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“What You Really Want Is an Autopsy”: Frances Perkins and the U. S. Government Conference in Joplin, Missouri, 1940

by Frances Perkins

In April 1940 Secretary of Labor Frances Perkins convened a conference in Missouri concerning the silicosis crisis that had emerged in the late 1930s. The differing perspectives on the disease and workers’ health are apparent in these excerpts from the Tristate Silicosis Conference. Evan Just, representing industry, claimed that silicosis is a social, not an industrial, problem. Ex-miner Tony McTeer disputed Just’s analysis, arguing that he, himself, contracted silicosis even though he had worked only in mines that employed the improved “wet drilling” method. The legendary public health advocate Dr. Alice Hamilton, representing the Public Health Service, spoke on the medical aspects of industrial hygiene and showed that, despite industry’s claims, little had improved over the past twenty-five years.

TRI-STATE CONFERENCE - JOPLIN, MISSOURIFrances Perkins, Secretary of Labor, presiding April 23, 1940

The meeting was opened with an invocation by Rev. Eart.

Frances Perkins, THE SECRETARY OF LABOR. First of all I want to say how glad I am that so many of you have shown interest in this problem, which we in the United States Department of Labor believe to be a part of one of the great problems of the United States - the prevention of industrial and occupational diseases. There is nothing unique about your situation, except that you have here at your gates one of the most difficult industrial diseases and one for which it is most difficult to find a cure.

We in the Department of Labor have a mandate which we received from the Congress of the United States in the basic act which creates the Department of Labor and the office of Secretary of Labor, in those words: “It shall be the duty of this Department and of the Secretary to foster, promote, and develop the welfare of the wage earners of the United States of America, to improve their working conditions, and to advance their opportunities for profitable employment.” So it becomes the duty of the Department of Labor to inquire into anything that hinders the welfare of the wage earners of the United States, and to be as specific and practical as possible with regard to each situation.

One great problem is the exposure of workers to industrial and occupational diseases. Silicosis is not the only industrial disease; there are many others. Some of them take greater ravages in life and in continuing disability.

Silicosis is newly important to us because we have newly discovered it. Lead poisoning, chrome poisoning, nickel poisoning, these are some of the industrial diseases which everybody 25 and 30 years ago know something about. But it was only about 20 years ago that we in the United States began to realize what silicosis was, and to differentiate it from the old diseases that used to be called “grinder’s rot” and “miner’s consumption” and “miner’s asthma.”

The first basis medical literature on the subject came from South Africa. There they had long recognized this disease as one of the hazards of workers in the diamond mines.

In the past 25 years we have become conscious of silicosis, not only in mines and tunnels and open-cut foundations, but also in factories and mills where people work upon substances of with substances which generate a silica dust or have a silica basis. So, having become conscious of this disease and its extent, it is our duty in the Department of Labor of the United States to see if we can find ways to prevent it...

This morning I spoke with a group of women here in the mining area. They told me in their own simple words that they and their children and their husbands, many of them, had what they regarded as “the lung disease.” Some of them spoke with bitterness, and some with question, and some with resignation. There was only one thing I could say for slight comfort to women who have lost their husbands, or whose little children are infected. It was that by cooperating with the doctor and the county health nurse and the State medical society and the State tuberculosis society, perhaps they could make it possible not only for their own children to be cured, but for others whom they did not know, whom they had never seen, who perhaps were yet to be born, to be protected from the ravages of this disease.

So I say to you that although some of you may not like the idea of this Tri-State area being used as a laboratory, can you not think of it perhaps as a great privilege? You may work out here the methods by which thousands of others, millions of others perhaps yet unborn, may be protected from the hazards which I know all of you - employers, taxpayers, labor people—regret as much as we in the Department of Labor do. Perhaps by the use of this area as a laboratory you may contribute more to the welfare of this community, and of the whole United States, than anyone has yet thought.

All of us here today have a social responsibility, a moral responsibility, and perhaps that lesser degree of responsibility which I call legal responsibility. For the latter is not as important as the social and moral responsibility which those who know of a problem have regard to it.

The owners and operators of these properties have a great moral responsibility, and many of them have acknowledged it. That is one of the things that gives us courage to come here and ask them to cooperate in making a laboratory of their area, to find a way to prevent not only this but similar situations everywhere.

