Some hidden history of occupational medicine

Abstract

Irving J. Selikoff's research and publications on asbestos-related disease constitute a landmark in recent medical history. Many investigators contributed to the asbestos story, starting at the turn of the century, and the salient features of asbestos diseases were in the literature by the 1940s. But it remained for Selikoff's work, some of it done in collaboration with the trade unions representing the affected workers--a sponsorship not common in occupational medicine--and its prompt and effective publication, to stimulate widespread public interest and the consequent lawsuits which contributed in part to the control of these diseases. Some of the people, and one of the insurance companies involved in the episodes described, made constructive contributions to occupational health in the early part of the century. A. J. Lanza, for example, conducted studies on asbestosis and silicosis and their relationship to tuberculosis among hard rock miners. In 1949, he became director of the Institute of Industrial Medicine at New York University. Louis Dublin, statistician for the Metropolitan Life Insurance Company, contributed substantially to the understanding of silicosis and tuberculosis and the impact of work conditions on health. These facts make the following story all the more poignant. Both asbestos and diatomaceous earth diseases 1 came to industry's attention in the late 1920s and early 1930s. In the Johns-Manville facilities in Canada and the United States, and in the Raybestos-Manhattan textile manufacturing plants and in other asbestos fabrication industries, damage claims for asbestosis had been increasing. During the same period a study in Lompoc, California, at the JohnsManville plant, the largest producer of diatomaceous earth (diatomite, or DE) uncovered an epidemic of silicosis and silico-tuberculosis (Legge and Rosencrantz, 1932). Labor complaints (L'Amiantose, 1950) as well as lawsuits combined to alert the industries to the problems. So serious were these problems that several of the companies were impelled to subsidize scientific investigations. Johns-Manville, Raybestos-Manhattan, and several other companies joined together to sponsor research on asbestos, and Johns-Manville supported studies on diatomite. In both instances, they called on the Trudeau Foundation Laboratory at Saranac Lake, New York, headed by Dr. Leroy U. Gardner.