One of my childhood joys was roaming the stacks of libraries and browsing for arcane learning stored in aging books. Often, I had no particular goal in my roaming, and I flitted from topic to topic. Occasionally, however, I came across useful learning. It was in one college library, for instance, that I discovered the process for making nitrogen tri-iodide, which provided me with some simple-minded amusement for years. (I only narrowly avoided detection by Dean Brownlee for a prank involving NI3 in chemistry lab.)
Nowadays, most old book are off limits to the casual library visitor, but digital archives can satisfy my occasional compulsion to browse what is new and compelling in the world of research on topics of interest. And there can be no better source for new and topical research than browsing dissertations and theses, which are usually required to open new ground in scholarly research and debate. There are several online search tools for dissertations, such as ProQuest, EBSCO Open Dissertation, Theses and Dissertations, WorldCat Dissertations and Theses, Open Access Theses and Dissertations, and Yale Library Resources to Find Dissertation.
Some universities generously share the scholarship of their graduate students online, and there are some great gems freely available.[1] Other universities provide a catalogue of their students’ dissertations, the titles of which can be browsed and the texts of which can be downloaded. For lawyers interested in medico-legal issues, the London School of Hygiene & Tropical Medicine has a website, “LSHTM Research Online,” which is delightful place to browse on a rainy afternoon, and which features a free, open access repository of research. Most of the publications are dissertations, some 1,287 at present, on various medical and epidemiologic topics, from 1938 to the present.
The prominence of the London School of Hygiene & Tropical Medicine makes its historical research germane to medico-legal issues such as “state of the art,” notice, priority, knowledge, and intellectual provenance. A 1959 dissertation by J. D. Walters, the Surgeon Lieutenant of the Royal Nayal, is included in the repository.[2] Walters’ dissertation is a treasure trove of the state-of-the-art case – who knew what when – about asbestos health hazards, written before litigation distorted perspectives on the matter. Walters’ dissertation shows in contemporaneous scholarship, not hindsight second guessing, that Sir Richard Doll’s 1955 study, flawed as it was by contemporaneous standards, was seen as establishing an association between asbestosis (not asbestos exposure) and lung cancer. Walters’ careful assessment of how asbestos was actually used in British dockyards documents the differences between British and American product use. The British dockyards had full-time laggers since 1946, and they used spray asbestos, asbestos (amosite and crocidolite) mattresses, as well as lower asbestos content insulation.
Walters reported cases of asbestosis among the laggers. Written four years before Irving Selikoff published on an asbestosis hazard among laggers, the predominant end-users of asbestos-containing insulation, Walters’ dissertation preempts Selikoff’s claim of priority in identifying the asbestos hazard, and it shows that large employers, such as the Royal Navy, and the United States Navy, were well aware of asbestos hazards, before companies began placing warning labels. Like Selikoff, Walters typically had no information about worker compliance with safety regulations, such as respiratory use. Walters emphasized the need for industrial medical officers to be aware of the asbestosis hazard, and the means to prevent it. Noticeably absent was any suggestion that a warning label on bags of asbestos or boxes of pre-fabricated insulation were relevant to the medical officer’s work in controlling the hazard.
Among the litigation relevant finds in the repository is the doctoral thesis of Francis Douglas Kelly Liddell,[3] on the mortality of the Quebec chrysotile workers, with most of the underlying data.[4] A dissertation by Keith Richard Sullivan reported on the mortality patterns of civilian workers at Royal Navy dockyards in England.[5] Sullivan found no increased risk of lung cancer, although excesses of asbestosis and mesothelioma occurred at all dockyards. A critical look at meta-analyses of formaldehyde and cancer outcomes in one dissertation shows prevalent biases in available studies, and insufficient evidence of causation.[6]
Some of the other interesting dissertations with historical medico-legal relevance are:
Francis, The evaluation of small airway disease in the human lung with special reference to tests which are suitable for epidemiological screening; PhD thesis, London School of Hygiene & Tropical Medicine (1978) DOI: https://doi.org/10.17037/PUBS.04655290
Gillian Mary Regan, A Study of pulmonary function in asbestosis, PhD thesis, London School of Hygiene & Tropical Medicine (1977) DOI: https://doi.org/10.17037/PUBS.04655127
Christopher J. Sirrs, Health and Safety in the British Regulatory State, 1961-2001: the HSC, HSE and the Management of Occupational Risk, PhD thesis, London School of Hygiene & Tropical Medicine (2016) DOI: https://doi.org/10.17037/PUBS.02548737
Michael Etrata Rañopa, Methodological issues in electronic healthcare database studies of drug cancer associations: identification of cancer, and drivers of discrepant results, PhD thesis, London School of Hygiene & Tropical Medicine (2016). DOI: https://doi.org/10.17037/PUBS.02572609
Melanie Smuk, Missing Data Methodology: Sensitivity analysis after multiple imputation, PhD thesis, London School of Hygiene & Tropical Medicine (2015) DOI: https://doi.org/10.17037/PUBS.02212896
John Ross Tazare, High-dimensional propensity scores for data-driven confounder adjustment in UK electronic health records, PhD thesis, London School of Hygiene & Tropical Medicine (2022). DOI: https://doi.org/10.17037/PUBS.046647276/
Rebecca Jane Hardy, (1995) Meta-analysis techniques in medical research: a statistical perspective. PhD thesis, London School of Hygiene & Tropical Medicine. DOI: https://doi.org/10.17037/PUBS.00682268
Jemma Walker, Bayesian modelling in genetic association studies, PhD thesis, London School of Hygiene & Tropical Medicine (2012) DOI: https://doi.org/10.17037/PUBS.01635516
- Marieke Schoonen, (2007) Pharmacoepidemiology of autoimmune diseases.PhD thesis, London School of Hygiene & Tropical Medicine. DOI: https://doi.org/10.17037/PUBS.04646551
Claudio John Verzilli, Method for the analysis of incomplete longitudinal data, PhD thesis, London School of Hygiene & Tropical Medicine (2003) DOI: https://doi.org/10.17037/PUBS.04646517
Martine Vrijheid, Risk of congenital anomaly in relation to residence near hazardous waste landfill sites, PhD thesis, London School of Hygiene & Tropical Medicine (2000) DOI: https://doi.org/10.17037/PUBS.00682274
[1] See, e.g., Benjamin Nathan Schachtman, Traumedy: Dark Comedic Negotiations of Trauma in Contemporary American Literature (2016).
[2] J.D. Walters, Asbestos – a potential hazard to health in the ship building and ship repairing industries, DrPH thesis, London School of Hygiene & Tropical Medicine (1959); https://doi.org/10.17037/PUBS.01273049.
[3] “The Lobby – Cut on the Bias” (July 6, 2020).
[4] Francis Douglas Kelly Liddell, Mortality of Quebec chrysotile workers in relation to radiological findings while still employed, PhD thesis, London School of Hygiene & Tropical Medicine (1978); DOI: https://doi.org/10.17037/PUBS.04656049
[5] Keith Richard Sullivan, Mortality patterns among civilian workers in Royal Navy Dockyards, PhD thesis, London School of Hygiene & Tropical Medicine (1994) DOI: https://doi.org/10.17037/PUBS.04656717
[6] Damien Martin McElvenny, Meta-analysis of Rare Diseases in Occupational Epidemiology, PhD thesis, London School of Hygiene & Tropical Medicine (2017) DOI: https://doi.org/10.17037/PUBS.03894558