The people who work in those mines and those who represent the organized labor of the community generally, who take upon themselves the duty of speaking up for those who work in the mines, also have a moral responsibility to cooperate with every technical and economic effort to relieve the situation and to find the means of preventing silicosis and tuberculosis.

So too the community here, in Joplin and in all the towns down the line, have, as you have acknowledged by being here today, a moral and a social responsibility, because the problem is at your door. You didn’t make it, but it is there.

The presence in this audience of a number of the ministers of religion reminds us, too, of the duty to bring about that kingdom of heaven on earth to which we all give lip service, to bring about better conditions for all the people of the United States.

Then we have here the representatives of government—of the local government, of county government, of State government, of the Federal Government. To me they are symbols of an order to which all of us in America have subscribed; an order and a pattern of society in which each individual, no matter how poor, still has tremendous worth and value; and in which the disaster of one is the concern of all.

The officers of Government, be they State or county or Federal, came as the symbols of that great enterprise which we call government in a democracy. It is a government which does not rule, but expresses and gives reality to the desire of the people that everybody in America should have a chance. The men who are crushed by material burdens may still look to their government to find a way for them to contribute their moral worth to the building of our democratic society.

That is why it is much more important that the answer to this problem of silicosis in the Tri-State area should come from the understanding and moral force of the people of the community—the people who are affected by it, taxpayers, owners, workers in the mines—than that we should come from the outside with suggestions. I don’t mean that we haven’t got suggestions; we have, but they take secondary place on the program. What you do yourselves is more important than the most highly specialized contributions of scientists and technicians...

This is a joint problem. No one factor can solve it alone. It requires cooperation of every intelligence that comes to bear upon the problem. And so this conference is a conscious effort to focus all the knowledge and all the forces which can take necessary and practical action to overcome this hazard.

The political forces—the agencies of government, the governors of the States who have sent their representatives here today, the commissioners of labor of the States, the health commissioners of the States, the county commissioners—all of them must answer to the people of this community in some way for what they do in the solution of this problem.

The political forces, the economic forces, the moral forces, and the scientific knowledge and the social knowledge which we have, should, in a conference like this, crystallize into a program. In the next 10 years that program should bring about direct results in the lives of the men who are exposed to this hazard, and in the lives of the families who suffer economic disaster when then problem is not solved.

Great discoveries have been made and great work done, in the prevention of silicosis.

We began working on this in New York State 20-odd years ago, when the conditions of those who worked in the open-cut foundations, in the excavation for buildings in New York City, came to my attention as State Commissioner of Labor. From that, we worked back into the factories and the mills, and we there found much exposure too that needed correction. Exposure in the mills and factories is easy to correct. An exhaust system with a modern fan, with modern electrical power, can suck up the silica dust and take it off.

We used to have what was known as “rinder’s rot,”among those who ground on abrasive machinery. We have stopped that in all the States where they have factory exposure. It can be prevented by an exhaust system.

It is much more difficult when you have a tunnel through a mountain, when you have an open-cut foundation through solid granite as you have in New York City [subway construction], when you have the excavation of an ore hidden away, as yours is in this area, mixed in with other layers of rock which are high in silica. But the fact that the problem is difficult does not mean that it need not be solved or that it cannot be solved.

You have made progress here in the last 20 years. You have made progress by using a wet drilling process almost entirely. How completely successful wet drilling processes are, we don not yet know. We know that they are partly successful. We know that they prevent some cases of silicosis, because in the areas where they don’t do wet drilling they have a higher rate of silicosis than you have here. But does it prevent all of the silicosis? That we don’t know yet...

According to reports of management, apparently confirmed by impartial sources, considerable improvement has been effected by way of making the mining operations less dusty and therefore less hazardous. Wet drilling has been adopted, particularly in those mines operated by the larger companies. I have been told that there probably is not a mine in the whole area that does not have wet drilling today.

The principal operators, so far as I can learn, seem confident than they have checked or eliminated further hazards in respect to silicosis. On the other hand we have been told by workers, and by other observers, that there is still a considerable incidence of silicosis, and that there remains a considerable amount of dangerous exposure in various occupations...

As you know, there are in this conference representatives of the Governors of Kansas and Missouri and Oklahoma; the State mine inspectors, the State labor authorities, and the State and local health authorities. And I have invited representatives of labor and of management and of the public, since each of these groups has a major interest in the solution of this problem. I have also invited participation by several agencies of the Federal Government, which in one way or another are directed toward assistance to the States. These Federal agencies include the United States Public Health Service, the Bureau of Mines, the Bureau of Indian Affairs, the United States Housing Authority, the Work Projects Administration, and the Farm Security Administration. All of these agencies, in addition to the United States Department of Labor, are concerned with your problem in the Tri-State area...

