The Asbestos Story: a tale of public health and politics

The Asbestos Story: a tale of public health and politics
Public awareness of the hazards of asbestos can be dated to the period immediately following the death of Nellie Kershaw aged 33 in 1924.  She had worked during the previous seven years in a textile factory spinning asbestos fibre into yarn. She died of severe fibrosis of the lungs. The pathologist, William Cooke, who found retained asbestos fibres in the lungs, called the cause of death asbestosis.  Nellie Kershaw was not the first case to be reported of lung fibrosis caused by asbestos. Montague Murray in 1899 had reported the case of a 33-year-old man who had worked for 14 years in an asbestos textile factory. He had died of fibrosis of the lungs which Montague Murray, also finding asbestos in the lungs, had attributed to inhaled asbestos fibres.  The patient had told Murray he was the only survivor from ten others who had worked in his workshop.

However, unlike the Montague Murray case, which had aroused little interest, the death of Nellie Kershaw and its cause was widely reported. It led to the government commissioning the Chief Inspector of Factories, Edward Merewether, with an engineer, Charles Price, to report on workers’ health in the asbestos industry. They found, among those still at work who had been employed for more than five years, one third had asbestosis and of those still working in the factory after 20 years, four-fifths had the disease.

The government introduced regulations in 1931 to control exposure to asbestos, together with arrangements for regular medical surveillance of the workforce and eligibility for compensation for factory workers with asbestosis. A benefit commented on by the workers in one factory was a clock on the wall becoming visible to them for the first time. (more…)

Think peach: the true symbol of breast cancer awareness

It’s that time of year once again: Instagram and Twitter will adopt a light shade of pink, companies will adorn their products with the ubiquitous pink ribbon, all to remind us of Breast Cancer Awareness Month. To a breast cancer scientist such as myself, October always brings out ambiguous emotions. On one side, it serves as a reminder of all the great research and results that we have achieved. Statistics show that things are getting better for many women, as mortality rates have halved in the last 20 years. October also prompts many of us to remember that there is nothing better than prevention when talking about breast cancer. Early screening measures have revolutionised outcomes for women; it’s very likely that almost 50% of the lives that were saved depended on catching the cancer earlier.

The other major breakthrough was the development of targeted therapies for the most common molecular subtype of breast cancer (luminal subtypes) accounting for 70% of all new breast cancers. Years of rigorous clinical trials with these drugs have helped reduce the number of women that develop secondary disease (metastatic) – the consequence of the primary breast cancer cells spreading to other organs. This is where my ambivalence stems from; far too many women still have their breast cancer relapse. Outside of the beautiful pink narrative which Samantha King – author of Pink Ribbons, Inc: Breast Cancer and the Politics of Philanthropy – called “the tyranny of cheerfulness”, breast cancer remains the second largest cause of cancer-related deaths in women. (more…)