|
|||||||||||||
file: hph_lec4e.mp3 A History of Modern Public Health: Surveillance - The World of Work So in this section, I'd like to consider the relationship between work and disease using the example of asbestos mining in South Africa in the 20th century. First of all, I would like to say something about the properties of asbestos that make it such a crucial industrial and consumer material. Asbestos gives protection from fire, gives protection from corrosion and from noise. A single strand of asbestos, weighing less than one ounce, which is approximately 25 grams, can be spun for about 300 feet. Another property of asbestos is that even though it is very hard, it is also exceptionally light. And so these particular properties, its hardness and its lightness, the fact that it gives protection from these particular threats such as fire, corrosion, and noise, means that it is used widely in industrial and consumer products. And demand for asbestos rocketed in the post Second World War period. And it's common now to find asbestos in cars, cooling systems, cement sheeting, and vinyl flooring for example. And it is considered that asbestos is the carcinogen that human beings are most exposed to after tobacco. Unfortunately exposure to asbestos can cause some rather debilitating diseases. Three of the main ailments that it is related to are asbestosis, lung cancer, and mesothelioma. And mesothelioma is a rare cancer of the lining of the lung. And it is the knowledge of these three diseases and their relationship to asbestos exposure that becomes particularly crucial for the course of asbestos mining in South Africa which had taken place from the early 1890s. And it takes on increasing significance during the 20th century as global production of asbestos increased. So by 1920, twenty thousand tons of asbestos were being mined across the world. That 20,000 tons represents less than « of a percent of global production by 1976. So you can get a grasp from those figures of the type of explosion for consumer demand for asbestos that took place during the second half of the 20th century. One of the key points about mining in South Africa was that the mine companies were predominantly British-owned. So we had companies that had originally mined asbestos in the UK, and I am thinking here particularly of the company called Turner & Newall that some of you may have heard of, and they actually owned mines in South Africa. But unfortunately, the legislation that applied to other forms of mining in South Africa, that is the Mines Act of 1911 that legislated for the inspection of conditions within mines and fines for breaches of safety, this mines act didn't apply to the asbestos fields in South Africa. So you have an industry here that is not subjected to regulations in the same way that the mining industry as a whole was in this period. This particular map of the South African asbestos mines shows the distribution of the mining in the country, and there are 4 particular places that I want to draw your attention to that have relevance to this debate about the relationship between asbestos and disease that we are going to be exploring. First of all is Pengye in the northeast, and then there are 3 fields in the southwest that are particularly significant: Kuruman, Koegas, and Prieska. And it is these 4 towns that become the subjects of intensive research and survey in the 1960s that we are going to be looking at now. Now it is important to understand that British research from the 1930s onwards had actually linked asbestos to lung disease, and the knowledge was fairly open certainly by the mid to late 1940s that there were specific links between exposure to asbestos and certainly asbestosis and mesothelioma. In 1956 there was a pneumoconiosis act introduced in South Africa, and this gave state officials compensatory powers to examine exposed workers. And what happened with this intervention is that employers became responsible for x-rays of the workers, for periodical examinations, and for keeping records about the medical history of their employees, but it didn't actually, in terms of prevention, cause employers to restrict the level of exposure to asbestos that the mine workers were subjected to nor did it expect the asbestos mine owners to change working practices to secure the safety of their workers. And one important development was the setting up of the Pneumoconiosis Research Unit in the 1960s. And this unit carried out a survey in the 4 towns on the map that I mentioned earlier: Pengye, Kuruman, Koegas, and Prieska. And the survey took a sample of less than 3000 residents in these 4 towns, and it identified 4 cases of mesothelioma. Now that doesn't seem very many, but you have to remember that mesothelioma is a very rare disease, and it is considered that four cases actually represented an epidemic for mesothelioma in such a relatively small sample of the population. And in the early 1980s additional research showed that 30% of South African stevedores were found to have asbestosis which reflected past exposure to the material in the 1960s and 1970s, and you can understand that link when you consider the slide on the top right-hand side which shows the stevedores in Mozambique transporting bags of asbestos on their shoulders from the land to the ships. There is an emerging and continuing level of evidence to show that asbestos exposure was linked to lung disease. And yet there was official silence in South Africa about this link. Both the government knew, and the industry, the mine owners, knew about these clear links between asbestos exposure and the risk of lung disease. One example comes from 1963 when a memorandum from the Secretary of State for South African Mines, J.S. Nell, showed that he knew of the link between asbestos and lung diseases, and it also showed that he suggested that further research should be conducted into these links, but there was absolutely no indication that he considered it was important that workers, the mine workers who were most exposed to asbestos or their families who were also exposed to asbestos by dust that was suspended in the air around the mines and tended to settle on the surrounding towns, there was no indication that he thought that those people should be informed of the possible risk. And there is even evidence that in the late 1950s, Turner & Newall, one of the main companies to have asbestos mine holdings in parts of South Africa, there is evidence that the company executives knew of the link between asbestos and mesothelioma but refused to change mining practices or to inform the workers of the potential hazards. So what this brief overview has shown is that the mining industry and the government displayed a historic lack of concern to the sorts of exposure to asbestos that you can see in the slide on the right-hand side. This is an example from the 1930s, and it shows children sorting asbestos, probably in the northern province. The levels of exposure here are rather frightening. And around about the 1930s and into the 1940s, it became obvious that this sort of exposure had important implications for levels of lung disease and that relatively little was being done about it. And part of the argument that historians have made about this lack of concern is that commerce has an interest in keeping this link between an industrial material and disease secret, and this is because silence was profitable. In the mid 1960s, one company called Cape Asbestos was returning a dividend of 25% to its shareholders. For there to have been a link admitted between asbestos and disease would have meant affecting those very high profit margins. Another argument that has been made by the historian Jock McCulloch is that the system was inextricably linked to the system of apartheid that was present in South Africa during this period. And what apartheid did was it created a very large pool of cheap black labor for working in the mines. You will have noticed that in all the representations of the asbestos mining and the photographs that we have seen, all the workers are black. And also, there is an absence during the system of apartheid of trade unions. So the representations of the workers, the concerns of the workers were not brought to bear on the debate between asbestos and lung disease. And so for mines that were owned predominantly in Western Europe, and particularly in Britain, for these companies to have access to the pool of labor and also to a non-unionized work force represented an economy and a potential for profits that couldn't be realized elsewhere in the world. And partly for these reasons, there was a lack of concern over the link between the industrial exposure to asbestos and lung disease, and mining continued in South Africa, asbestos mining continued until the mid 1990s. And so on that point, we can begin to think about the connections between two seemingly disparate examples: the match-making industry in Great Britain at the end of the 19th century and the case of asbestos mining in South Africa in the 20th century. Last Modified 9/29/07 10:32 AM |
