Sleights of Hand: South Africa's Gold Mines and Occupational Disease.

South Africa's gold mines were the first to compensate silicosis and tuberculosis as occupational diseases. They were also the first mines to introduce a state-sanctioned regime of medical surveillance. Despite those innovations, the major mining houses are currently facing class actions by former miners with occupational lung disease. The obvious reason for this medical and legislative failure is to be found in the economic fabric of South Africa's gold industry. In this article, I will argue that it is also found in the system of mine medicine, which was designed to hide rather than reveal the actual disease rates.

Shooting the messenger: the vilification of Irving J. Selikoff.

Dr. Irving J. Selikoff (1915-1992), a New York physician based at Mount Sinai Hospital, was the leading American medical expert on asbestos-related diseases between the 1960s and early 1990s. In a country that had been the world's greatest consumer of asbestos, he was also at the center of the key controversies connected with the mineral. In these controversies, Selikoff was consistently demonized as a media zealot who exaggerated the risks of asbestos on the back of bogus medical qualifications and flawed science. Since his death, the criticism has become even more vituperative and claims have persisted that he was malicious or a medical fraud. However, most of the attacks on Selikoff were inspired by the asbestos industry or its sympathizers, and for much of his career he was the victim of a sustained and orchestrated campaign to discredit him. The most serious criticisms usually more accurately describe his detractors than Selikoff himself.

Science is not sufficient: Irving J. Selikoff and the asbestos tragedy.

Professor Irving J. Selikoff (1915-1992) was America's foremost medical expert on asbestos-related diseases between the 1960s and early 1990s. He was also well known to the public for his media appearances on the burgeoning asbestos problem. Yet his reputation has been strikingly mixed. On the one hand, he has been portrayed as a mischief maker and irresponsible demagogue, who exaggerated the risks of asbestos and so destroyed an industry; on the other, as a pioneer in asbestos epidemiology, whose landmark studies of insulation (and other) workers demonstrated the severity of a modern occupational and public health tragedy. Drawing upon unprecedented access to the Selikoff archive at Mount Sinai Hospital in New York City, this article demonstrates that the most serious criticisms of Selikoff are either ill-founded or simply false. It also shows that Selikoff, in the highly politicized world of asbestos science, was a far more complex and conservative individual than previous studies have suggested.

Mining and mendacity, or how to keep a toxic product in the marketplace.

The corruption of medical evidence about the hazards of asbestos began with the Canadian mines. Quebec at one time boasted ten of the 13 mines in Canada. Work conditions in the mines were harsh, and the mills were full of airborne fiber. Given the size of the industry, the Quebec mines were where occupational asbestosis should first have been identified, but research at the mines was done in company towns, where clinics were staffed by company doctors. Since the late 1920s U.S. parent companies and their Canadian subsidiaries have maintained that there is little if any disease among mine workers. Asbestosis in textile workers, they have claimed, has been due to the conditions in that industry and not the inherent dangers of asbestos. That fiction continues to shape the discourse about the usefulness of asbestos.

Double standards: the multinational asbestos industry and asbestos-related disease in South Africa.

This study documents and contrasts the development of knowledge about asbestos-related disease (ARD) in South Africa and the United Kingdom. It also contributes to the globalization debate by exploring corporate decision-making in a multinational industry. Between the 1930s and 1960s, the leading U.K. asbestos companies developed a sophisticated knowledge of ARD, though in South Africa, where the leading companies such as Turner & Newall and Cape Asbestos owned mines, there was little attempt to apply this knowledge. Asbestos mines (and their environments) in South Africa were uniquely dusty and ARD was rife. Social and political factors in South Africa, especially apartheid, allowed these companies to apply double standards, even after 1960 when the much more serious hazard of mesothelioma was identified. This shows the need for greater regulation of multinationals. Because of the lack of such regulation in the early 1960s, an opportunity was lost to prevent the current high morbidity and mortality of ARD both in South Africa and worldwide.

Chrysophiles versus chrysophobes: the white asbestos controversy, 1950s-2004.

In the first half of the twentieth century, asbestos was a controversial mineral because of its association with asbestosis and asbestos-related lung cancer. It has proved no less so since the 1960s, when another asbestos cancer, mesothelioma, was identified. Mesothelioma appeared to be more strongly linked with blue asbestos (crocidolite) than with the other asbestos varieties, brown (amosite) and white (chrysotile). This finding triggered a fierce debate between "chrysophiles" (those who declared chrysotile innocuous) and "chrysophobes" (those who believed it was a mortal hazard). This essay attempts the first history of the chrysotile controversy, which shows that a scientific consensus on the safety of white asbestos was very slow to emerge. This was only partly due to the complexities of scientific research. Political, economic, and social factors have militated against a speedy resolution of the debate, facilitating the continued production and use of asbestos in the developing world.

Asbestos mining in Southern Africa, 1893-2002.

Asbestos has been mined in Southern Africa for more than a century. Chrysotile from the mines of Swaziland and Zimbabwe was marketed around the globe, while South African mines produced almost all of the world's amphibole fiber. The major mines were owned and operated by British firms that in the United Kingdom from 1931 were subject to occupational health and safety legislation. The failure of those companies to apply knowledge of the dangers of asbestos to their Southern African operations saw men, women, and children labor in conditions that would have been unthinkable in Britain. The result has been a legacy of disease and environmental pollution.