Edgar Leigh Collis: Industrial lung disease and ergonomics.

Edgar Collis was appointed as the second Medical Inspector of Factories in 1908, holding the post until the outbreak of the First World War when he became Medical Director of the Ministry of Munitions. After the war, he was appointed to the chair in public health in the University of Wales. He held this post while living in Lossiemouth in Scotland, some 570 miles distant. His research interests were in industrial lung disease, industrial hygiene, and the health of coal miners. He made important contributions to the first and third subjects, but was a less significant figure in the field of industrial hygiene. Among his achievements were the recognition of the relationship between silicosis and tuberculosis, the harmful effects of non-silicaceous coal dust, and the need to fit the worker to the job, and the job to the worker.

Death in the New Town: Edinburgh's hidden story of stonemasons' silicosis.

The building of the Edinburgh New Town, from the mid-18th to the mid-19th centuries, was a major advance in harmonious and elegant town planning. However, there is anecdotal evidence that it led to the occurrence of an epidemic of silicosis/tuberculosis among the stonemasons. We have reviewed contemporary accounts of the episode and early records of the understanding of silicosis. We have also studied the lung of a contemporary stonemason, preserved in the museum of the Royal College of Surgeons of Edinburgh, and confirmed the presence of silico-tuberculosis in it. The evidence shows that a major epidemic did occur, caused by a combination of factors. The size of the undertaking attracted many stonemasons to Edinburgh over a period of almost 100 years, intensively cutting and dressing stone. The principal stone worked was a very high-quartz sandstone, derived from the local Craigleith quarry, having properties that made it desirable for prestige buildings. However, even before the construction of the New Town, Craigleith sandstone was notorious for its dustiness and the Edinburgh stonemasons worked the stone in unventilated sheds. Stonemasons appeared to be aware of the risk of their trade, but little was known about preventive measures. It appears it was assumed that the risks to stonemasons disappeared after the Craigleith quarry closed, the employers emphasising (without evidence) the lack of health risks in other quarries, and the tragic episode appears to have been forgotten. However, we point to the continuing occurrence of silicosis among stonemasons to the present day; the importance of remembering such episodes is stressed lest the lessons of the past be forgotten.

Truncating a disease. The reduction of silica hazards to silicosis at the 1930 international labor office conference on silicosis in Johannesburg.

The current nosology and etiology of silicosis were officially adopted by the 1930 International Labor Office (ILO) Conference on silicosis in Johannesburg. Convened by the International Labor Office and by the Transvaal Chamber of Mines, it paved the way to the adoption of a 1934 ILO convention which recognized silicosis as an occupational disease. Even though it constituted a social and sanitary turning point, the Johannesburg conference, strongly influenced by South African physicians working for the gold mining industry, reduced silica hazards to silicosis, an equation which is questioned nowadays. While the definition of silicosis adopted in 1930 was a major step in the recognition of occupational pneumoconioses, it also led to the under-identification of some pathogenic effects of silica. Going back to history opens new avenues for contemporary medical research.

Miners, silica and disability: The bi-national interplay between South Africa and the United Kingdom, c1900-1930s.

This paper investigates silicosis as a disabling disease in underground mining in the United Kingdom (UK) before Second World War, exploring the important connections between South Africa and the UK and examining some of the issues raised at the 1930 International Labour Office Conference on silicosis in Johannesburg in a British context. The evidence suggests there were significant paradoxes and much contestation in medical knowledge creation, advocacy, and policy-making relating to this occupational disease. It is argued here that whilst there was an international exchange of scientific knowledge on silicosis in the early decades of the twentieth century, it was insufficient to challenge the traditional defense adopted by the British government of proven beyond all scientific doubt before effective intervention in coal mining. This circumspect approach reflected dominant business interests and despite relatively robust trade union campaigning and eventual reform, the outcome was an accumulative legacy of respiratory disease and disability that blighted coalfield communities.

From the definition of silicosis at the 1930 Johannesburg conference to the blurred boundaries between pneumoconioses, sarcoidosis, and pulmonary alveolar proteinosis (PAP).

The 1930 International Labour Office Conference on silicosis in Johannesburg identified silicosis by setting a medicolegal framework to its nosology: as with other occupational illnesses, its medical content was fixed under economic pressure. This article follows a reading of all the proceedings of this conference (debates and reports of experts) to examine their potential impact on the etiology and nosology of other diseases, specifically sarcoidosis and pulmonary alveolar proteinosis (PAP), "idiopathic" diseases in which inorganic particles may be involved. We propose renewed study of the role of inorganic particles in these diseases. To do this, we propose to mobilize detection means such as mineralogical analysis and electron microscopy and in depth interviewing that are currently seldom used in France, in order to establish diagnosis and the potential occupational and environmental origin of these diseases.

The pathologist's view of silicosis in 1930 and in 2015. The Johannesburg Conference legacy.

The 1930 International Labour Office Conference on silicosis in Johannesburg was a turning point in the history of silicosis and in the recognition of the associated pathologic patterns. Since 1930, pneumoconioses such as silicosis have become much rarer in developed countries and can now be diagnosed at an early stage based on clinical and radiologic criteria. However, in spite of these advances, pathologists must remember to look for silica in tissues, particularly when clinical and radiologic findings are more uncertain. Furthermore, nowadays pathologists essentially observe silicotic lesions as incidental findings adjacent to lung cancers. In addition to identifying the characteristic lesions, pathologists must also try to identify their causative agent, in the case of crystalline silica firstly by using polarized light examination, followed as appropriate by more sophisticated devices. Finally, pathologists and clinicians must always keep in mind the various implications of exposure to silica compounds in a wide range of diseases.