We have here today responsible representatives of the owners of these mines, representatives of the public, representatives of the technical services which are familiar with the conditions that bring about silicosis, and representatives of those working people who are organized in trade unions in this area. We hope to hear from all of those, and from every other group in this conference which can throw light upon a problem which is not exclusively your problem in the Tri-State area but the problem of all of us as a people.

MR. EVAN JUST (Secretary-Treasurer, Tri-State Zinc and Lead Ore Producers Association, Miami, Oklahoma).

Because the function of our Association is to represent the Tri-State Mining district in public affairs, and because of my personal knowledge of the various aspects of the problems before this conference, I have been requested to represent the mine operators and to express their viewpoint. We are please to welcome you to this district and we invite your detailed scrutiny of the conditions under which our workmen are employed. We believe you will find that our industry has been progressive in combating its natural hazards and that completely modern prosecutions are being taken to make our working places safe...

Insofar as local living conditions are concerned, we are dealing with a social, not an industrial problem, one which is nationwide and worldwide, and exists in many places in this country far more seriously than here. However, as citizens of this community, we welcome your friendly interest in this social problem and are very happy indeed to have your cooperation in seeking improvement...

An exhaustive study [of health conditions in the Tri-State area] was made [between 1924 and 1929], including over 30,000 examinations. Several thousand venereal cases were also treated. The published results are contained in Technical Papers 545 and 552 of the Bureau of Mines. It is my understanding that this still stands as the most complete investigation of silicosis ever made in this country. Technical Paper 552 says that as of 1929, only 22% of the miners were silicotics and that the average miner took 12 years to acquire first stage silicosis.

(Interpolation No. 5—By that I don’t mean to say we are proud of 20 per cent, but it represents an advance over those previous days when it was so very high.)

Five per cent of the miners had advanced silicosis and less than 4% had tuberculosis. One fourth of the tuberculosis was uncomplicated by silicosis.

All available evidence indicates that all these averages have been substantially reduced in more recent years. Judging from records of limited numbers of employees the percentage of tuberculars is less than two, and one third of these are not silicotics. With but few exceptions the small minority of employees who have silicosis have it in a mild form which cannot be fairly construed either as a direct source of disability or as materially lowering resistance to tuberculosis. As you well know, except in its most extreme form simple silicosis is not a source of disability. It is only when associated with an infection of tuberculosis that it is classifiable as a source of concern...

We have kept up with improvements in technique and are constantly engaged in efforts to make the good dust control in our industry better. Dust counts and air analyses are made in all the working places of the members of our Association every quarter, and the same service is available at cost to non-members. When our findings are reported to the operators concerned, great stress is laid upon unsatisfactory conditions if found, along with suggestions as to the means of improvement.

In these dust surveys we use the strictest limit of permissible dustiness that has ever received wide recognition, namely 5 million particles per cubic foot. This work has been productive of great benefits that were not possible before a rapid and reliable method of dust determination was available. With this technique we can ascertain just where and how dustiness is created, and are no longer “shooting in the dark.” In the first year of routine dust counts, surveying underground we found that 76% of the counts were under 5 million and 92% under 10 million, with an average of 3.9 million. In our fiscal year 88% of the counts were under 5 million, 97% were under 10 million, and the average count was 3.3 million.

We urge you to inspect our mines and mills at firsthand as the surest way of ascertaining the true conditions.

(Interpolation No. 7—I may say for the benefit of our audience that at our suggestion Miss Perkins has brought a dust hygienist with her who will be given every facility that I can create to go into the mines of this district. We don’t feel that we have anything to hide and we realize that coming on a very short trip, no matter what we will do we will be accused of rigging up some kind of set-up—


MR. JUST. Not by Miss Perkins, I realize that, but we don’t want to make it possible for anyone else to make such an accusation and we are going to make it possible for this man to go into any of the ground that I can persuade—well, any of the ground, that is all.)

In our opinion the history of silicosis research and dust control in our industry completely refutes the insinuation that our employers are so intent on profits that they are indifferent to the healthfulness of their working places, and we believe that our present status in the matter of dust control should be the subject of admiration rather than scorn.

