History of health concerns and regulation

History of health concerns and regulation

Until 1900

By the first century AD, Greeks and Romans are claimed to have observed that slaves involved in the weaving of asbestos cloth were afflicted with a sickness of the lungs, although this is not confirmed by examination of primary sources.

Early concern in the modern era on the health effects of asbestos exposure can be found in several sources. Among the earliest were reports in Britain. The annual reports of the Chief Inspector of Factories reported as early as 1898 that asbestos had "easily demonstrated" health risks.

At about the same time, what was probably the first study of mortality among asbestos workers was reported in France. While the study describes the cause of death as chalicosis, a generalized pneumoconiosis, the circumstances of the employment of the fifty workers whose death prompted the study suggest that the root cause was asbestos or mixed asbestos-cotton dust exposure.

Asbestos 1900s to 1910s 

Further awareness of asbestos-related diseases can be found in the early 1900s, when London doctor H. Montague Murray conducted a post mortem exam on a young asbestos factory worker who died in 1899. Dr. Murray gave testimony on this death in connection with an industrial disease compensation hearing. The post-mortem confirmed the presence of asbestos in the lung tissue, prompting Dr. Murray to express as an expert opinion his belief that the inhalation of asbestos dust had at least contributed to, if not actually caused, the death of the worker.

The record in the United States was similar. Early observations were largely anecdotal in nature and did not definitively link the occupation with the disease, followed by more compelling and larger studies that strengthened the association. One such study, published in 1918, noted:

All of these processes unquestionably involve a considerable dust hazard, but the hygienic aspects of the industry have not been reported upon. It may be said, in conclusion, that in the practice of American and Canadian life insurance companies, asbestos workers are generally declined on account of the assumed health-injurious conditions of the industry.

Asbestos 1920s - 1930s

Widespread recognition of the occupational risks of asbestos in Britain was reported in 1924 by a Dr. Cooke, a pathologist, who introduced a case description of a 33-year-old female asbestos worker, Nellie Kershaw, with the following: "Medical men in areas where asbestos is manufactured have long suspected the dust to be the cause of chronic bronchitis and fibrosis..." Dr. Cooke then went on to report on a case in 1927 involving a 33-year-old male worker who was the only survivor out of ten workers in an asbestos carding room. In the report he named the disease "asbestosis".

Dr. Cooke's second case report was followed, in the late 1920s, by a large public health investigation (now known as the Merewether report after one of its two authors) that examined some 360 asbestos-textile workers (reported to be about 15% of the total comparable employment in Britain at the time) and found that about a quarter of them suffered from pulmonary fibrosis. This investigation resulted in improved regulation of the manufacturing of asbestos-containing products in the early 1930s. Regulations included industrial hygiene standards, medical examinations, and inclusion of the asbestos industry into the British Workers' Compensation Act.

The first known U.S. workers' compensation claim for asbestos disease was in 1927. In 1930, the first reported autopsy of an asbestosis sufferer was conducted in the United states and later presented by a doctor at the Mayo Clinic, although in this case the exposure involved mining activities somewhere in South America.

In 1930, the major asbestos company Johns-Manville produced a report, for internal company use only, about medical reports of asbestos worker fatalities. In 1932, a letter from U.S. Bureau of Mines to asbestos manufacturer Eagle-Picher stated, in relevant part, "It is now known that asbestos dust is one of the most dangerous dusts to which man is exposed."

In 1933, Metropolitan Life Insurance Co. doctors found that 29% of workers in a Johns-Manville plant had asbestosis. Likewise, in 1933, Johns-Manville officials settled lawsuits by 11 employees with asbestosis on the condition that the employees' lawyer agree to never again "directly or indirectly participate in the bringing of new actions against the Corporation." In 1934, officials of two large asbestos companies, Johns-Manville and Raybestos-Manhattan, edited an article about the diseases of asbestos workers written by a Metropolitan Life Insurance Company doctor. The changes downplayed the danger of asbestos dust. In 1935, officials of Johns-Manville and Raybestos-Manhattan instructed the editor of Asbestos magazine to publish nothing about asbestosis. In 1936, a group of asbestos companies agreed to sponsor research on the health effects of asbestos dust, but required that the companies maintain complete control over the disclosure of the results.

Asbestos in 1940s

In 1942, an internal Owens-Corning corporate memo referred to "medical literature on asbestosis… scores of publications in which the lung and skin hazards of asbestos are discussed." Testimony given in a federal court in 1984 by Charles H. Roemer, formerly an employee of Unarco, described a meeting in the early 1940s between Unarco officials, J-M President Lewis H. Brown and J-M attorney Vandiver Brown. Roemer stated, "I’ll never forget, I turned to Mr. Brown, one of the Browns made this crack (that Unarco managers were a bunch of fools for notifying employees who had asbestosis), and I said, ‘Mr. Brown, do you mean to tell me you would let them work until they dropped dead?’ He said, ‘Yes. We save a lot of money that way.'"  In 1944, a Metropolitan Life Insurance Company report found 42 cases of asbestosis among 195 asbestos miners.

Asbestos in 1950s

In 1951, asbestos companies removed all references to cancer before allowing publication of research they sponsored. In 1952, Dr. Kenneth Smith, Johns-Manville medical director, recommended (unsuccessfully) that warning labels be attached to products containing asbestos. Later, Smith testified: "It was a business decision as far as I could understand… the corporation is in business to provide jobs for people and make money for stockholders and they had to take into consideration the effects of everything they did and if the application of a caution label identifying a product as hazardous would cut into sales, there would be serious financial implications."