[Medical Knowledge in Accident Insurance : Assessing "Pneumatic Tool Damages" at the Bergmannsheil Hospital, 1929-1944]. / Medizinisches Wissen in der Unfallversicherung : Die Begutachtung von "Preßluftschäden" im Krankenhaus Bergmannsheil, 1929­1944.

The article focuses on one central element of medical activity in the context of the German social insurance system: providing expert assessments in accident pension cases. Taking an example from interwar coal mining, it aims to reconstruct how social policy makers first conceived of "pneumatic tool damages" as occupational disease and how trauma surgeons had to deal with this new entity of social law once it had been institutionalized in 1929. Drawing on physicians' publications as well as archival sources from the supreme court in social insurance, the Reichsversicherungsamt, the article examines how the controversial generation of new knowledge took place. It argues that medical knowledge was neither simply applied to administration and law nor was it compromised by the necessity to adjust it to those fields of decision-making. Expert medical opinions should instead be understood as a specific form of medical knowledge.

Deep coal mining and meningococcal meningitis in England and Wales, 1931-38: Ecological study, with implications for deep shaft mining activities worldwide.

The hypothesized role of deep coal mining in the development of community-based outbreaks of meningococcal meningitis has gone largely unexplored. Taking the coalfields of Britain as a historical testbed, techniques of linear and binomial logistic regression were used to assess the association between meningococcal meningitis rates and male occupation rates for coal mining in England and Wales during the national epidemic of 1931-32 and in its aftermath. Adjusting for the epidemiological effects of age, residential density, recent changes in the number of families, housing stock and low social class, the analysis yielded evidence of a significant and positive association between coal mining occupation rates and notified levels of meningitis activity in the epidemic period. Communities in areas of the world that currently maintain substantial deep coal extraction industries may be at increased risk for the epidemic transmission of meningococcal meningitis.

James Craufurd Gregory, 19th century Scottish physicians, and the link between occupation as a coal miner and lung disease.

By the mid-19th century about 200,000 miners were employed in a UK coal mining industry still growing with the advances of the Industrial Revolution. Coal miners were long known to suffer poor health but the link to inhaling dust in the mines had not been made. In 1813 George Pearson was the first to suggest that darkening of lungs seen in normal individuals as they aged was caused by inhaled soot from burning oil, candles and coal, which were the common domestic sources of heat and light. In 1831 Dr James Craufurd Gregory first described black pigmentation and disease in the lungs of a deceased coal miner and linked this to pulmonary accumulation of coal mine dust. Gregory hypothesised that the black material seen at autopsy in the collier's lungs was inhaled coal dust and this was confirmed by chemical analysis carried out by Professor Sir Robert Christison. Gregory suggested that coal dust was the cause of the disease and warned physicians in mining areas to be vigilant for the disease. This first description of what came to be known as 'coal worker's pneumoconiosis' sparked a remarkable intellectual effort by physicians in Scotland, culminating in a large body of published work that led to the first understandings of this disease and its link to coalblackened lungs. This paper sets out the history of the role of Scottish physicians in gaining this understanding of coal worker's pneumoconiosis. It describes Gregory's case and the lung - recently discovered in the pathology collection of the Surgeons' Hall Museums, Edinburgh, where it has lain unnoticed for over 180 years - on which Gregory based his landmark paper.

Miners, silica and disability: The bi-national interplay between South Africa and the United Kingdom, c1900-1930s.

This paper investigates silicosis as a disabling disease in underground mining in the United Kingdom (UK) before Second World War, exploring the important connections between South Africa and the UK and examining some of the issues raised at the 1930 International Labour Office Conference on silicosis in Johannesburg in a British context. The evidence suggests there were significant paradoxes and much contestation in medical knowledge creation, advocacy, and policy-making relating to this occupational disease. It is argued here that whilst there was an international exchange of scientific knowledge on silicosis in the early decades of the twentieth century, it was insufficient to challenge the traditional defense adopted by the British government of proven beyond all scientific doubt before effective intervention in coal mining. This circumspect approach reflected dominant business interests and despite relatively robust trade union campaigning and eventual reform, the outcome was an accumulative legacy of respiratory disease and disability that blighted coalfield communities.

Reconstructing disturbance history for an intensively mined region by time-series analysis of Landsat imagery.

Surface mining disturbances have attracted attention globally due to extensive influence on topography, land use, ecosystems, and human populations in mineral-rich regions. We analyzed a time series of Landsat satellite imagery to produce a 28-year disturbance history for surface coal mining in a segment of eastern USA's central Appalachian coalfield, southwestern Virginia. The method was developed and applied as a three-step sequence: vegetation index selection, persistent vegetation identification, and mined-land delineation by year of disturbance. The overall classification accuracy and kappa coefficient were 0.9350 and 0.9252, respectively. Most surface coal mines were identified correctly by location and by time of initial disturbance. More than 8 % of southwestern Virginia's >4000-km(2) coalfield area was disturbed by surface coal mining over the 28-year period. Approximately 19.5 % of the Appalachian coalfield surface within the most intensively mined county (Wise County) has been disturbed by mining. Mining disturbances expanded steadily and progressively over the study period. Information generated can be applied to gain further insight concerning mining influences on ecosystems and other essential environmental features.

The labor movement's role in gaining federal safety and health standards to protect America's workers.