(Interpolation No. 8—I may say parenthetically again that, Miss Perkins, we don’t for a moment mean that you have imputed motives like that to us. But there are people in this country who are making a great burst of publicity with just that intention, and that is why I say it.)

Efforts have been made to dramatize dust conditions on the surface in the Picher field as a cause of silicosis. The numerous piles of tailings or “chats” as they are termed locally, are unusual and picturesque, and can be portrayed to the uninformed as a health hazard for all the dwellers in their vicinity. It has even been suggested that the surface dustiness is so extreme and poisonous that it inhibits the growth of vegetation. This whole story has no basis in fact.

Silicosis is a disease produced by breathing excessive quantities of extremely fine particles of silica dust over a long period of exposure. It is true that on windy days in dry weather considerable dust is evident in the mining area. This comes from two principal sources, primarily from the passage of vehicles over chat roads, and secondarily from a relatively small number of deposits of sands and slimes produced by the fine grinding incidental to the treatment of ores by flotation. The chat piles are not a significant source of dust at all, for the simple reason that they are composed principally of material far too coarse to be picked up by winds of less than hurricane velocities...

Although such conditions are not typical of our district or due to industrial policies, there are a number of poor and destitute people living in the midst of the Picher mining area. This circumstance is not new; it has existed throughout the life of the field, through boom and depression, good times and bad. It is not agreeable to contemplate, and I know of nobody who would be out of accord with its elimination.

On the other hand the great bulk of the employees of our industry live in neat, respectable homes. Non-residents of the area commonly fail to realize that the majority of the miners do not live within the confines of the Picher field. One has only to stand on the highway at the beginning or end of the working day to see the great streams of “buddy cars” carrying the men to or from homes in all the towns of this region, extending from Carthage, Missouri, to Miami, Oklahoma, a distance of nearly 60 miles. That some of our employees live in poor homes is undeniable. However, the wages paid in our industry are certainly adequate to support decent living. That many people who can afford better homes, prefer to live in small, unpainted two or three room shacks and spend their surplus funds on automobiles and radios cannot be charged against the mining industry.

(Interpolation No. 13—I may say there that we don’t mean to say all these shacks you saw down there are of that type, but a considerable portion are people who can afford better conditions, if they choose to have them.)

Many uninformed people have been led to assume that the mining companies have some means of controlling living conditions. This is not so. It has never been customary here to provide living quarters or commissaries for employees or otherwise to exercise any control over their mode of life...

There was also a reference made to a considerable incidence of silicosis. I believe this audience should realize that it takes, even under rather bad conditions some 10 or 12 years to acquire silicosis, and that obviously a community will have a residue, a hangover, of a condition which dates back years. Even though the industry has made all these efforts that I described to alleviate the hazard, there is naturally, where such a length of time is involved in obtaining a disease, a residue in the community which we believe is not being created today.

Miss Perkins, you mentioned the subject of occupational disease legislation, and I believe I should discuss that to some extent, because it is of some concern to all of us here. You people who are specialists on that subject—I know Mr. Zimmer is very much interested in that—realize that every place that silicosis compensation has come up there arises this problem of what is called “accrued liability.”That is that the workers who in past years have obtained that are still in the industry. Something has to be done to cushion that accrued liability responsibility.

We cannot create a law which makes it the only feasible thing to do to throw a bunch of men out of work. There is no person who would want that. There has to be some kind of a cushion.

I will say that if the means can be devised of having fair legislation of that type, and of providing a cushion which we can bear, the mine operators of this district are not opposed to occupational disease legislation.

Now there is another problem there which may sound like throwing a red herring into the picture, but it is here and I believe Miss Perkins and the rest of this audience should know this. At the present time we have accidental injury workmen’s compensation in all these three States. Incidentally, occupational disease is optional in Missouri and I understand that all the employers in Missouri have it, but with those laws which are fairly designed and which I thoroughly believe the administrators are trying to do a good job.

We have a few people in this district, a very few, not more than that, who exploit that situation to the utmost and I say to you folks that the cost of compensation due to that situation is just about double what it should be. You may not know that silicosis is one of those things where you can get doctors on the stand and argue indefinitely, and the poor commissioner faced with the very difficult problem in trying to make determination, and with the condition that we have here being exploited in this way, we must have legislation which does something to prevent the silicosis burden being exploited in the same way.

