Dr. Cooke and Nellie Kershaw
Nellie Kershaw was 13 years old when she began working at Turner Brothers Asbestos Company on a "roving" machine (used to twine threads of asbestos). By all accounts, Nellie's health was quite good when she began working at Turner, and began to decline when she was around 29 years old. At 29, she started treatment for a lung condition and "for 2 or 3 years her pulmonary symptoms waxed and waned but she continued to work…" Selikoff, I. and Greenberg, M. A Landmark Case in Asbestosis. JAMA 265.7: 898-901 (1911). View the article A Landmark Case in Asbestosis. In 1922, she was declared unable to continue work and her physician, Dr. Joss, issued a certificate entitling her to workers compensation. The certificate bore the diagnosis "asbestos poisoning." (Id. at 898.) Turner refused to pay her workers compensation benefits, telling its insurance company it would be "exceedingly dangerous to accept any liability whatever in such a case. They felt that they out to do all in their power to repudiate the claim." (Id. at 899.) Nellie, quite the fighter, refused to accept the Turner denial and wrote the company herself:
What are you going to do about my case? I have been home 9 weeks now and have not received a penny—I think it's time that there was something from you as the National Health refuses to pay me anything. I am needing nourishment and the money, I should [have had 9] weeks wages by now through no fault of my own. (Id. at 899.)
Nellie Kershaw died on March 15, 1924. The diagnosis of asbestos poisoning by Dr. Joss garnered the attention of the local coroner and a full corner's inquest commenced. Dr. W. E. Cooke, a pathologist, became part of the formal inquest and it was he that carried out the examination of the lungs. (Id.) Dr. Cooke ultimately published his findings in The British Medical Journal in 1924. Dr. Cooke explained the nature of his examination in the first sentence of his report: "the following case is of importance because it is the first in English medical literature to be definitely proved." Cooke, W. E. Fibrosis Of The Lungs Due To The Inhalation Of Asbestos Dust. The British Medical Journal: 147 (1924.) View Fibrosis of the Lungs Due to the Inhalation of Asbestos Dust.
As Dr. Cooke noted: "Medical men in areas where asbestos is manufactured have long suspected the dust to be the cause of chronic bronchitis and fibrosis, and Professor J. M. Beattie has shown that the dust causes fibrosis in guinea-pigs. (Id. at 147.)
Dr. Cooke's examination of Nellie Kershaw's lungs revealed a thickened pleura over the entire surface of the lung and "the lung tissue being replaced by fibrous tissue" (Id.) In sections of both of Nellie Kershaw's lungs, Dr. Cooke found "particles of mineral matter" of various shapes, the majority with sharp angles and various lengths from 393.6 to 3 microns in length (Id.) Dr. Cooke attached a micrograph to illustrate the various sizes and shapes of the bodies shown in the micrograph.
Based on his examination, Dr. Cooke included that Nellie Kershaw died from fibrosis caused by exposure to asbestos dust.
Dr. Joss also certified the disease that took also Nellie's life as "Asbestos poisoning." Greenberg, M. Knowledge of the Health Hazard of Asbestos Prior to the Merewether and Price report of 1930. The Society for the Social History of Medicine: 510 (1994). Dr. Joss also informed the former coroner that he saw "10-12 cases a year among his patients working in asbestos." (Id. at 510.) View Knowledge of the Health Hazard of Asbestos Prior to the Merewether and Price Report of 1930.
Nellie Kershaw's death sparked additional reports by doctors but no action by asbestos companies such as Turner. Turner took no actions to protect workers, or to tell others about the death of Nellie Kershaw. Dr. Cooke, however, expanded on his 1924 article with an article entitled Pulmonary Asbestosis published in the British Medical Journal in 1927. Cooke, W. E. Pulmonary Asbestosis. The British Medical Journal: 1024-1027 (1927). View Pulmonary Asbestosis.