Harvard School of Public Health W. I. Clark of the Norton Company A. J. Lanza W. P. McConnell and J. W. Fehnel of Metropolitan Life Insurance Company James A. Britton of Northwestern University Medical School W. G. Hazard of Illinois Glass Company R. R. Sayers Albert E. Russell R. R. Jones J. J. Bloomfield and Dalla of the U.S. Public Health Service Leroy U. Gardner Donald Cummings Homer Sampson Andrew Radlin and Thomas Durkan of Saranac Laboratory George Brink John Cunningham and A. R. Riddell of Toronto Canada H. K. Pancoast and E. P. Pendergrass of University of Pennsylvania A. S. Gray and Warren Cook Connecticut State Department of Health T. Lyle Hazlett and Edgar C. Barnes of Westinghouse Electric and Manufacturing Company 13. See the account in David Rosner and Gerald Markowitz Deadly Dust Silicosis and the Politics of Occupational Disease in Twentieth Century America Princeton Princeton University Press 1991 pp 66 69 14. Theodore F. Hatch and Eugene P. Pendergrass The Konicide Club 1932-1940 A Brief History Journal of Occupational Medicine 19 May 1977 351-52 15. Theodore F. Hatch and Eugene P. Pendergrass The Konicide Club 1932-1940 A Brief History Journal of Occupational Medicine 19 May 1977 351-52 At that meeting L. U. Gardner presented a brief sketch of What is Known About Asbestosis 16. William P. Yant to Mr. Fieldner January 5 1935 National Archives Record Group 70 Records of the Bureau of Mines Box 2201 File 437.4 1935 The founding members of the Club and the committees of the Air Hygiene Foundation overlapped significantly Drinker Hatch Lanza Gardner Pendergrass Sayers Dreesen Hazlett Sander Sayers Dalla Cook Yant Jones among others formed the core of the Engineering and Medical Committees of the Foundation 17. In late 1936 the members of the Club met in the Metropolitan Life Insurance Company's headquarters in New York City in a session organized by Met Life officials A. J. Lanza W. P. McConnell and William Fehnel The following year the club was hosted by the Montreal Mining Company of Montreal Wisconsin with whom the Saranac Laboratory had close association In January 1939 the session was devoted to the health problems of the asbestos industry and it seems that there were no subsequent meetings under the formal sponsorship of the Konicide Club See Theodore F. Hatch and Eugene P. Pendergrass The 50 JOURNAL OF PUBLIC HEALTH POLICY 4 SPRING 1995 ical legal social and economic implications of the early silicosis crisis without ever providing the work force with the information it needed to protect itself and to make informed decisions about the safety of the work place 75 In the 1970s and 1980s faced by the continued existence of silicosis and a new spate of lawsuits industry once again mobilized to downplay the existence of the disease and to insist once again that technical solutions could be found to prevent it in the future In the 1970s and 1980s the public health community once again placed the control of silicosis on the public health agenda identifying it as a serious occupational danger In the early 1970s insurance companies in California documented over 1,000 deaths from the disease In the shipyards of Louisiana and Texas researchers at Tulane University documented at least 100 cases of silicosis among sandblasters In 1974 following a series of studies sponsored by the National Institute of Occupational Safety and Health that detailed deaths in Texas NIOSH called for the banning of sand in abrasive blasting and the lowering of the PEL by half in other silica industries In the late 1980s the New Jersey Department of Health doc- umented that over four hundred cases of silicosis had occurred in the state between 1979 and 1987. More recently numerous cases of silicosis have been diagnosed in the West Texas oil fields where sandblasters hired to clean pipes and storage tanks are now coming down with the disease Despite the assurances of industries that argued and still argue that the disease was under control NIOSH once again is- sued a silicosis Alert in 1992 calling for the banning of sand in abra- sive blasting and a reduction in the allowable PEL 76 Certainly silicosis is clearly still with us despite decades of assurance that it is a disease of the past It is unclear however whether public health concerns will outweigh economic interests and political power in the public policy debate over risk and health REFERENCES 1. M. D. Harbaugh to Donald E. Cummings Jan. 21 1933 Plaintiff's Exhibit No. 5196. This document was provided by Wilentz Goldman & Spitzer Woodbridge New Jersey Hereafter cited as Wilentz 2. M. D. Harbaugh to Donald E. Cummings Jan. 21 1933 Plaintiff's Exhibit No. 5196 Wilentz 48 JOURNAL OF PUBLIC HEALTH POLICY SPRING 1995 ican Industrial Hygiene Association in 1947 70 He and other Foundation leaders complained that general practitioners were keeping the silicosis issue alive by diagnosing silicosis too frequently Doctors pressed by the demands of workers and their families and trying to meet the rigid criteria of state compensation systems were too quick to equate breathing difficulties after a lifetime of work in a dusty trade with a diagnosis of silicosis It was time to write silicosis obituary In a 1945 symposium on accurate diagnosis of silicosis sponsored by the Foundation Leroy U. Gardner the Trudeau Foun- dation's Director and a member of the IHF's Medical Committee apologized for devoting a session to such a trite and hackneyed subject But attention was necessary because far too many doctors and technicians were still diagnosing silicosis when in fact few such diagnoses were appropriate 71 Dr. O. A. Sander also of IHF's Medical Committee went even further maintaining that the term pneumoconiosis should be redefined because it was widely misunderstood to imply pathology Sander held that pneumoconiosis should simply mean dust added to the lungs without any implication of fibrosis or disability 72 Sander suggested that there were really very few deleterious dusts Cotton dust for example was too often suspected of causing pneumoconiosis He suggested