Every grain of sand
Start with what is right rather than what is acceptable
Franz Kafka 1
Silicosis, which is also known as miners’ phthisis or grinders’ asthma is an occupational lung disease and form of pneumoconiosis caused by inhalation of respirable crystalline silica. It was initially recognised by Bernadino Ramazzini, an early pioneer in occupational medicine. The Italian physician identified arenaceous substances in the lungs of stonemasons, which produced classic asthmatic symptoms such as coughing, fever, dyspnoea and cyanosis. The disease was often incorrectly diagnosed as pulmonary oedema, pneumonia or even tuberculosis. During the industrial revolution the frequent use of powered hand tools such as the pneumatic hammer drill and sandblasting techniques generated more dust and increased its prevalence. This was evident throughout the Welsh slate industry, especially around Blaenau Ffestiniog in the late nineteenth century. A subsequent study revealed many slate miners were frequently exposed to quartz or silica dust and predisposed to contracting tuberculosis, which often left them maligned as potential sources of infection. 2–17
An overly simplistic cause effect ideology soon emerged with the social amplification and attenuation of risk to protect or secure vested interests of various factions. General practitioners in the region refuted the findings with one physician even claiming slate dust was beneficial to health. The medical consensus held that its extraordinary incidence rate was influenced by the prevailing perception of tuberculosis as a social disease. Quarry owners maintained quartz was no more harmful than road dust and the prevalence of tuberculosis was merely coincidental. Any introduction of preventive legislation would incur substantial expenditure and render the industry economically unviable. Despite legislation under the British Factories Acts, which required containment of dust at the source, efforts were directed towards behaviourism and included education of housewives. Even by the 1930s, very little was accomplished regarding prevention of exposure to dust hazards. The prevailing sociopolitical and economic conditions rendered unions ineffective and miners were reluctant to report the disease lest they were dismissed as asymptomatic carriers. This traditional blame the victim doctrine persists and is reflected by the contemporary reactive focus on monitoring dust levels with prescribed limits for coal mines, quarries and tunnelling…………Plus ça change, plus c’est la même chose. 18–30
Industrial disease
Silicon is an extremely common element and when combined with oxygen it forms silicon dioxide or silica, which accounts for almost 75% of the earth’s crust. It is a major component of sand and also found in soil, mortar, plaster and shingles. Silica occurs naturally in many igneous, sedimentary and metamorphic rocks such as granite, sandstone, slate and gneiss or as silicates in metallic ores, which are chemically combined with cations. These include talc, mica and the notorious asbestiform minerals chrysotile, crocidolite and amosite. 31–46
Free silica exists as pure silicon dioxide with crystalline, cryptocrystalline or amorphous structures that are not chemically combined with other elements. Its crystalline polymorphs include quartz, which is one of the most abundant minerals on earth. Cristobalite and tridymite, are much less common and occasionally found in some igneous rocks. These substances are extremely resilient and chemically inert with exceptionally high melting points. It makes them ideal for many industrial applications including refractory processes and other activities such as drilling, grinding, cutting, crushing, milling and abrasive or sand blasting. This generates airborne contaminants and potential exposure to highly toxic respirable crystalline silica, which may cause silicosis and many other pulmonary complications. The hapless victims are often predisposed to tuberculosis and autoimmune diseases including nephritis, scleroderma and systemic lupus erythematosus. Moreover, crystalline silica has been classified as carcinogenic by the International Agency for Research on Cancer. 47–66
Exposure to crystalline silica and the onset of silicosis and other related diseases is particularly dependent on particle size distribution and aerodynamic properties. This determines which fractions are likely to penetrate the respiratory system’s inhalable, thoracic and respirable regions, which are summarised in Figure 1 and Figure 2 and defined by BS EN 481:1993. Under these conventions, a 4µm (micron) diameter dust particle has a 50% chance of penetrating the alveolar region of the lungs and causing pulmonary complications. The risk decreases exponentially to a 30% likelihood with inhalation of larger 5µm dust particles. Conventions in ISO 7708:1995 provide further details on numerical values as percentages of total airborne particulates….There’s panic at the coal face and tongues are tied in knots, some come out in sympathy, some come out in spots. Some blame management or militant employees but everybody knows it’s an industrial disease. 67–75