Now again I may be accused of trying to inject a red herring into this picture. But I feel that we must take some notice - I don’t like to do it, but we must take some notice—of the circumstance that some people have been going around the country showing a motion picture and indulging in other propaganda. Here is a copy of the 120 pages which was circulated as far as I know to most of the newspapers in this country, and I state to everybody here that that thing is a very clever and in my opinion a very vicious distortion of the truth. I hope that the people in this audience can see that picture to see how thoroughly it distorts by a clever use of actual facts, and by a very clever use of sound effects, and by a lot of effects that were imported into the picture and don’t belong to this district at all, they have made a picture and are circulating it around the country, which in my opinion is pure poison...

THE SECRETARY OF LABOR. That is true, Missouri is a small section of the total part of the industry today. But in the other two States, occupational disease or silicosis is not covered by the act.

In Missouri, Mr. Just says, a large part of the employers have elected to come under the act, and therefore their employees are covered under the workmen’s compensation sections of the act. I don’t know the exact number, and perhaps Mr. Just doesn’t. It is, however, important to remember that, with an elective process, there always comes up that marginal employer who didn’t elect to come under the act, and who, when the crisis comes about, proves not to have been covered and whose workmen prove not to have been covered...

Elective coverage is one of the most elusive and unreliable coverages in the world. I cannot believe that men are safely under the workmen’s compensation act until all occupational diseases are covered on a compulsory basis.

I used the word “compulsory” not with any desire to compel anybody to do anything, except in so far as we recognize that the individual choices may not always be sufficiently imbued with a moral understanding of what the real obligation is. No one of us thinks that the fire is ever going to break out in our barn, or in the tenement which we own. We always think it won’t happen to us, and so do employers who have men exposed to this particular hazard.

I would like to know whether or not there is real concurrence with the statement which Mr. Just made: “As you well know, except in its most extreme form, simple silicosis is not a source of disability. It is only when associated with an infection of tuberculosis that it is classifiable as a source of concern.” I don’t know your source for that rather technical medical opinion, Mr. Just, and I wonder if anyone here of the medical men has a contribution to make. Dr. Sayers, who was formerly of the Public Health Service, now the head of the Bureau of Mines.

DR. SAYERS. I am representing the Public Health Service here.

As far as this particular statement is concerned, if you will read it rather carefully, I think you will see it says that simple silicosis excepting in extreme forms is not a source of disability. Now simple silicosis in early stages does not show great disability, and we in our conferences in Washington concluded that we did not want men to lose their jobs just because they had simple silicosis, and this is in conformity with that.

Now as to infection, it isn’t always just tuberculosis, and this statement is different from the statement we had on that basis. It is usually that the infection is tuberculosis, but not always. And we do have disability and marked disability in silicosis, even though in its simple form to start with and maybe in early stages when infection supervenes, usually tuberculosis.

THE SECRETARY OF LABOR. I think that we are all in some confusion here because the technical differentiation of diagnosis between tuberculosis and silicosis is so difficult. I am speaking as a layman. I have been shown the X-ray plates of lungs that were clearly, to the medical man, silicotic; and lungs that were clearly tubercular, to the medical men. The line between the two is very difficult; only the most expert observers can distinguish; and they themselves think they need more clinical experiment. Is that correct?

DR. SAYERS. It is correct. We wish more than just an X-ray. We want all the facts concerning the individual, in order to make that diagnosis.

THE SECRETARY OF LABOR. I am sorry to say that what you really want is an autopsy in every case. Most of us really have to work along, you see, here on the line of probabilities because the medical men have not yet been able to make a clear differential diagnosis between the two in their early stages, and what we are interested in, of course, is the prevention of whatever speeds up the tubercular process, or whatever it itself causes a disability.

Now may I ask one more question? There was a statement made, I think by you, Mr. Just, that 12 years' exposure was regarded as probable preceding any disability.

MR. JUST. That was the finding in that analysis of 1929.

THE SECRETARY OF LABOR. Is there any change of opinion on that as to disability from silicosis, Dr. Sayers?

DR. SAYERS. It would vary with the region and the exposures in this particular region before disability did occur. In that group of people, about 7,000 as I remember, that we analyzed, it was about 12 years.

THE SECRETARY OF LABOR. You don’t say that is always the case?

DR. SAYERS. It is not always the case.

