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Biomedical subjects

Morris Greenberg

Publications and source records attributed to Morris Greenberg.

At least 19 recordsLinked to original sources

The last Senior Medical Inspector of Factories and his place in the history of occupational health.

BACKGROUND: Apart from a few industrialists with senses of enlightened self-interest and of ethics, 19th century Occupational Health (OH) in the United Kingdom was essentially in the care of Her Majesty's Factory Inspectorate (HMFI). Two World Wars drew attention to the special health and efficiency needs of workers in the armaments industry, but it required the climate of a Welfare State after the Second for more general provision to be considered. A number of committees made recommendations for enhancing OH that were not implemented, and it was not until 1972 that a political will developed to enhance the State's provision. As a result of a far-sighted senior civil servant, a remarkable Senior Medical Inspector was in post, ready and willing to assist in bringing about change. METHODS: Published official materials have been reviewed in the light of the author's observation of events and persons from 1967 onwards. RESULTS: For a few years, as a consequence of a political will, academic, corporate, and governmental OH burgeoned in Britain, but with a decline in the economy and political change favoring deregulation, it underwent regression. CONCLUSIONS: Any number of committees may meet to discuss OH provision but their reports will moulder until there is a will for implementing their recommendations, at which the requisite funds and persons materialize to establish institutions. When the political climate changes, it will not be difficult to find persons who for a consideration will assist in their demolition.

Health Plan Implementation↗

Revising the British Occupational Hygiene Society asbestos standard: 1968-1982.

BACKGROUND: In 1968 the British Occupational Hygiene Society (BOHS) published a chrysotile asbestos hygiene standard. As a consequence of acknowledged inadequacies of the data, it underestimated the risks of exposure, but its influence was international and operated for longer than it merited. Five years later, BOHS reported the standard not to be in need of amending, despite its own doubts and no cognizance having been taken of the cancer hazard. Within months, stung by criticism from Dr. Irving J. Selikoff, industry required it to review the standard, which BOHS continued to do for a number of years before giving up. METHODS: Material obtained for the American Courts by means of legal discovery from an asbestos company's archive, provided information on the membership of the new BOHS committees, and on its operation. RESULTS: Alterations in the composition of the new committees included importantly the introduction of certain independent scientists, whose rigor militated against the ready production of a new hygiene standard acceptable to industry. CONCLUSIONS: There was a time in Britain when a learned society might with impunity omit to consult the views of workers or their representatives when making value judgments about their health and safety, but consider it proper to accede to industry's decision as to what hygiene standard it would accept. Health and Safety at Work legislation in 1974, established an organization on which industry and labor were represented, with the onus for recommending hygiene standards. For several years the BOHS Asbestos Sub-Committee continued attempting to reconcile the interests of industry, until finally abandoning hygiene standard setting as its mission.

Academies and Institutes↗

A report on the health of asbestos, Quebec miners 1940.

BACKGROUND: Twenty years after the start-up of the Canadian asbestos industry, reports began to appear of respiratory disease and deaths in asbestos workers in England and in France. An inquiry from the UK in 1912 as to the health of Quebec miners was met by a denial of ill-health, but the loading of the premiums of asbestos workers in the 1930s indicated that, despite further reassuring health studies on Quebec miners, actuaries had data that gave cause for serious concern. METHODS: A report made to the Canadian asbestos industry by a company doctor in 1940, reviewing the literature and presenting his health findings on some 500 employees, was studied in the context of the published information available at the time, and of unpublished contemporaneous material subsequently obtained by legal discovery. RESULTS: The physician denied that the health and longevity of Quebec's miners and millers were adversely affected, and was dismissive of earlier reports of there being serious health risks associated with working with asbestos. CONCLUSIONS: The methodology employed in his health study was defective and his denial of the literature uninformed. The study was widely circulated, and while it may have boosted Canadian industry morale, it met with a sceptical response from British industry. In denying that conditions in Quebec's asbestos mines and mills disabled and killed workers, the author allied himself to fellow professionals loyal to Government and to industry.