In the United States, unions sometimes joined by worker advocacy groups (e.g., Public Citizen and the American Public Health Association) have played a critical role in strengthening worker safety and health protections. They have sought to improve standards that protect workers by participating in the rulemaking process, through written comments and involvement in hearings; lobbying decision-makers; petitioning the Department of Labor; and defending improved standards in court. Their efforts have culminated in more stringent exposure standards, access to information about the presence of potentially hazardous toxic chemicals, and improved access to personal protective equipment-further improving working conditions in the United States.

Risk identification and prediction of coal workers' pneumoconiosis in Kailuan Colliery Group in China: a historical cohort study.

BACKGROUND: Prior to 1970, coal mining technology and prevention measures in China were poor. Mechanized coal mining equipment and advanced protection measures were continuously installed in the mines after 1970. All these improvements may have resulted in a change in the incidence of coal workers' pneumoconiosis (CWP). Therefore, it is important to identify the characteristics of CWP today and trends for the incidence of CWP in the future. METHODOLOGY/PRINCIPAL FINDINGS: A total of 17,023 coal workers from the Kailuan Colliery Group were studied. A life-table method was used to calculate the cumulative incidence rate of CWP and predict the number of new CWP patients in the future. The probability of developing CWP was estimated by a multilayer perceptron artificial neural network for each coal worker without CWP. The results showed that the cumulative incidence rates of CWP for tunneling, mining, combining, and helping workers were 31.8%, 27.5%, 24.2%, and 2.6%, respectively, during the same observation period of 40 years. It was estimated that there would be 844 new CWP cases among 16,185 coal workers without CWP within their life expectancy. There would be 273.1, 273.1, 227.6, and 69.9 new CWP patients in the next <10, 10-, 20-, and 30- years respectively in the study cohort within their life expectancy. It was identified that coal workers whose risk probabilities were over 0.2 were at high risk for CWP, and whose risk probabilities were under 0.1 were at low risk. CONCLUSION/SIGNIFICANCE: The present and future incidence trends of CWP remain high among coal workers. We suggest that coal workers at high risk of CWP undergo a physical examination for pneumoconiosis every year, and the coal workers at low risk of CWP be examined every 5 years.

The influence of dust standards on the prevalence and severity of coal worker's pneumoconiosis at autopsy in the United States of America.

CONTEXT: Coal worker's pneumoconiosis is a major occupational lung disease in the United States. The disease is primarily controlled through reducing dust exposure in coal mines using technological improvements and through the establishment of dust standards by regulatory means. OBJECTIVE: To determine if dust standards established in the US Federal Coal Mine Health and Safety Act of 1969 have reduced the prevalence and severity of coal worker's pneumoconiosis. DESIGN: The study population included materials from 6103 deceased coal miners submitted to the National Coal Workers' Autopsy Study from 1971 through 1996. Type and severity of coal worker's pneumoconiosis were classified using standardized diagnostic criteria. RESULTS: Among miners who worked exclusively prior to the 1969 dust standard, 82.6% had coal macules, 46.3% coal nodules, 28.2% silicotic nodules, and 10.3% progressive massive fibrosis. Lower prevalences were noted among miners exposed exclusively to post-1970 dust levels: 58.8% had coal macules, 15.0% coal nodules, 8.0% silicotic nodules, and 1.2% progressive massive fibrosis. The differences in prevalence were highly significant (P < .001) for all types of pneumoconiosis, including progressive massive fibrosis, after adjustment for age, years of mining, and smoking status. CONCLUSIONS: The study confirms a beneficial impact of the first 25 years of the dust standard established by the 1969 act on the prevalence and severity of coal worker's pneumoconiosis in US coal miners. However, pneumoconiosis continues to occur among miners who have worked entirely within the contemporary standard, suggesting a need for further reductions in exposure to respirable coal mine dust.

Towards "a different kind of beauty": responses to coal-based pollution in the Witbank coalfield between 1903 and 1948.

This article assesses the changing conceptions of the environmental impact of South African coal mining in the first half of the twentieth century, with special reference to the Witbank coalfield in the Mpumalanga province of South Africa. The anticipated development of the emerging coal town of Witbank was founded on the growing demand for coal. As Witbank's local landscape became visibly scarred, coal-based pollution was continually challenged and redefined. In an attempt to market electricity, and appease the doubts of potential consumers, attempts were made by Escom to romanticise features of Witbank's industrialised environment. Once mines were decommissioned, they were abandoned. Coal production increased dramatically during the Second World War, which provided an economic windfall for the local electrical, steel and chemical industries, placing undue pressure on the coal industry to step up production. The severe damage caused by coal mining during this period resulted in the ecological devastation of affected landscapes. The findings of an inter-departmental committee established to conduct research during the mid-1940s revealed the gravity of coal-based pollution, and set a precedent in the way that the state conceived of the impact of industry and mining. The report of this committee was completed in the wake of the war, by which time the Witbank coalfield had become one of the most heavily polluted regions of South Africa.

The politics of silicosis in interwar Spain: Republican and Francoist approaches to occupational health.

This article explores the emergence and recognition of silicosis as an occupational disease in interwar Spain. Following International Labour Office guidelines, growing international concerns and local medical evidence, Republican administrators provided the first health care facilities to silicosis sufferers, who eventually became entitled to compensation under the Law of Occupational Diseases (1936), poorly implemented due to the outbreak of the Civil War (1936-39). Silicosis became a priority issue on the political agenda of the new dictatorial regime because it affected lead and coalmining, key sectors for autarchic policies. The Silicosis Scheme (1941) provided compensation for sufferers, although benefits were minimised by its narrow coverage and the application of tight criteria.