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Nellie Kershaw (c. 1891 – 14 March 1924) was an English textile worker from
Rochdale Rochdale ( ) is a large town in Greater Manchester, England, at the foothills of the South Pennines in the dale on the River Roch, northwest of Oldham and northeast of Manchester. It is the administrative centre of the Metropolitan Boroug ...
,
Lancashire Lancashire ( , ; abbreviated Lancs) is the name of a historic county, ceremonial county, and non-metropolitan county in North West England. The boundaries of these three areas differ significantly. The non-metropolitan county of Lancashi ...
. Her death due to pulmonary asbestosis was the first such case to be described in medical literature, and the first published account of disease attributed to
occupational Employment is a relationship between two parties regulating the provision of paid labour services. Usually based on a contract, one party, the employer, which might be a corporation, a not-for-profit organization, a co-operative, or any othe ...
asbestos Asbestos () is a naturally occurring fibrous silicate mineral. There are six types, all of which are composed of long and thin fibrous crystals, each fibre being composed of many microscopic "fibrils" that can be released into the atmosphere ...
exposure. Before his publication of the case in the ''
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Orig ...
'', Dr William Edmund Cooke had already testified at Kershaw's inquest that "mineral particles in the lungs originated from asbestos and were, beyond reasonable doubt, the primary cause of the fibrosis of the lungs and therefore of death". Her employers, Turner Brothers Asbestos, accepted no liability for her injuries, paid no compensation to her bereaved family and refused to contribute towards funeral expenses as it "would create a precedent and admit responsibility". She was buried in an unmarked
pauper's grave A potter's field, paupers' grave or common grave is a place for the burial of unknown, unclaimed or indigent people. "Potter's field" is of Biblical origin, referring to Akeldama (meaning ''field of blood'' in Aramaic), stated to have been pu ...
. The subsequent inquiries into her death led to the publication of the first Asbestos Industry Regulations in 1931.


Early life

Nellie Kershaw was born to Elizabeth and Arthur Kershaw in Rochdale in 1891. In 1903 she left school, aged 12, to take up employment as a cotton rover in a
cotton mill A cotton mill is a building that houses spinning or weaving machinery for the production of yarn or cloth from cotton, an important product during the Industrial Revolution in the development of the factory system. Although some were dri ...
and 5 months later began working at Garsides asbestos mill. She transferred to Turner Brothers Asbestos on 31 December 1917, where she was employed as a
rover Rover may refer to: People * Constance Rover (1910–2005), English historian * Jolanda de Rover (born 1963), Dutch swimmer * Rover Thomas (c. 1920–1998), Indigenous Australian artist Places * Rover, Arkansas, US * Rover, Missouri, U ...
, spinning raw asbestos fibre into yarn. She was married to Frank Kershaw, a slater's labourer, and had at least one child, a daughter born in about 1920.


Illness and death

She first began to exhibit symptoms in 1920 at the age of 29 but continued to work in the asbestos mill until 22 July 1922, when she was certified unfit to work. Because Kershaw's medical certificate (produced by her local physician Dr Walter Scott Joss) recorded the diagnosis as "asbestos poisoning" she was ineligible for
National Health Insurance National health insurance (NHI), sometimes called statutory health insurance (SHI), is a system of health insurance that insures a national population against the costs of health care. It may be administered by the public sector, the private sector ...
sickness benefits. As the illness was linked to her occupation, the insurers advised her that she should instead seek sickness benefits from her employers, under the Workmen's Compensation Act, and wrote to Turner Brothers on her behalf on several occasions. However, Turner Brothers refused to pay any benefits because asbestos-related illness was not a recognised occupational disease at that time, and instructed their insurance company to "repudiate the claim" as it would be "exceedingly dangerous" to accept "any liability whatever in such a case." Percy George Kenyon, Turner's works' manager at Rochdale, wrote to Dr Joss demanding that he "inform us what you have said to Miss Kershaw about suffering from Asbestos poisoning" and then wrote to the medical insurance board stating that "We repudiate the term "Asbestos Poisoning". Asbestos is not poisonous and no definition or knowledge of such a disease exists. Such a description is not to be found amongst the list of industrial diseases in the schedule published with the Workmen's Compensation Act." She is known to have written to Turner Brothers herself on at least one occasion, asking: "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 now through no fault of my own."Mrs N. Kershaw, letter to Turner Brothers Asbestos Company, 1922. Quoted in Selikoff; Greenberg, above. There is no record that she received payments of any form from any official source between July 1922 and her death. She died at 6.30am on 14 March 1924, aged 33.