Asbestos↗

The art of perpetuating a public health hazard.

OBJECTIVES: Canadian chrysotile (white asbestos) could be a paradigm for those agents that are successfully exploited commercially long after they have been found to be lethal. Mining started in the late 1870s, and reports of disability and death followed in Britain (1898), in France (1906), and Italy (1908), but it was not until 1955 that Canada acknowledged asbestosis in its asbestos miners and millers. Even when shortly after asbestos was shown to be carcinogenic, Canadian Public Relations experts assisted by their scientists exculpated chrysotile by deeming other agents to have been causal. RESULTS: The PR techniques that have been successfully used in the defense of chrysotile are reviewed, to forewarn scientists involved in formulating public health policy for similar agents, as to the tricks that will be played on them.

Animals↗

The doctors and the dockers.

BACKGROUND: London Dockers unloading a dusty asbestos cargo in 1965, consulted an eminent Occupational Health physician, Dr. Donald Hunter who informed them that they had been at serious risk. A second, opinion provided jointly by a Consultant Chest Physician, the Port Medical Officer, and the Medical Advisor to the Trades Union Congress, declared that they knew of no disease affecting dockers, and stated that intermittent exposure to asbestos constituted an inconsiderable risk that with certain precautions would be eradicated. METHODS: Archival material have been obtained to supplement limited published material and eyewitness accounts of the event, to provide a clearer picture of the issues. RESULTS: Reassured by the Chest Physician, the Port Medical Officer, and the Medical Advisor to the Trades Union Congress that they had little to fear, London dockers resumed unloading asbestos. From time to time dockers at other ports were to express concern and interrupt work, only to be similarly reassured. CONCLUSIONS: Had the medical troika in 1965 considered the available health statistics, they would have had reason to take a less sanguine attitude to the cancer mortality of dockers. An analysis of data for 16 selected occupations for the years 1900-1902, showed dockers to have an unhealthy job, with deaths from 'All Cancers' of 1.09 per 1,000 years of life (the fourth highest). The Registrar General's occupational mortality report for 1951, noted excess tumors of the lung and stomach for dockers. Elevated Standardized Mortality Ratios for lung cancer had consistently been calculated by the Registrar General for the 20-64 age group of dockers; in 1931 (183), 1951 (149), and 1961 (169): by 1971 it would be 182. A total of 266 dockers were to be registered in the UK by 1999 as having died of malignant mesotheliomas, proving that Donald Hunter's concern for dockers had not been excessive.

Asbestos↗

Mineral fiber problems and their management: UK 1890-1935.

BACKGROUND: The first intimation that mineral fibers other than asbestos were biologically active, is generally identified with reports of experimental studies by Stanton and Wrench, and Pott and Friedrichs, in the early 1970s. In 1890 however, man-made mineral fiber was recognized to present human health hazards; in 1912 experimental study confirmed asbestos to be fibrogenic, and by 1935 other mineral fibers came to notice as potential lung hazards. METHODS: Published and archival sources have been reviewed to trace the emergence between 1890 and 1935 of the awareness of the health hazards of various fibrous minerals, and the development of strategies for their control. RESULTS: By the early 1900s there was evidence that the asbestos substituted for the man-made mineral fiber insulation material employed to improve the thermal efficiency of steam powered engines, presented a serious health problem. In the early 1930s, other mineral fibers came to be suspected of causing pneumoconiosis. CONCLUSIONS: Containment, local exhaust ventilation and personal respiratory protection were instituted for the amelioration of asbestosis, but because of the limitations of what was perceived to be reasonably practicable on economic grounds, and what was feasible technologically, their benefits were severely limited. Initial and periodic medical examination were introduced as precautionary measures, based on hope rather than on experience. When in the early 1930s, the investigation of coal mine dust and siliceous dust, threw up the hypothesis that fibrous natural mineral dusts other than asbestos might be fibrogenic, this was ignored and no further investigations were pursued and no precautionary measures were set in train.

