Litigation Management

Book Review

G Tweedale. Magic Mineral to Killer Dust: Turner & Newall and the Asbestos Hazard. New York: Oxford University Press, 2000. Hardcover, 313 pages.

In 1995, Chase Manhattan Bank sued the British asbestos company, Turner & Newall, to recover costs associated with removal of asbestos-containing products from its New York office building. During the discovery phase of this litigation, Turner & Newall was required to release approximately one million documents, which were subsequently microfilmed and made public by Chase Manhattan. This archive proved to be a valuable resource for historian Geoffrey Tweedale, who sifted through these and other materials to author a chronology of British social policy for asbestos-related diseases and how it impacted one of the world’s major asbestos products manufacturers. The remainder of this review will present some highlights of his analysis.

The rise of asbestos medicine in Britain occurred in phases. Although originally marketed as a “magic mineral,” allegorically depicted in advertisements as a Greek goddess, “Lady Asbestos” was noted over one hundred years ago to negatively impact the health of exposed workers. Even though the connection was not well understood prior to the 1920’s, some British physicians coined the term “asbestos poisoning” in an attempt to define medical conditions they observed in asbestos workers but could not fully comprehend.

Dr. William Cooke first coined the term “asbestosis” to describe the lung pathology he observed in a 1927 autopsy on an asbestos worker. The rising numbers of deaths from asbestosis soon alarmed the British government; consequently, in 1931 Asbestos Industry Regulations were implemented to control dust exposures in a limited number of specified asbestos occupations. Concurrently, the Medical Arrangements Scheme was put in place to provide medical monitoring and compensation for certain restricted categories of asbestos workers.

British asbestos policy functioned essentially unchanged until 1970--with disastrous effects according to Tweedale. For forty years, the British approach to the asbestos problem emphasized medical monitoring of workers with asbestosis, rather than addressing the actual etiology of the problem. In part, this policy was a victim of its times. During the Depression of the 1930’s people were preoccupied with maintaining employment. Subsequently, Britain’s rearmament for World War II placed a focus on national security needs. To a great degree the medical and epidemiological aspects of asbestos exposure and asbestos-related diseases remained poorly understood.

Until the 1940’s, instances of lung cancer among British asbestos workers were so uncommon that some medical authorities disputed the association. As an increasing number of these cases arose, research documenting the asbestos-lung cancer connection was published beginning in the early 1950’s. Up to this point, British asbestos policy had been driven by the 1930’s asbestosis paradigm. The author notes that this narrow perspective had an unfortunate outcome in that it provided the foundation for programs of medical evaluation and compensation for workers with other, more life threatening asbestos-related diseases. In some cases, financial compensation for asbestos-related lung cancer victims was denied because it did not fall under the 1930’s Medical Arrangements Scheme. It was to take thirty years for the British government to recognize asbestos-related lung cancer as a compensable disability.

In the meantime, the third and most severe asbestos-related disease appeared among British workers. It was some time before British physicians understood the disease process and etiology of mesothelioma, and understandably so. For example, while asbestosis demonstrates a dose-response relationship, mesothelioma has more of an “all or none” type of response. The actual exposure insult can be relatively brief. In addition, mesothelioma is characterized by a long lag period, that can be as long as forty or more years between the date of offending exposure and onset of disease. Rising numbers of mesothelioma cases delivered a deathblow to the British asbestos industry. Once perceived as a “magic mineral,” Lady Asbestos had become a “killer dust.”

As the asbestos saga unfolds in this text, readers will be moved by the plight of British workers and their families who fell through the cracks of an emerging public policy system that failed, for whatever the reasons, to remain abreast of evolving medical knowledge. Although sensitive to these humanistic elements, Tweedale has clearly sought to objectively frame the actions of persons, institutions, and companies depicted in his manuscript within the proper historical context.

Despite the implementation of strong occupational control measures coupled with the movement away from use of asbestos-containing products, the medical fallout from asbestos exposure is expected to continue well into the new millennium. Tweedale predicts a continued rise in British mesothelioma mortality with a peak in the year 2020 at 2,700-3,300 deaths. Citing a British government estimate, Tweedale forecasts annual mortality of 5,000 to 10,000 for all asbestos-related diseases combined. Indeed, the asbestos crisis is far from over.

Reviewed by:	Elizabeth B. Juliano
	James R. Fell

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