that byssinosis due to cotton fiber exposure was really nothing more than an allergic response resulting in typical asthma without any demonstrable lung pathology He mentioned this only to show how easy it is to be misled in the pneumoconiosis field 73 A review of articles listed in Index Medicus for the period between 1929 and 1964 confirms that the American medical community accepted this view of industrial lung disease The number of articles published worldwide on the pneumoconioses rose during the Depression tapered off during World War II and then rose dramatically during the late 1950s and early 1960s with the growing attention to coal workers pneumoconiosis and asbestos disease In the United States a similar pattern prevailed during the Depression but diverged dramatically after World War II While the percentage of pneumoconiosis articles published worldwide expanded the percentage in American journals declined from over third of all publications during the Depression to only 13.2 percent by 1961-64 The absolute number of articles on the pneumoconioses also steeply declined from over 50 per year between 1933-1936 to only 31 per year by 1957-1960 ROSNER & MARKOWITZ SILICOSIS 57 lon Institute Industrial Fellowship 259-6 where McMahon reports that Dr. Meller and Dr. Lanza met at Lake Chautauqua N. Y. to discuss changes in the Foundation's research program for next year It was felt that in view of world affairs and emergency production for defense the Foundation should emphasize work of immediate practical plant benefit 60. C. E. Ralston Report of Membership Committee Air Hygiene Foundation of America Inc. Fifth Annual Meeting of Members Pittsburgh PA Nov. 12-13 1940 p 6 61. A. C. Hirth to Board of Trustees Air Hygiene Foundation of America Jan- uary 31 1938 Record Group 70 Box 2534 022 1937 62. Roger A. Hitchins Introduction Air Hygiene Foundation of America Inc. Fifth Annual Meeting of Members Pittsburgh PA November 12-13 1940 pp 1-3 63. Silicosis is Not Threat to Workers Health Science News Letter 50 Nov. 30 1946 345 64. Lung Lab Pays Off Quickly Business Week July 20 1946 p 54 65. Voyta Wrabitz Silicosis Legislation Administration in B. E. Kuechle Fourth Saranac Laboratory of Silicosis Wassau Wisconsin Employers Mutual Liability Insurance Company 1939 p 342 66. Andrew Fletcher Changing Concepts of Industrial Health Industrial Hy- giene Foundation 20th Annual Meeting Transactions Bulletin No. 29 1955. p 8 67. Director to Mr. E. O. Jones Belle City Malleable Iron Company June 4 1932 Vorwald Collection Box 3 68. Humphrey & Humphrey to Robert Downs September 24 1947 Vorwald Collection Box 27 69. Case Files Vorwald Collection 48-428 Box 127 70. Foundation Facts June 1947 71. Leroy U. Gardner Accurate Diagnosis of Silicosis- Possible Sources of Error Industrial Hygiene Foundation Transactions Medical and Engi- neering Session 10th Annual Meeting November 14-15 1945 Pittsburgh PA 1946 pp 10 12 72. O. A. Sander Discussion Industrial Hygiene Foundation Transactions Medical and Engineering Session 10th Annual Meeting November 14-15 1945 Pittsburgh PA 1946 pp 21 23 73. O. A. Sander The Pneumoconioses Industrial Medicine 15 Sept. 1946 p 528 74. J. J. Forbes Sara J. Davenport Genevieve G. Morgis Review of Literature on Dusts U.S. Department of Interior Bureau of Mines Bulletin 478 Washington GPO 1950 p 6 75. See Gerald Markowitz and David Rosner The Limits of Thresholds American Journal of Public Health February 1995 46 JOURNAL OF PUBLIC HEALTH POLICY - SPRING 1995 of the past Professionals were the new authorities in the field of in- dustrial hygiene and they all agreed with the leaders of the Industrial Hygiene Foundation that the dangerous trades of our fathers has sic all but disappeared Dust was now considered more of a danger to the inner workings of machinery than to the lungs of men Not infrequently we find nuisance dust exposures to be more injurious to the mechanical equipment than to workmen these experts declared 63 In 1946 Business Week wrote that the only silica problem was that some workers were hypersensitive to dust In the most absurd manifestations of this consensus silicosis was presented as a product of racial or ethnic characteristics that made certain workers susceptible In one mill where there were some cases of silicosis still appearing the magazine claimed that this was just proof that the company should have avoided hiring blond workers Brunettes who generally have more hair on the body naturally have more hair in the nostrils which tends to keep silica dust from reaching the lungs 64 At the prestigious Saranac Laboratory symposium on sil- icosis one state official echoed earlier management arguments of the 1920s and 1930s that claimed that technological innovation had eradicated the silicosis problem The most important accomplishment of these preventive measures is that silicosis is becoming a negligible factor and that in the future it will largely be stamped out by preventive measures that have been instituted 65 The Industrial Hygiene Foundation joined with researchers at Saranac to lend authority to this position By 1955 Andrew Fletcher the Board Chairman of the Industrial Hygiene Foundation told the annual meeting that both industry and the Industrial Hygiene Foundation can look back proudly on their achievements Occupational diseases are for the most part eliminated he maintained in a naive or congratulatory address entitled Changing Concepts of Industrial Health 66 The interlocking relationship between industry technical experts lawyers and the very foundations involved in silicosis research raised few ethical qualms for scientists during the 1930s and 1940s In fact even the most prestigious centers associated with the Air Hygiene Foundation such as the Trudeau Foundation in Saranac Lake New York openly and sometimes aggressively pursued corporate funding because there were few other alternatives Traditionally the Saranac Laboratory had conducted studies of tuberculosis and had gradually involved itself in the 1920s in studies of the relationship between tu-