Miners' Lung: A History of Dust Disease in British Coal Mining (review)

The history of occupational health has flourished in recent years. McIvor and Johnston have themselves made notable contributions to this burgeoning literature, particularly with their book, Lethal Work. A History of the Asbestos Tragedy in Scotland (2000), but also with a string of articles. Scotland looms large in the present study but, unlike several of their previous collaborations, Miners' Lung also considers England and Wales. Since coal workers' pneumoconiosis (CWP) was particularly prevalent in the huge South Wales coalfield, the Welsh connection is prominent.

McIvor and Johnston describe work-induced respiratory disease among coal miners as "the largest occupational health disaster in British history" (p. 2). It could hardly be otherwise given the size of the workforce, which peaked at substantially over a million laborers, a large proportion of whom worked in extremely confined areas and dusty conditions deep underground. The neglect of labor and medical historians is, therefore, surprising. Contrast this position with the plethora of studies on asbestos-related disease. Even the multivolume History of the British Coal Industry (1984–93) provides scant coverage. So the appearance of Miners' Lung is a long-overdue addition to the historiography. In many ways, the book does for Britain what Alan Derickson's Black Lung: Anatomy of a Public Health Disaster (1998) did for the U.S. Unlike Derickson, however, McIvor and Johnston have used oral evidence: mainly interviews with miners born between 1909 and 1953. This personal testimony provides a valuable insight into the experience of living with chronic pulmonary disease.

Recognition that the inhalation of coal dust could impair health came slowly. Coal dust was long thought to protect against tuberculosis, and a British expert continued to insist in the 1930s that coal dust was benign. Although CWP became a compensable disease in 1943, the precise nature of the coal-dust hazard remained in doubt; as Archie Cochrane, a leading expert, wrote in 1951, "the factors which may make coal dust dangerous are not yet known" (p. 112). Only in the 1990s, when British coal mining had virtually ceased, were bronchitis and emphysema accepted as diseases of coal miners.

Scholars have often blamed high rates of occupational disease on exploitative industrialists. Governments, organized labor, and the medical profession, with their eyes on other issues, have also been criticized. As for the workers, they are usually portrayed as helpless victims. McIvor and Johnston do not fully subscribe to such interpretations. They criticize the prenationalization private coal owners but are much more generous (unwontedly so, perhaps, given their numerous caveats) in their appraisal of the National Coal Board. Medical science, which created a "long tradition of high-quality research into miners' lung disease" (p. 124), is largely exonerated from blame. The policies and practices of the labor unions and Trades Union Congress are viewed far more sympathetically than is often the case. Miners are seen as victims but also as architects of their own ill health through refusing to wear respirators, "cutting corners," working excessive hours, and engaging in dry hewing. They accepted a high degree of risk partly because such an attitude suited the hard-man culture of which they were a prominent part.

It is pleasant to encounter a volume with that rarest of paraphernalia in modern academic publishing: footnotes. Unfortunately, praise cannot be heaped on McIvor and Johnston's index and bibliography, both of which are far from satisfactory. Numerous individuals mentioned in the text, some of them significant figures, do not appear in the index. Similarly, many publications cited in the notes are absent from the bibliography. This complaint apart, Miners' Lung is a thorough, balanced, and readable study; it will be a standard reference for years to come.