Air Pollutants, Occupational↗

The British approach to asbestos standard setting: 1898-2000.

BACKGROUND: The asbestos industry started in the late 1870s, and the first accounts of severe respiratory disease in its workers were published in England (1898, 1906), France (1907), and Italy (1908). For a hundred years, a series of increasingly lower standards were set for asbestos in Britain: initially they purported to prevent asbestosis, and latterly to reduce asbestosis and malignancies to acceptable levels. METHODS: Published accounts of how British asbestos exposure standards came to be derived are reviewed in the light of archival materials originated by industry and government. RESULTS: The earliest standard, of necessity, was not evidence based and while subsequent standards purported to relate doses to effects, the indifferent quality of the measurement of dose, and the poor discrimination of effects, militated against arriving at a standard in which trust should be placed. Each successive standard that was accepted, conformed to what could be achieved in production processes, as far as it was reasonably practicable on technological and economic grounds. CONCLUSIONS: For the better part of a hundred years, confidence was misplaced in the ability of process engineers and physicians to protect workers against asbestos. Finally, deciding that asbestos was neither technologically nor economically essential, and was unsafe in use, Europe issued a Directive, to which Britain will conform, that will virtually ban it use throughout the Community by 2006.

Asbestos↗

Cape Asbestos, Barking, health and environment: 1928-1946.

BACKGROUND: The mining of chrysotile began in the province of Quebec in the late 1870s. Twenty years later, while annual exports were still measured in hundreds of tons, serious and lethal effects were being reported in England and shortly after in France. In 1913, after a number of years of operating in South Africa, Cape Asbestos Company established a factory in Britain in Barking, Essex. Some 15 years later, in 1929, the local Medical Officer of Health was seeing their asbestotic workers at his Chest Clinic, the local Chest Hospital was investigating them and publishing their findings, and the Coroner began what was to be a long series of inquests. METHODS: Documents from the Institute of Mining and Metallurgy, The Royal School of Mines, Central Library of Imperial College, The Porton and Barking Archives, and documents obtained by legal discovery were utilized in preparing this historical perspective. RESULTS: Despite complaints from the local authority, Parliament was assured that there was no special incidence of disease at Cape, Barking, and that its exhaust ventilation was quite up to the general standard and constantly being improved. Reports on the factory environment and information on the health of Cape's workforce that are available for the years 1928-1934, provide a less sanguine view of the situation, as was confirmed by subsequent health reports on its workforce. CONCLUSIONS: The case of asbestos is considered as a paradigm for the economic considerations that are considered to justify the perpetuation of unsafe and unhealthy occupations, decisions with which medical opinion can be found to concur.

Asbestos, Serpentine↗

Biological effects of asbestos: New York Academy of Sciences 1964.

BACKGROUND: In 1964, the New York Academy of Sciences held a conference on asbestos that was to promote the slow decline in the fortunes of asbestos. It brought together a Who's Who of international scientists who had conducted and reported on experimental and human studies of the effects of asbestos. Very little new data were presented at the conference, but by bringing together a compendium of knowledge of the adverse effects of asbestos, it served further notice to asbestos-using industry of the major public health problem that they had created. With the assistance of its employees and certain scientists, industry mounted public relations exercises to counter the adverse publicity of lung cancer and malignant mesothelioma. Attempts were made to minimize the impact of these diseases by suggesting that their alleged associations with asbestos were spurious, and by diversionary ad hominem attacks on Professor Irving J. Selikoff who had played an important role in the organization of the conference. METHODS: Consideration of the contents of the meeting program, other previously published information and documents revealed through legal discovery by Chase Manhattan Bank provide the sources on which this paper is based. CONCLUSIONS: Today, asbestos is no longer seen as a material indispensable on technical grounds and a mainstay of industry and the economy. Its progressive banning in developed countries may be seen as the consequence of the momentum initiated in New York in 1964.

Academies and Institutes↗