Jock McCulloch and Geoffrey Tweedale are labor historians, which means mostly they write about the issues of interest to industrial workers, from an unremittingly pro-labor and anti-management perspective. Recently, these British writers have weighed in on American labor history, and the role of Dr. Anthony Lanza in the litigation that followed the Gauley Bridge tunnel construction. See Jock McCulloch and Geoffrey Tweedale, “Anthony J. Lanza, Silicosis and the Gauley Bridge ‘Nine’,” 26 Social History of Medicine (2013), in press [cited as M&T]
Here is the authors’ abstract:
“Gauley Bridge was the scene of America’s biggest industrial disaster, in which hundreds of workers died from silicosis in the aftermath of the drilling in 1930–31 of a hydro-electric tunnel at Hawk’s Nest. This article scrutinises for the first time the role of Dr A. J. Lanza (a medical director of Metropolitan Life Insurance Company) in hiding the extent of acute silicosis amongst the tunnellers. Lanza and his allies in the medical profession were able to impose their own interpretation on events at Gauley Bridge. Their analysis of nine autopsies ignored the evidence of acute silicosis, in favour of one which emphasised tuberculosis, racial susceptibility, syphilis, the supposed negligence of the workforce and alleged racketeering by lawyers. The result was that acute silicosis largely disappeared from medical discourse and Gauley Bridge was denied a place in America’s national consciousness.”
McCulloch & Tweedale’s investigation into Lanza’s role in the litigation is interesting, but hardly surprising. He was, after all, a medical director of a large insurance company, and no doubt that the Gauley Bridge litigation, which started in 1932, threatened Met Life’s interests and his own. These British authors, however, do a much less convincing job of investigating the bias of the physicians who testified for some of the Gauley Bridge victims, and of the plaintiffs’ lawyers, who had a substantial interest in passing off tuberculosis, pneumonia, and other respiratory illnesses as silicosis.
Was Gauley Bridge Denied A Place in America’s National Consciousness?
McCulloch and Tweedale claim that the Gauley Bridge disaster hardly registered in the nation’s memory. Their claim is demonstrably false. M&T at 2. These authors appear to make their claim to advance a conspiratorial labor view of history that fails to account for evidence from many other walks of life. They write:
“The neglect of Hawk’s Nest—which is indicative of the way that risks in the workplace and silicosis in particular have been underplayed or ignored by historians and social scientists—is unfortunate.”
M&T at 3. While their suggestion that Hawk’s Nest, another name for the Gauley Bridge locale, has been ignored by social historians until recently has some plausibility, their implication of more widespread neglect cannot be sustained. Furthermore, their suggestion that Gauley Bridge fits into their Marxist paradigm of corporate corruption of science (citing similar works by Michaels, Castleman, Rosner, et al.) ignores the robust debate from all sectors of society, including the scientific community, organized labor, political actors, industry, government, and academia.
The Gauley Bridge disaster, and disaster it was, was memorialized in song, in literature, and most important, in a refined understanding of how extreme silica exposures can lead to rapid onset of silicosis. These “non-labor” sources are generally ignored in the authors’ “tunnel vision.” McCulloch and Tweedale’s indictment against Lanza asserts that Lanza:
“did not seek to find a truthful explanation for the premature deaths of these men(and countless others), but instead hijacked the medical agenda to serve powerful business interests. In doing so, they certainly proved to be accomplices, but hardly unknowing ones.”
M&T at 3-4.
The historical evidence may support Lanza’s work behind the scenes in the Gauley Bridge trials, but the authors broad, overwrought implications are non-sequiturs:
“As a result, for almost half a century Hawk’s Nest was denied a place in the national consciousness and silicosis was elided as a major public health issue in the USA.”
M&T at 4.
In Song
In 1936, Josh White wrote and sang a labor protest song, “Silicosis is Killing Me”:
I said silicosis, you made a mighty bad break of me.
Awww, silicosis made a mighty bad break of me.
You robbed me of my youth and health;
All you brought poor me was misery.
Now silicosis, you’re a dirty robber and a thief.
Awww silicosis, dirty robber and a thief.
Robbed me of my right to live and all you brought poor me was grief.
I was there digging that tunnel for six bits a day;
I was there digging that tunnel for six bits a day;
Didn’t know I was digging my own grave, silicosis eating my lungs away.
I says mama, mama, mama, cool my fevered head.
