Beyond a shadow of a doubt? Experts, lay knowledge, and the role of radiography in the diagnosis of silicosis in Britain, c. 1919-1945.

The history of silicosis provides an important chapter in the history of occupational and environmental health. Recent historical scholarship has drawn attention to the importance of patient attitudes, popular protests, and compensation claims in the formation of a "lay epidemiology" of such a disease, frequently challenging the scientific orthodoxies devised by large corporations and medical specialists. Surprisingly little research has been undertaken on the United Kingdom, which provided much of the early expertise and medical research in respiratory diseases among industrial workers. This article examines the introduction of a particular technique, x-radiography, and its use by radiologists and others in debates on the causes and consequences of silica inhalation by the laboring population in Britain during the early decades of the twentieth century. In contrast to some recent interpretations, and also to the narrative of progress that practitioner historians have developed since the 1940s, this article suggests that the use of this technology was contested for much of this period and the interpretation of X-rays remained disputed and uncertain into the 1950s. The article also questions recent accounts of lay epidemiology as an adequate model for understanding the progress of such innovations in medical history.

Coming up for air: experts, employers, and workers in campaigns to compensate silicosis sufferers in Britain, 1918-1939.

Government regulation of dangerous trades and the compensation of those injured by their work remains a matter of considerable debate among medical historians. Trade unions have frequently been criticized for pursuing financial awards for their members rather than demanding improvements in health and safety at the workplace. This article examines the neglected subject of silicosis injuries in Britain from the time when the first legislation was passed for compensation of those suffering from the harmful affects of silica dust in 1918 to the outbreak of war in 1939, when a major new study was under way which would transform the scientific understanding and the legal compensation of those who were diagnosed as being ill with pneumoconiosis. It is argued that in framing legislation from compensation, politicians and their civil servants sought to retain the legal framework created in 1897-1906 and developed a model of industrial insurance which depended to a large extent on a co-operative relationship with leading employers. Medical scientists identified silica as a uniquely hazardous agent in workers' lung disease, which emphasizing the specialist knowledge required for its diagnosis. One remarkable feature of the selective compensation schemes devised after 1918 was the reliance on geological rather than pathological evidence to prove compensation rights as well as strict employment limits on those eligible to claim. only the campaigning of labour organizations and persistent evidence of lung disease among anthracite coal miners led to a significant relaxation of compensation rules in 1934 and the fresh scientific investigation which transformed the medical understanding of respiratory illness among industrial workers.