THE SECRETARY OF LABOR. The Public Health Service advised us recently, that they regarded a 5-year exposure as likely to result in disabling silicosis, unless there were other factors. I understand that Dr. Helm of the Kansas public health department is making some studies in the area we visited this morning, studies in the area we visited this morning, studies of cases all of whom have been in the district at least five years. They are studying the effect of surface exposures, but that does not mean underground exposures in direct contact with the drilling.

MR. PAT McGUIRE. I would like as a laymen much interested in this to ask Dr. Sayers to explain this point, "with an infection of tuberculosis. Tuberculosis is an infectious germ. But does silicosis ever produce tuberculosis?

DR. SAYERS. Your question is, does silicosis ever produce the infectious germ?

MR. McGUIRE. Tuberculosis is an infectious germ, I understand, but how about silicosis? Could I catch silicosis from you?

DR. SAYERS. You cannot.

THE SECRETARY OF LABOR. As I understand it, Mr. McGuire, it is something like this. Tuberculosis comes from a disease germ. The physicians say that in almost every human being the germs of tuberculosis can be found within the system, and a remarkable number of autopsies show that a large number of us have had tubercular lesions at some time. Silicosis is not an infection; it is the result of poisoning by silica, which is taken into the lungs and acted upon by other substances in the body.

Since many of us probably have the germs of tuberculosis within our systems, any damage to the lungs, such as might be caused by breathing silica dust, may have this result: that the body’s defense barriers are broken down, and the tubercular germs have a chance to grow.

MR. TONY McTEER. Madam Secretary, ladies and gentlemen, conferences as such are not new to you, and to many people it is the usual approach to a problem, to sit down with all interested parties and discuss what is wrong in order to agree on a remedy. I can frankly tell you that a conference of this sort is new and different to the working people of the Tri-State area...

Some people believe that because the miners have not made a lot of noise about their troubles, because of the ignorance of themselves and others, that the workers have no troubles. That is not correct.

I am proud of our miners here. They know they have troubles aplenty, and what they are, but they also know false hopes when they see them. They have been fooled too often, so that now they don’t let themselves in for another deception.

However, they also know a good beginning when they see it. And this conference was received by the people of the Tri-State with great hope and anticipation of beneficial results...

We appreciate your coming this long distance, knowing that you would be convinced that here lies a serious problem.

Young men are dying. Ailing mothers and sick little children arouse in you the interest you have shown by being here today. Our district has the greatest percentage of widowhood in the United States; a sad commentary. These are the things that must be stopped for the future welfare of all the citizens who live here.

The problem as we see it is threefold. First, dust control; second, proper hospital facilities; third, adequate housing.

To reduce the high death rate among the miners requires better dust control and better working conditions in the mines. Stopping silicosis is one step in the direction of curbing the infection of tuberculosis. Mines today go in for more mechanical equipment, as we are living in a world of progress. I haven’t myself worked in a mine for the last five years, but the mining conditions and the health of the miners are my business. Our people working in the mines today give many exact reports of what does on in the mines.

It is said that wet drilling has solved the problem of dust control.

There have been two general fields of mining in this district. First, what we term the old country, which is the Joplin, Webb City area. Second, the Oklahoma and Kansas mining district. In the Joplin district the drilling was done with the piston machine or dry drills. The water liner drilling machine was introduced into Oklahoma and Kansas fields in 1916 or 1917, and from around that period it has been used exclusively. I wish to speak from my own experiences on this. I have never worked in mines except where water-lined drills were used, and I have silicosis, or dust on my lungs. We can produce the names of hundreds of men who have never worked except under wet drilling conditions, and we have buried a great many of them. I have prepared a list of some of those men who I know have died. I am turning it, with my statement, over to the chairman of this meeting.

Since wet drilling alone does not solve the problem, the problem still is dust control. We must get at the root of the problem. . . .

MR. REED: I am here today as a representative of the International Union of Mine, Mill and Smelter Workers, whose name is well known in the Tri-State area; also representative of the Congress of Industrial Organizations. In behalf of those two organizations I wish to thank Secretary Perkins for her interest in this district, for her coming out to discuss with all of us the problems that we agree face us here. . . .

Now we, the representatives of the workers in the area, believe that a 3-point program will solve it. First there must be an intensified program for dust control. Second, there must be more and better hospital facilities in the area. And third, there must be a housing program to take care of all the people in this area. Statistics could be argued back and forth here by all of us the rest of the afternoon, and probably for several days, but the general consensus of opinion, as I stated before, is that there is a problem. . . .