Occupational silicosis
Occupational exposure to respirable crystalline silica occurs across a comprehensive range of industrial sectors. This includes quarrying, mining, mineral processing, foundries, stonemasonry, refractory processes, construction, tunnelling, demolition, pottery, glass, ceramics, and cement and concrete manufacturing. In some operations, especially with ineffective ventilation, dust emissions are often unnoticeable and extremely fine particles remain airborne and uncontrolled for prolonged periods. The consequences are dependent on many variables and risk factors include the nature, frequency and intensity of exposure, physicochemical dust properties and the operator’s physiological attributes. These may be exacerbated by unhygienic conditions and personal habits such as smoking. 76–94
Silicosis is a recognised occupational fibrotic lung disease and its severity varies from simple or complicated forms to progressive massive fibrosis. It is caused by inhalation of respirable crystalline silica and usually categorised into three principal classifications. Acute silicosis occurs following severe exposure over a relatively short period, which produces a rapid progression of dyspnoea or breathlessness and death typically occurs within several months. Accelerated silicosis develops within five to ten years following direct exposure to high concentrations of airborne contaminants. Chronic silicosis manifests over time following prolonged exposure to low concentrations of respirable crystalline silica in the occupational environment. It is entirely preventable and controls must focus at the upstream source with better design to eliminate exposure or reduce the risk via effective engineering controls. These include mechanical extraction or local exhaust ventilation and dust suppression techniques using water sprays with chemical additives or coagulants. Preventive action should be supplemented with active and passive dust monitoring, education, training and personal protective equipment This must be complemented by reliable health surveillance with humane rehabilitation protocols, especially for the incapacitated and retired victims. 95–111
During the early 1990s throughout the United States of Amnesia almost 300 deaths were attributed to silicosis each year and over recent decades the mortality rate has declined. However, a resurgence of black lung and rapid onset of progressive massive fibrosis amongst Appalachian coal miners is quite alarming, especially considering the region was the scene of America’s worst industrial disaster during the great depression. 112–116
The town of the living dead
During the early 1930s Union Carbide Corporation awarded a major engineering contract to Rinehart & Dennis, which involved construction of the Hawks Nest tunnel beneath Gauley Mountain in West Virginia. The independent contractor submitted the cheapest tender and the project achieved notoriety as the worst industrial disaster in US history. It resulted in the deaths of at least 750 construction workers from silicosis although most Americans remain oblivious to the carnage. 117–122
Union Carbide, which was also responsible for the Bhopal disaster some sixty years later conspired with lobbyists, politicians and media liaison officers to suppress the atrocity. Most of the hapless victims were stigmatised as destitute African-American drifters from the deep south. The indentured servants or peons merely hopped aboard trains and headed towards the Appalachian ranges in search of sustenance during the great depression. This apparently attenuated the desolation, which was further diminished with a Bernaysian dexterity that crystallised public opinion and the corporate barbarism was deceptively disguised as the progress of man. 123–129
Construction of the five-kilometre tunnel began midway through 1930 using a continual supply of impoverished migrant labourers. It was part of a deceitful hydroelectric project, which also generated cheap power for the Electro Metallurgical Company, a subsidiary of Union Carbide. The mountain rock contained extremely high concentrations of silica and dry drilling techniques were employed to expedite construction and reduce project costs. 130–132