I says mama, mama, come and cool my fevered head.
I’m going to meet my Jesus, God knows I’ll soon be dead.
Six bits I got for digging, digging that tunnel hole.
Six bits I got for digging, digging that tunnel hole.
Takes me away from my baby, it sure done wrecked my soul.
Now tell all my buddies, tell all my friends you see;
Now tell all my buddies, tell all my friends you see.
I’m going way up yonder, please don’t grieve for me.
In Cinema
Silicosis was addressed in the emerging art form of cinema, but perhaps most notably in The Citadel (1938), which featured Robert Donat as a physician trying to treat and prevent silicosis. The movie was nominated for an Academy Award, for best picture in 1939; King Vidor was nominated for his directing of the movie.
Perhaps less artistic, but no less compelling than King Vidor, in 1937, Secretary of Labor Frances Perkins declared war on silicosis, toured mines, convened national conferences on the problem, and issued a film entitled, “Stop Silicosis.”
Secretary Perkins as she appeared in “Stop Silicosis.”
In Media
The Gauley Bridge disaster and aftermath were covered widely in newspapers and magazines through the mid- to late-1930s. McCulloch and Tweedale concede the existence “extensive national media coverage.” M&T at 14. They complain, however, that “press interest subsided.” Id. Before we advert to conspiracy theories and suggestions of mass attention deficit disorder, we need only remind ourselves that soon after the Congressional hearings, and the National Silicosis Conference, of the 1930s, Hirohito and Hitler occupied center stage. Press interest is, almost by definition, ephemeral.
In Legislative Action
In 1936, Congress reacted angrily to the media coverage of the Gauley Bridge tunnel workers’ developing and dying of acute silicosis.
A contemporaneous account described the congressional hearings and quoted from the Committee’s official report:
“In a two hundred printed page report the Committee on Labor of the House of Representatives at Washington furnishes the ‘Hearings’ on House Joint Resolution 449 – the legislative vehicle which rudely trundled into the light of publicity the secrets of the silicosis tragedy at Gauley Bridge, West Virginia. This Committee of the Congress presents the testimony of many specialists, including several from the United States Bureau of Mines and the Public Health Service, as well as of special investigators and several surviving victims of the occupational disease from this now notorious tunnel operation. The official report of the investigation
concludes:
‘That the whole driving of the tunnel was begun, continued, and completed with grave and inhuman disregard of any consideration for the health, lives, and future of the employees.
That as a result many workmen became infected with silicosis; that many died of the disease and many not yet dead are doomed to die from the ravages of the disease as a result of their employment and the negligence of the employing contractor. That such negligence was either willful or the result of inexcusable and indefensible ignorance there can be no doubt on the face of the evidence presented to the committee.’
The record presents a story of a condition that is hardly conceivable in a democratic government in the present century. It would be more representative of the middle ages. It is the story of a tragedy worthy of the pen of a Victor Hugo–the
story of men in the darkest days of the depression, with work hard to secure, driven by despair and the stark fear of hunger to work for a mere existence wage under almost intolerable conditions.”
26 Am. Labor Legis. Rev. 66 (1936)
Francis Perkins, Roosevelt’s Secretary of Labor, in 1938 convened a National Silicosis Conference, which brought together organized labor, industry, government, and academics to address the outstanding safety and health issues in industries that gave rise to unsafe silica exposures among their workers. The National Silicosis Conference published its proceedings in a series of reports, which in turn were memorialized in textbooks of the time. See, e.g., Jewett V. Reed & A.K. Harcourt, The Essentials of Occupational Disease 162 & n. 15 (1941) (citing National Silicosis Conference, Report on Medical Control. United States Dep’t of Labor Bull. No. 21, Part 1 (1938)).
LITIGATION: plus ça change, plus c’est la même chose
Jock McCulloch and Geoffrey Tweedale deplore Dr. Lanza’s participation in the silicosis litigation that followed the Gauley Bridge disaster. They go to great lengths to suggest that Lanza suppressed the diagnostic entity of “acute silicosis,” and that he was motivated by race prejudice against the African American tunnel workers and bias in favor of the insurance company for which he worked.