Inquest

E. N. Molesworth, the
coroner A coroner is a government or judicial official who is empowered to conduct or order an inquest into the manner or cause of death, and to investigate or confirm the identity of an unknown person who has been found dead within the coroner's jur ...
for Rochdale, was obliged to investigate all cases of "unnatural" death, and Dr Joss's diagnosis of "asbestos poisoning" led Molesworth to launch a formal
inquest An inquest is a judicial inquiry in common law jurisdictions, particularly one held to determine the cause of a person's death. Conducted by a judge, jury, or government official, an inquest may or may not require an autopsy carried out by a coro ...
on 14 March 1924, which was adjourned awaiting an
autopsy An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any d ...
, to be conducted by Dr F.W. Mackichan.Selikoff and Greenberg record the pathologist as Dr "Machichan" while Cooke writing in 1924 gives "Mackichan". Mackichan gave the cause of death as "
pulmonary tuberculosis Tuberculosis (TB) is an infectious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in w ...
and
heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, ...
" but a further adjournment was granted for microscopic examination of the lungs. When the inquest was resumed on 1 April 1924 Turner Brothers instructed a barrister, Mr. McCleary, and their solicitor G.L. Collins, of Jackson & Co., to attend in order to represent their interests and to "evade any financial liability for Mrs. Kershaw's death." Dr William Edmund Cooke, a
pathologist Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
and
bacteriologist A bacteriologist is a microbiologist, or similarly trained professional, in bacteriology -- a subdivision of microbiology that studies bacteria, typically pathogenic ones. Bacteriologists are interested in studying and learning about bacteria, as ...
at Wigan Infirmary and Leigh Infirmary, testified that his examination of the lungs indicated old scarring indicative of a previously healed tuberculosis infection, and in addition, extensive
fibrosis Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of perma ...
, in which were visible "particles of mineral matter ... of various shapes, but the large majority have sharp angles. The size varies from 393.6 to 3  μm in length." Having compared these particles with samples of asbestos dust provided by Dr S.A. Henry, Medical Inspector of Factories, Cooke concluded that they "originated from asbestos and were, beyond a reasonable doubt, the primary cause of the fibrosis of the lungs and therefore of death". In his written testimony to the inquest, Walter Joss stated that his diagnosis of "asbestos poisoning" was based upon his "previous experience of such a lung condition for many of his patients who were asbestos workers", and that he personally saw 10 to 12 similar cases each year, all in persons working with asbestos. Nellie's death certificate was issued 2 April 1924, citing "Fibrosis of the lungs due to the inhalation of mineral particles" as the cause of death. In a fuller version of Kershaw's case published in the ''BMJ'' in 1927, Dr Cooke gave the disease the name by which it is still known: "pulmonary asbestosis".


Parliamentary inquiry

As a result of Cooke's paper,
Parliament In modern politics, and history, a parliament is a legislative body of government. Generally, a modern parliament has three functions: representing the electorate, making laws, and overseeing the government via hearings and inquiries. ...
commissioned an inquiry into the effects of asbestos dust by Dr E. R. A. Merewether, Medical Inspector of Factories, and , a factory inspector and pioneer of dust monitoring and control. Their subsequent report, ''Occurrence of Pulmonary Fibrosis & Other Pulmonary Affections in Asbestos Workers'', was presented to parliament on 24 March 1930.Published as ''Report on the effects of asbestos dust on the lungs and dust suppression in the asbestos industry. Part I. Occurrence of pulmonary fibrosis and other pulmonary affections in asbestos workers. Part II. Processes giving rise to dust and methods for its suppression.'' London:
HMSO The Office of Public Sector Information (OPSI) is the body responsible for the operation of His Majesty's Stationery Office (HMSO) and of other public information services of the United Kingdom. The OPSI is part of the National Archives of the Un ...
, 1930.
It concluded that the development of asbestosis was irrefutably linked to the prolonged inhalation of asbestos dust, and included the first health study of asbestos workers, which found that 66% of those employed for 20 years or more suffered from asbestosis. The report led to the publication of the first Asbestos Industry Regulations in 1931, which came into effect on 1 March 1932.


Memorial

In April 2006, a relative of Kershaw unveiled a memorial stone to asbestos victims worldwide in Rochdale. The memorial service was organised by the Save Spodden Valley campaign, an action group concerned about asbestos contamination on the former Turner's factory site where Kershaw had been employed.


References

{{DEFAULTSORT:Kershaw, Nellie 1890s births 1924 deaths Asbestos People from Rochdale Textile workers