Blasting, drilling and cutting activities generated persistent clouds of swirling white dust as the labourers toiled without adequate ventilation or respiratory protective equipment. Dozens of peons collapsed under the oppressive conditions and were hauled outside via wheelbarrows to recuperate in the fresh air. Following a brief respite they were forced to return underground by company appointed guards to complete their ten-hour shifts or face dismissal. Legions of labourers became seriously ill with acute silicosis following repetitive, intense and unprotected exposure to significant concentrations of freshly fractured silica dust. Many of the victims died in their beds at the primitive and overcrowded converted boxcars in the project’s segregated accommodation camps near Gauley Bridge, which was referred to by the local community as….The town of the living dead. 133–137
The death toll began to escalate and additional emotive and political issues soon emerged via the Jim Crow laws and the legal doctrine of separate but equal, which covered racial segregation in public facilities including cemeteries. Repatriation of the deceased became increasingly complicated because many victims were unknown itinerants without any identification, next of kin or dependents. Union Carbide responded instinctively and a local undertaker was rewarded with a fruitful contract to bury the victims. The unidentified bodies were unceremoniously loaded onto a flatbed truck belonging to a local resident, transported to makeshift cemeteries near Summersville and dumped into unmarked mass graves. Some incapacitated workers managed to return home and suffered unbearably harrowing deaths. The initial symptoms included a rasping cough and excruciating chest pains with a rapid onset of progressive massive fibrosis until their lungs eventually ossified. 138–143
Union Carbide executives and West Virginia state officials conspired to conceal the magnitude of the disaster, which was rarely covered in tertiary education curricula or commemorated via remembrance services. Newspaper editors were somewhat reluctant to publish inflammatory articles and most media reports inevitably blamed the victims. The escalating disease was mistakenly attributed to poor nutrition or an unhealthy diet and unhygienic behaviour. During the late 1930s the state governor described a federal writers’ project and guide covering the region as blatant propaganda and refused to sanction its publication until references to the disaster were moderated. After leaving office, Governor Homer Holt was rewarded with a sinecure as general counsel with Union Carbide. 144–150
The corporate turpitude displayed by Union Carbide is incontestable. The primary objective of the Hawks Nest project was to provide cheap power for its metallurgical facility and use the excavated silica for production of ferrosilicon alloys, which were used extensively throughout the steel industry. The creation of the New Kanawha Power Company was merely a deceptive tactic enabling Union Carbide to circumvent statutory requirements and mine the vast silica reserves and the peons became collateral damage. Its vituperative recklessness and contumelious irresponsibility resulted in the deaths of at least 764 workers although the exact number of fatalities will never be known. In 2009, the West Virginia Humanities Council awarded a $10,000 grant towards a memorial in honour of the victims and the words from Albert Camus resonate…..No cause justifies the deaths of innocent people. 151–158
Sands of time
Exposure to respirable crystalline silica and development of silicosis is not restricted to underground mining. It presents a much greater risk than coal dust and may be responsible for the rapid onset of progressive massive fibrosis amongst coal miners throughout Appalachia in the United States. In Australia, a former BHP Billiton Mitsubishi Alliance employee was recently diagnosed with silicosis and eventually succumbed to the debilitating disease in June 2018. The victim worked for almost 30 years at its Goonyella Riverside open cut coal mine in Queensland’s Bowen Basin. Substantive evidence from a renowned thoracic physician confirmed the silicosis was quite severe and caused by excessive exposure to respirable crystalline silica throughout a prolonged mining career. 159–167
Another coal miner from northern New South Wales developed typical silicosis symptoms following six years work as a contractor with Anglo American at its Moranbah North and Grosvenor underground coal mines in Queensland’s Bowen Basin. The victim alleges the mining behemoth breached its duty of care and failed to provide a safe working environment. It has left him with extensive scarring of the lungs and scleroderma, an auto immune disease, which restricts blood circulation and creates cyanosis with inflammation of the joints and excruciating pain. Despite the implementation of dust monitoring standards several mines continue exceeding prescribed limits and very few statutory inspections are unannounced. Indeed most of the corporate transgressors or recidivists treat its workforce as indentured servants or peons and the regulatory authority with contempt, which was quite evident during the coal workers’ pneumoconiosis parliamentary inquiry. 168–174