A Tri-State compact on all of these problems is important. Each State, however, can do an individual job.

None of the three States involved has taken advantage of the present governmental housing program. Each State, and all of us here, should do everything in our power to try to establish in the Tri-State area a substantial housing program to take care of these people. If we establish a good housing program, we are going a long way along the road to taking care of the health conditions of the workers in the area. If there are good, clean, sanitary living quarters for the workers, you are going to reduce the tuberculosis rate, whether they be from the Tri-States, or, like Miss Perkins, from New York. We are going to reduce that rate, and if we will all put our shoulders to the wheel behind such a program for the individual States in housing, take advantage of the opportunities that the Federal Government presents today, we are going to go a long way in that field.

Through a cooperative arrangement in all those three States between the labor organizations and the employers we know that a better dust control can be obtained. I know that in organized districts throughout the Nation we have better dust control. I know that a cooperative program could be work out here, and that we can lessen the dangers from silicosis.

The same thing applies to hospitals. There is an opportunity at this time, if we would all take advantage of it, to get help from the Federal Government. Those three States could ask the Federal Government for assistance in building adequate hospitals in this region. The conference here this afternoon should not end when we adjourn, but a continuing committee, representative of all of the interested parties, should be set up. And we should work diligently, the operators cooperating with the union, the union cooperating with the operators; the States cooperating one with another; and I know that we can better the conditions in the Tri-State area. I pledge the fullest cooperation, both to the States and to the Federal Government, and to the operators in this industry and in this area, to work out some program that will better the living and the health conditions of the workers in this area. . . .

THE SECRETARY OF LABOR: There are a number of experts here who have come from long distances, who are very glad to be consulted while they are here, about all the details of these problems. Dr. [Alice] Hamilton has been for a long time one of the leading experts on the medical aspects of industrial hygiene. Dr. Sayers is here from the Public Health Service. There are engineers here. All of them are available for consultation in the next two days.

Dr. Hamilton, you have been here before, and perhaps you have a word you would like to say?

DR. ALICE HAMILTON: As has been said, I was here about 25 years ago. I am sorry to say that it seemed a very familiar landscape to me as I looked over it going through it today—the heaps of tailings (only they are bigger now), and the housing that I saw reminded me of 25 years ago. Of course, I did pass prosperous little villages that I don’t remember from 25 years ago. One does not remember, after all, the worst things one sees more than better things. But the area is singularly unchanged in its outward appearance from when I was here.

At that time we knew very little about the silicosis hazard. And we never contemplated that there might be a danger to the community from the heaps of tailings. As has been said over and over again here, the problem does seem to resolve itself into three sub-problems—the control of the dust in the mining operation; the control of the surface dust; and the provision of better housing.

I noticed that one or two people said that this region is thoroughly “seeded” with tuberculosis. Why should it be? One can understand why an old neglected tenement, a slum area that has been standing in the city for a couple of generations, why those houses should be seeded with tuberculosis, but off here in the country there must be some real reason for it.

If that is true, then your housing problem really does become quite serious. Suppose you have only one case of open tuberculosis in the family; it is inevitably going to spread. I noticed another thing, that in the talk about the control of tuberculosis the stress was laid on the treatment and care of the incipient case. Of course that is very important. To leave a hopeless case in the bosom of his family because there is no use trying to do anything for him, is to neglect what is needed for the family. He must be removed in order to save the others in the family, especially the children, from that fate.

I should have supposed that wet drilling would solve this silicosis problem, and having all your much heaps wet would solve your dust problem. But if you have been doing that for 20 years and the cases of silicosis and tuberculosis haven’t been prevented, even if they take 12 years to develop—why it is obvious that wet drilling isn’t enough. So that there you have a problem that is still to be solved.

Then you have the main problem, which is only beginning to be worked on, of the surface dust. I understand that is being studied and that, although those of us who study it are not willing to make any statement yet, we shall really know whether that constitutes a danger to the families living in the region.

Source: Tri-State Conference—Joplin, Missouri. Frances Perkins, Secretary of Labor, presiding. April 23, 1940, National Archives, Washington, D.C., Record Group 100 (Division of Labor Standards).

See Also:"Must a Fellow Wait to Die?": Workers Write to Frances Perkins
"Hearty Big Strong Men All Died": The Lasting Impact of the Silicosis "Plague" in the 1930s