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Alan Derickson - Black Lung: Anatomy of a Public Health Disaster

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In the definitive history of a twentieth-century public health disaster, Alan Derickson recounts how, for decades after methods of prevention were known, hundreds of thousands of American miners suffered and died from black lung, a respiratory illness caused by the inhalation of coal mine dust. The combined failure of government, medicine, and industry to halt the spread of this diseaseand even to acknowledge its existenceresulted in a national tragedy, the effects of which are still being felt.

The book begins in the late nineteenth century, when the disorders brought on by exposure to coal mine dust were first identified as components of a debilitating and distinctive illness. For several decades thereafter, coal miners dust disease was accepted, in both lay and professional circles, as a major industrial disease. Derickson describes how after the turn of the century medical professionals and industry representatives worked to discredit and supplant knowledge about black lung, with such success that this disease ceased to be recognized. Many authorities maintained that breathing coal mine dust was actually beneficial to health.

Derickson shows that activists ultimately forced society to overcome its complacency about this deadly and preventable disease. He chronicles the growth of an unprecedented movementfrom the turn-of-the-century miners union, to the social medicine activists in the mid-twentieth century, and the black lung insurgents of the late sixtieswhich eventually won landmark protections and compensation with the enactment of the Federal Coal Mine Health and Safety Act in 1969. An extraordinary work of scholarship, Black Lung exposes the enormous human cost of producing the energy source responsible for making the United States the worlds preeminent industrial nation.

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Also by Alan Derickson Workers Health Workers Democracy The Western Miners - photo 1
Also by Alan Derickson:
Workers Health, Workers Democracy:
The Western Miners Struggle, 18911925
To my parents ILLUSTRATIONS CONTENTS PREFACE Richard Nixon could not face - photo 2
To my parents
ILLUSTRATIONS
CONTENTS
PREFACE
Richard Nixon could not face the widows. The president fully intended to veto the coal mine health and safety legislation passed by Congress on December 18, 1969. Although he could tolerate the disagreeable prospect of federal intervention to regulate conditions in this most hazardous industry, Nixon could not accept the wholly unprecedented plan to compensate victims of work-induced respiratory disease. With a series of warnings that the cost of federal benefits would be exorbitant and that the states properly had jurisdiction over workers compensation, representatives of his administration laid the groundwork for killing this sweeping reform measure.
On December 29, 1969, a delegation of seven women whose husbands had died a year earlier in a mine explosion in Farmington, West Virginia, arrived at the White House to demand passage of the health and safety bill. On the same day, protest strikes broke out in the coalfields. Rather than chance a disruptive, nationwide strike and an unpleasant encounter with the widows, the president gave in. Nixon refused to meet with the women, but sent word that he would approve the mining bill. The following day, without public ceremony, he signed the Federal Coal Mine Health and Safety Act, which included the highly objectionable Black Lung Benefits Program. After Nixon had slipped away, the women received a tour of the White House. In the empty Oval Office they picked up pens used in signing the bill, souvenirs that the president left lying on his desk. Looking past the snub, Sara Kaznoski, the leader of the group, declared it a wonderful day for all miners.
The ascendance of the ill-informed complacency that dominated the half century up to 1969 was preceded by almost a half century during which coal miners dust disease was accepted, in both lay and professional circles, as a major form of industrial disease. Complacency settled in only after a concerted effort to discredit and supplant established ideas.
The defeat of complacency depended upon forceful advocacy as well as cogent science. The thesis of this book is that social movements, more than any of the other forces operating on this problem, fostered advances in recognition of coal workers lung disorders. The turn-of-the-century miners union, social medicine activists at mid-century, and the black lung insurgents of the late sixties each played decisive roles in giving this issue broader visibility. At critical junctures in the political contest over medical ideas, confrontational collective action accomplished what careful scientific investigation and subtle private negotiation could not. Especially when miners and their professional allies promoted accessible vernacular conceptions of diseaseminers asthma or black lungthe fog of mystifying scientific jargon lifted to reveal masses of breathless, displaced old men, destroyed by their work.
It would have saved millions of years of lost life and diminished quality of life for coal workers and their families.
It is a pleasure to acknowledge those who enabled me to complete this project. Many archivists and librarians graciously guided me to research material. I thank the patient staff at the National Archives, the Library of Congress, the National Library of Medicine, the Pennsylvania State Archives, the Birmingham Public Library, the Catherwood Library at Cornell University, the West Virginia University Library, the Bancroft Library at the University of California, the King Library at the University of Kentucky, the Butler Library at Columbia University, the Pattee Library at the Pennsylvania State University, the Stapleton Library at Indiana University of Pennsylvania, and the Illinois Historical Survey Library at the University of Illinois. Maier Fox provided expert guidance to the records of the United Mine Workers of America during the time when the union held its own historical records. Other exceptionally helpful archival workers whom I must thank individually are Denise Conklin, Peter Gottlieb, and Diana Shenk.
Several individuals gave me access either to their own personal papers and libraries or to those of deceased family members. I thank Sara Anderson, Leslie Falk, Louis Friedman, Ken Hechler, and Murray Hunter for granting me this privilege. Many people gave me access to their memories. I want to express my appreciation to all those who participated in my oral history interviews.
In its various incarnations, this work benefited from the exertions of numerous careful critics. Helpful readings of all or part of the manuscript came from Robert Asher, Allan Brandt, Martin Cherniack, Paul Clark, Tom Dublin, Elizabeth Fee, Maier Fox, the late Lorin Kerr, Dan Letwin, Robert Proctor, Donald Rasmussen, David Rosner, Kitty Sklar, Mark Wardell, and Jim Weeks. I took some, but probably not enough, of their suggestions. Peter Agree played the part of the canny editor, offering a seemingly endless supply of smart advice. Grey Osteruds copyediting improved the manuscript in many ways.
Generous assistance from Pennsylvania State University included a sabbatical leave and two research grants. The university also made available the services of four very able research assistants: Deirdre Curristin, Sharon Litchkowski, Jennifer Stewart, and Lynn Vacca. Funds from the National Institute for Occupational Safety and Health enabled me to conduct a valuable series of oral history interviews.
My family handled this lengthy expedition with a mixture of stoicism and good humor. My daughters, Elizabeth and Katherine, lifted my spirits and even took on a few editorial chores. My wife, Peg, offered not only moral support but medical wisdom and editorial sense as well. I am very grateful to them for all their help.
ALAN DERICKSON
University Park, Pennsylvania
ABBREVIATIONS
AALLAmerican Association for Labor Legislation
ACGIHAmerican Conference of Governmental Industrial Hygienists
ACSCU.S. Anthracite Coal Strike Commission
ADMWAssociation of Disabled Miners and Widows
BLAWest Virginia Black Lung Association
BLSU.S. Bureau of Labor Statistics
BOMU.S. Bureau of Mines
CWPcoal workers pneumoconiosis
HEWU.S. Department of Health, Education, and Welfare
HRFAUnited Mine Workers of America Health and Retirement Funds Archives
ILOInternational Labor Organization
MRCMedical Research Council
NCLCNational Child Labor Committee
PHSU.S. Public Health Service
RGRecord Group
TCITennessee Coal, Iron and Railroad Company
UMWUnited Mine Workers of America
UMWJUnited Mine Workers Journal
VISTAVolunteers in Service to America
WRFUnited Mine Workers of America Welfare and Retirement Fund
CHAPTER ONE
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