A recent escalation of acute silicosis amongst tradesmen and stonemasons with the manufacture and installation of fashionable stone kitchen benchtops has prompted health officials to warn of an impending public health emergency. The Queensland government issued an urgent warning following the recent lodgement of 22 silicosis claims, which included six terminally ill victims. It has been described by a senior physician as the worst occupational lung disease crisis since asbestosis and confirms that organisations are an anthropomorphic fallacy and have no memory…….There’s a dying voice within me reaching out somewhere, toiling in the danger and the morals of despair. I’m hanging in the balance of the reality of man, like every sparrow falling, like every grain of sand. 175–183
History may not repeat itself but it sure does rhyme and much of the narrative covering the tragic events at Hawks Nest in West Virginia following the great depression is eerily familiar. Fast forward almost eight decades and there are currently 81 confirmed cases of mine dust lung diseases throughout Queensland’s mining industry and an unction of undertakers awaits with a fleet of pristine hearses instead of flatbed trucks. It was only true leadership and intervention from a determined member of parliament and an uncompromising union campaign that initiated a state parliamentary inquiry. 184–190
Testimonies at many regional public hearings provided ample evidence of egregious leadership, militaristic intimidation and pure corporate bastardry without a skerrick of admonishment from its fawning industry associations. This was reinforced by a conspiratorial sound of silence from the Safety Institute of Australia, despite its promotion and endorsement of zero harm ideology. Meanwhile, the state government procrastinates and connives with corporate recidivists and their legal predators to protect vested interests and forestall the establishment of an independent regulatory authority. A project management office has over analysed the parliamentary inquiry recommendations and become unnecessarily embroiled in the purity of scientism or positivism. This has degenerated into a tyranny of bureaucracy and its venal and reactive focus on dust monitoring and health surveillance has diverted attention from meaningful preventive action. 191–205
During the resources boom workers were engaged via monotonous and wearisome antisocial rosters under precarious employment arrangements to circumvent duty of care requirements. Accommodation quarters were effectively concentration camps and no better than the Manus or Nauru regional processing centres. The impact on personal relationships and socioeconomic consequences for remote communities is well documented with evidence of escalating psychosocial risks and increasing suicide rates. 206–215
This merger of state and corporate interests has created a race to the bottom and regulatory or policy capture prevails. It is exacerbated by perpetually revolving doors in a malevolent attempt to protect reputations, secure assets and socialise loss via brutal austerity measures. These are complemented by quantitative easing and extraordinary low interest rates to stem the haemorrhaging. Meanwhile, the federal government with its failed free market ideology struggles to restore confidence in a listless global economy that is nothing more than an enormous festering Ponzi scheme. 216–222
Figure 1: Inhalable, thoracic and respirable regions
Dichotomous model of aerosol fractionation according to Görner P. and Fabriès J.F. Available from: https://www.nepsi.eu/sites/nepsi.eu/files/content/editor/good_practice_guide_-english_original_additional_task_sheets-251006_modified_16072012-.pdf; (p. 10).
Figure 2: Dust fractions
The inhalable, thoracic and respirable conventions as percentages of total airborne particles.
Available from BS EN 481:1993 Workplace atmospheres: Size fraction definitions for measurement of airborne particles British Standards Institution:
http://infostore.saiglobal.com/store/details.aspx/details.aspx?ProductID=666644
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Rob Long says
As usual Bernard, a very thoroughly professional paper. Well done. Your insights are most appreciated.
Dave Collins says
Thanks Bernard
An extremely well researched and constructed article.
Many years ago I visited a small quarry to take part in their 20 years without an LTI milestone celebrations. A few weeks later chest X-rays revealed advanced silicosis in the entire workforce – very sad