Their narrative of the Gauley Bridge litigation, however, is selective and fatally incomplete. They report that the first case to go to trial in 1933, Raymond Johnson v. Rinehart & Dennis Company, resulted in a hung jury, and they offer multiple hearsay to suggest that the defense bribed several members of the jury. Perhaps there is something to the innuendo, but these historians ignore the contemporaneous accounts that described the circus atmosphere created by the histrionics of the plaintiffs’ counsel. Newsweek described the “legal pyrotechnics”: the plaintiffs’ lawyers
“threw handfuls of white silica dust into the air to show jurors how it hung like an ectoplasmic pall. The plaintiffs’ legal team arranged a court room procession of doomed silicosis sufferers — the parade of the living dead.”
“Silicosis Tunneling Through an Atmosphere of Deadly Dust” Newsweek 33, 34 (Jan. 25, 1936). Rinehart & Dennis settled 200 cases in the aftermath of the hung jury. The plaintiffs’ lawyers filed additional cases, but McCulloch and Tweedale fail to report that the next jury, sitting in Charleston, rejected the worker’s claim. Id.
In 1949, the U. S. Supreme Court, following the lead of the New York Court of Appeals, declared it to be a matter of common knowledge that breathing silica dust “is injurious to the lungs and dangerous to health,” a fact the plaintiff’s employer “was bound to know.” Urie v. Thomas, 337 U.S. 163, 180 (1949), citing Sadowski v. Long Island R.R., 292 N.Y. 448, 456 (1944).
In Occupational Medicine
Before the Gauley Bridge disaster, acute silicosis was not a well-defined diagnostic condition. A paper published in the Journal of the American Medical Association, in 1932, states that “acute silicosis” did not gain recognition until 1929. Earle M. Chapman, “Acute Silicosis,” 98 J. Am. Med. Ass’n 1439 (1932). The author described cases arising out of the abrasive soap manufacturing industry, where silica exposures were confounded by exposure to alkali soap powder.
Two papers in 1933, in the American Journal of Public Health, gave tentative recognition to acute silicosis, and cautiously labeled the condition, “so-called acute silicosis.” Homer L. Sampson, “The Roentgenogram in So-Called ‘Acute’ Silicosis, 23 Am. J. Pub. Health 1237 (1933); and Leroy U. Gardner, “Pathology of So-Called Acute Silicosis,” 23 Am. J. Pub. Health 1237 (1933).
Unfortunately for McCulloch and Tweedale’s thesis, the recognition of acute silicosis, and the assessment of the prevalence of all varieties of silicosis, were confounded by the wide-spread prevalence of tuberculosis (TB). The radiographic appearance of TB often consists of nodular opacities, which physicians, using early, unsophisticated chest radiography, could easily confuse with silicosis. Often workers had both TB and silicosis, and the severity of the patients’ conditions could not easily be attributed to one or the other condition.
Reading the medical literature of the day is a healthful antidote to the glib generalizations that unfairly import present-day knowledge into the discussion of silicosis in the 1930s. In 1934, Dr. John Hawes, in the New England Journal of Medicine, noted that:
“Our ideas concerning silicosis have undergone radical changes during the past ten to fifteen years.”
John B. Hawes, II & Moses Stone, “The Effect of Acute Respiratory Tract Infections Upon Latent Silicosis,” 211 New Engl. J. Med. 1147, 1147 (1934). Tuberculosis and tuberculosilicosis were major confounders in the clinical, diagnostic picture confronted by physicians in the 1930s and 1940s. See, e.g., Louis Benson, “Tuberculosilicosis,” 223 New Engl. J. Med. 398 (1940); H. K. Taylor & H. Alexander, “Silicosis and Silico-Tuberculosis,” 111 J. Am. Med. Ass’n 400 (1938); G. Ornstein & D. Olmar, “Tuberculosis and Silicosis,” 2 Quarterly Bulletin Seaview Hospital 28 (1936).
An editorial in the New England Journal of Medicine, in 1936, presented a balanced view of the issues, and noted that both labor and management had important work to do to bring the safety issues under control. Editorial, “The Problem of Silicosis,” 214 New Engl. J. Med. 794 (1936).
Effective therapies for TB became available in the 1950s. During the 1930s, silicotuberculosis was often called “complicated” silicosis; i.e., silicosis was complicated by mycobacterial infection. In the 1950s, with the advent of antiobiotic therapies for TB, “complicated silicosis” changed meaning to refer to advanced chronic silicosis in which small silicotic nodules had coalesced into large nodules.
