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

Over the course of the past two decades, historians have begun to pay serious and sustained attention to the history of occupational health, much of it analyzing the role of social, economic, and political factors in the medical recognition of industrial disease. Although much has been published about the British coal industry, this is the first book to address the issue of health and safety in this critically important sector of the British economy. Miners' Lung, building on the work done by Jo Melling and Mark Bufton on silicosis and mining, analyzes the complex negotiation that resulted in the recognition of coal workers' pneumoconiosis and the classification of emphysema and bronchitis as occupational diseases. In some important ways, it advances the methodology and sophistication of occupational health research, especially in its use of oral histories, its critique of the role of trade unions in advancing the cause of health and safety, and in its examination of the miners' views of masculinity on health and safety.

The story that Arthur McIvor and Ronald Johnston tell of the recognition of coal workers' pneumoconiosis (CWP) is compelling: in the mid-nineteenth century, there was acceptance of the idea that coal dust caused a distinctive and debilitating lung disease; by the end of the nineteenth century the medical literature shifted, declaring that dust diseases from coal were declining, with one eminent occupational disease specialist, Sir Thomas Oliver, declaring, "Coalmining [sic] is now a healthy occupation" (66). It was not that miners were not dying and becoming ill, but as with other occupational lung diseases such as silicosis, their deaths were attributed to nonoccupational diseases, e.g., tuberculosis, or asthma. As coal became more vital to the British economy in the 1920s and 1930s, mechanization of the mines proceeded apace, producing more dust, with increasing numbers of miners suffering disability and death. Indeed, it was government research, at the urging and insistence of the miners' unions, that successfully demonstrated that coal dust caused CWP.

After World War II, the British nationalized their coal industry (1947) and established the National Coal Board (NCB) to run their mines. The initial priority of the NCB was to produce more coal (consumption rose from 190 millions tons in 1947 to 230 million tons in 1955), and this was accomplished by closing the smaller, less productive mines and mechanizing the remaining ones, bringing forth still greater levels of dust. Despite a commitment to reduce the dust, "what developed in many instances was a priority of production over dust control" (183). Even so, the nationalization of the mines represented a watershed event in terms of a "commitment to controlling pneumoconiosis" (105), which by this time had become identified as a serious national problem. Part of that commitment was the extraordinary epidemiological research that one of the board's committees conducted, including exposure histories of thirty-five thousand men over decades of their working lives. As the authors demonstrate, the impetus for much of this research was the parallel development of the "social medicine" movement in Britain with its "new worker-oriented approach to medicine" (120). Although rates of CWP fell in the postwar era, they fell much more rapidly after 1970 when new standards were enforced.

The authors' challenge received orthodoxy that British trade unions failed to make the health of their members a top priority and to "lead a sustained and effective critique of 'orthodox' medical expertise" (185). While this critique may be true of unions representing asbestos workers and others, McIvor and Johnston prove that the successful effort to get CWP prescribed as an occupational disease, was, in some important respects, the result of a prolonged campaign of the Miners' Federation of Great Britain: "The combination of rank and file vigilance in the workplace and cumulatively effective pressure group activity at the national level by the miners' unions and the TUC, helped ensure British...