Historical and emerging workplaces affected by silica exposure since the 1930 Johannesburg conference on Silicosis, with special reference to construction.

INTRODUCTION: At the time of the 1930 International Labour Office Conference on silicosis in Johannesburg, mining was the main sector affected by silicosis; however, other industries would later emerge as areas of concern. METHODS: A search of the occupational hygiene and epidemiological literature was conducted to retrieve historical and current documents pertaining to silica exposure and associated hazards. RESULTS: The potential risk of silicosis in construction became evident starting in the 1960s, and the body of literature including case reports, sampling surveys, and medical surveillance continues to grow to this day. Among non-construction activities, hydraulic fracturing and engineered countertop manufacturing have recently appeared as industries with a potential for overexposure, while mining remains the industrial sector with the highest prevalence of exposure. CONCLUSIONS: The risk of developing this "ancient disease" remains a current issue in many workplaces, and requires ongoing surveillance and prevention efforts.

From the 1930 International Johannesburg conference on silicosis, to "tables" of occupational diseases, France, 2000 onward: A comparative reading.

Through the concept of "thought collectives" in particular, Ludwik Fleck was a pioneer in demonstrating how much scientific knowledge is inherently made up of social and historical material. In this article, I propose to follow a Fleckian path by comparing the proceedings of the 1930 International Labour Office Conference on silicosis in Johannesburg on the one hand, and on the other the content of the debates that took place in France in the 2000s to revise the "tables" of occupational diseases which define the compensation rules for salaried workers in the French general (as well as the farm) health insurance scheme. The text offers an analysis of the striking similarities between these two distant sources, pointing out particularly the repetitiveness of ignorance and knowledge, and the nature of what can be admitted as a body of "evidence" in medico-legal issues such as the definition and compensation of occupational diseases.

"Acute" silicosis at the 1930 Johannesburg Conference on silicosis and in its aftermath: Controversies over a distinct entity later recognized as silicoproteinosis.

BACKGROUND: Very rapidly progressive "acute silicosis" was observed prior to the 1930 International Labour Office Conference on silicosis, but its clinical significance and pathologic relationship to classic silica caused pneumoconiosis were not settled. METHODS: Textual analysis of the 1930 Conference proceedings identified data relevant to rapidly progressive silicosis. Standard bibliographic searches identified relevant biomedical literature dating from before and after the Conference. RESULTS: The 1930 Johannesburg Conference contained descriptions of acute silicosis, especially in the abrasive powders industry, but acute silica-related lung disease did not conform to a three-stage disease model in which tuberculosis supra-infection caused advanced disease, a model accepted at the Conference. Over following decades, additional reports appeared of rapidly progressive silicosis, unrelated to tuberculosis. Pulmonary alveolar proteinosis was identified only in 1958. CONCLUSIONS: Adoption by the 1930 Johannesburg Conference of a classification scheme into which acute rapidly progressive disease unrelated to tuberculosis fitted poorly may have impeded the understanding of acute silicosis and its importance.

Beyond a shadow of a doubt? Experts, lay knowledge, and the role of radiography in the diagnosis of silicosis in Britain, c. 1919-1945.

The history of silicosis provides an important chapter in the history of occupational and environmental health. Recent historical scholarship has drawn attention to the importance of patient attitudes, popular protests, and compensation claims in the formation of a "lay epidemiology" of such a disease, frequently challenging the scientific orthodoxies devised by large corporations and medical specialists. Surprisingly little research has been undertaken on the United Kingdom, which provided much of the early expertise and medical research in respiratory diseases among industrial workers. This article examines the introduction of a particular technique, x-radiography, and its use by radiologists and others in debates on the causes and consequences of silica inhalation by the laboring population in Britain during the early decades of the twentieth century. In contrast to some recent interpretations, and also to the narrative of progress that practitioner historians have developed since the 1940s, this article suggests that the use of this technology was contested for much of this period and the interpretation of X-rays remained disputed and uncertain into the 1950s. The article also questions recent accounts of lay epidemiology as an adequate model for understanding the progress of such innovations in medical history.

The politics of silicosis in interwar Spain: Republican and Francoist approaches to occupational health.

This article explores the emergence and recognition of silicosis as an occupational disease in interwar Spain. Following International Labour Office guidelines, growing international concerns and local medical evidence, Republican administrators provided the first health care facilities to silicosis sufferers, who eventually became entitled to compensation under the Law of Occupational Diseases (1936), poorly implemented due to the outbreak of the Civil War (1936-39). Silicosis became a priority issue on the political agenda of the new dictatorial regime because it affected lead and coalmining, key sectors for autarchic policies. The Silicosis Scheme (1941) provided compensation for sufferers, although benefits were minimised by its narrow coverage and the application of tight criteria.

The recognition of silicosis: labor unions and physicians in the Chilean copper industry, 1930s-1960s.

By the late 1930s, silicosis had become one of the most important occupational diseases in Chile. It was a medical and scientific problem, and a favorite topic in medical congresses; in Chile, a mining country, it also had serious political and economic implications. The recognition of silicosis did not happen in a vacuum, but was part of a national debate on the social role of the state and its responsibility toward working people's health and safety. This article traces the history of silicosis as an occupational disease from the late 1930s to the late 1960s, and argues that the recognition of the disease was the result of a medical, labor, and political struggle.