Even after antibiotics became available for TB, silicosis was hardly forgotten. Of course, the medical profession and the citizenry had other pressing issues in the 1950s: polio, an emerging epidemic of tobacco-related lung cancer, the threat of war and nuclear holocaust. Still, silicosis remained part of the larger discussion of occupational and environmental hazards. See, e.g., Harriet L. Hardy, “Medical Progress: Occupational Medicine,” 247 New Engl. J. Med. 473 (1951). See also Schachtman, “Conspiracy Theories: Historians, In and Out of Court” (2013) (discussing the quantitation of publication rates about silicosis in both PubMed and in Google labs, both of which show continuing interest in, and publication about, silicosis throughout the 1950s and 1960s, into the OSHA era).
The Gauley Bridge litigation was a short-lived side show in the history of silicosis. Contrary to the McCulloch and Tweedale’s narrative, however, acute or rapid-onset silicosis became a well-accepted diagnostic entity. See, e.g., Lewis Gregory Cole & William Gregory Cole, Pneumoconiosis (Silicosis) – The Story of Dusty Lungs – A Preliminary Report (N.Y. 1940); Jewett V. Reed & A.K. Harcourt, The Essentials of Occupational Disease 164 (1941); Rutherford T. Johnstone, Occupational Medicine and Industrial Hygiene 337 (1948); Donald Hunter, Diseases of the Occupations 837, 849 (1955).
Prevalent Racketeering
McCulloch and Tweedale concede that accurate diagnoses of silicosis require a chest X-ray (which labor radicals and plaintiffs’ lawyers in the 1930s disputed), as well as well as careful clinical examination and full occupational and personal medical histories. M&T at 5. Although they note the diagnostic difficulties, the authors miss the lack of specialization and experience among many general practice physicians to make an accurate diagnosis of silicosis. They acknowledge that the use of X-rays in diagnosis was still contested in the early 1930s. M&T at 11. The situation in the 1930s was thus ripe for specious claiming.
What McCulloch and Tweedale also seem to miss in their focus on a few compelling Gauley Bridge cases is that the diagnostic difficulties and confounders were a prescription for fraud and scamming on the wider stage. In deploring management’s lobbying for workmen compensation laws, they ignore that many labor unions concurred. In the context of silicosis hazards, plaintiffs faced serious legal hurdles against their employers, in the form of limitations, assumption of risk, fellow worker, and contributory negligence defenses.
In 1936, in the pages of the New England Journal of Medicine, Dr. Hawes commented upon the widespread scamming and racketeering that accompanied the serious silicosis cases in West Virginia.
“Very few physicians are aware of the extent to which claims for alleged injury and disease due to dust are being brought before courts and industrial accident boards in this country. The situation in this regard amounts to a ‘racket’ compared with which others, notorious in New York, Chicago and elsewhere, fade into insignificance. Unscrupulous lawyers have their ‘runners’ on the lookout for any employee who is exposed to dust in the course of his work, no matter what the nature of the dust nor however harmless it may be, who happens to come down with a cough or a cold or indeed with almost any other illness and then and there try to persuade him to bring suit. Unfortunately, in too many instances, physicians partly through ignorance and partly through an honest desire to help their patients and perhaps on the general theory of ‘soaking the insurance company’ are willing to testify that the dust to which this individual had been exposed was entirely responsible for his condition. In nearly 100 per cent of such cases the doctor takesat its face value the word of the worker and his friends as to the dust hazard without any real knowledge of the situation obtained from a personal inspection of the plant or at least by interviewing those in a position to know.”
John B. Hayes, II, MD, “Silicosis,” 215 New Engl. J. Med. 143 (1936).
Although the medical understanding of silicosis has advanced tremendously, the racketeering, alas, is still with us to this day. See In re Silica Products Liab. Lit., 398 F. Supp. 2d 563 (S.D. Tex. 2005) (Jack, J.) (describing the attorneys’ manufacturing fraudulent silicosis claims in MDL 1553). Of course, there are real silicosis cases, but overwhelmingly they are “simple” silicosis cases, typically unaccompanied by impairment or disability. Tuberculosis is now rarely a confounder, but histoplasmosis and coccidioidomycosis are important confounders of simple silicosis in some areas of the United States.
The Charge of Racism
McCulloch and Tweedale point out that Lanza formed an opinion that black workers were more prone to TB and silica-related disease because of their race and prevalent syphilis. To be sure, there was (and still is) much race, ethnic, and religious prejudice in the United States. Lanza’s views on race, however, are irrelevant to the ultimate acceptance of acute or rapid-onset silicosis as an occupational hazard of extremely high-levels of occupational silica exposure. The race theory appeared to play no role in the civil litigation in West Virginia, and it receives no mention in the many textbooks that describe and accept acute silicosis as a diagnostic entity. As for the continuing existence of race prejudice, McCulloch and Tweedale might have noted that Dr. Gerrit Schepers, who testified for plaintiffs in asbestos and silica cases in the United States for decades, described young black African children as “pickaninnies.” See Gerrit Schepers, “Discussion,” 132 Annals N. Y. Acad. Sci. 246, 247 (1965). It is a relatively easy, ad hominem game to play, to dismiss a scientist’s views because of his irrational race prejudices. Lanza may have been influenced by his racial theories in acting behind the scenes of the Gauley Bridge litigation, but McCulloch and Tweedale would be hard pressed to find them articulated in Lanza’s textbooks or articles.
The Rosner-Markowitz Hypothesis
The authors note that Lanza, with Metropolitan Life, helped to form the Air Hygiene Foundation (later the IHF), and they insinuate that these organizations were involved in various nefarious actions:
“The AHF (later named the Industrial Hygiene Foundation) was an enduring and powerful industry group, which helped defuse the silicosis crisis by helping companies defend compensation claims, by conducting industry-sponsored industrial hygiene studies and by assuaging public fears. This organisation, in effect, took the dust problem away from the trade unions and the public and sequestered it inside laboratories and private gatherings, where health issues could be mediated by experts and government, safe from untoward publicity. Industry lobbying was able to influence the shaping of state compensation laws for silicosis, which protected big business.”
M&T at 15-16. These insinuations are borrowed, with attribution, from fellow labor historians, David Rosner and Gerald Markowitz. The claims are a mixed lot. For instance, why would not an industry work to help companies defend compensation claims? Organized labor worked to help its members prosecute claims. Surely McCulloch and Tweedale do not believe that every claim made was valid or that every defense frivolous.
Assuming that the AHF/IHF had some role in pressing for state workman compensation laws, then it was aligned with many labor unions that pushed for similar reforms. As noted above, plaintiffs were often at a serious disadvantage in litigation against employers, and they frequently were turned out of court on grounds of limitations, contributory negligence, fellow-worker rule, or assumption of risk. Plaintiffs needed certainty in coverage for occupational disease, not a jury lottery system, and employers needed some reasonable limits on the extent of liability. Workman’s compensation was a compromise, bound not to satisfy everyone.
As for helping companies institute industrial hygiene measures and conduct hygiene studies, the AHF/IHF was helping industry live up to its obligations to provide a safe workplace. The United States government, under the Presidency of Franklin Roosevelt, was involved in similar measures in the 1930s. See, e.g., United States Dep’t of Labor, Silicosis Prevention: Dust Control in Foundries (1939).
McCulloch and Tweedale’s accusation that the AHF/IHF “in effect, took the dust problem away from the trade unions and the public and sequestered it inside laboratories and private gatherings, where health issues could be mediated by experts and government, safe from untoward publicity,” is, of course, borrowed directly from the writings of Rosner and Markowitz. The accusation does not gain any credibility from being repeated. Involving scientists and competent laboratories that would study the issues and publish their results was a responsible step for industry to take. Much of the early political rhetoric about silicosis was driven by personal, subjective anecdotes and uncontrolled observations. The involvement of scientists was a step followed by labor unions, as in the example of the asbestos insulation workers union hiring Dr. Irving Selikoff in the 1950s to investigate their concerns about occupational cancer risk.
There was much to be gained by de-escalating the emotion and vitriol of the labor-management conflicts of the 1930s, although the de-escalation was unsatisfactory to radicals on both sides. The fact is that the labor unions remained interested in, and concerned about, silicosis, both before and after World War II. Labor unions had their own private gatherings, and engaged in rent-seeking from state and federal agencies, as did industry. After the passage of the Occupational Health and Safety Act of 1970, labor’s interests generally prevailed at the agency level.
“The result was that acute silicosis largely disappeared from medical discourse and Gauley Bridge was denied a place in America’s national consciousness.” M&T at Abstract. This causal conclusion is demonstrably wrong. If you like conspiracy theories, McCulloch and Tweedale’s history might well be self-referentially labeled, Deceit and Denial, after the work of their American counterparts, Rosner and Markowitz.
