Opening Session Remarks - Symposium On Respirable Dust In The Mineral Industries, Pittsburgh, Pa., October 17, 1990. (4fa50f28-d2ad-458b-b304-b0fd051b90a1)

As you know, NIOSH is the part of the United States Public Health Service with responsibility for conducting and supporting research leading to prevention and control of occupational diseases and injuries. Some years ago, NIOSH went through a process of identifying and leading occupational health and safety problems in the United States. Candidate problems were evaluated in terms of the number of people affected, the importance of the effects, and how amenable the conditions are to preventive interventions. Lung diseases were ranked first on the resulting list. Diseases from mining continue to contribute substantially to this unfortunate position of prominence. The work of the Generic Center is one of many answers to this critical problem. Although the research is often expressed in terms of dust characterization or dust control, the reality is that high dust levels are much like high blood pressure. No one cares about hypertension per se. We are concerned about the consequences of exposure to untreated high blood pressure--heart disease, kidney disease, and stroke. Similarly, if dusts were truly only a nuisance, there would be little justification for the diverse research program supported by the Bureau of Mines or by NIOSH. But mineral dusts do cause a range of significant health problems: pneumoconiosis, bronchitis, and emphysema. The research supported by the Center is aimed at doing something about them. Within a public health approach to occupational health, we have a hierarchy of interventions. Primary prevention of problems is prevention at the source: solving a problem before it affects a worker. What we call secondary prevention is an attempt to identify health problems at a sufficiently early stage that some intervention will interrupt the disease process or the development of significant impairment. Tertiary prevention refers to rehabilitation of the worker who has already suffered significant loss of function. At NIOSH, and in the Generic Center research programs, the focus is on primary prevention. Basic investigations into those things about specific dusts that promote or reduce toxicity is critical for our understanding of how to prevent disease. Also, the search for engineering solutions to reduce or control dust generation is essential to solving problems of dust over-exposure. But until the engineers create the foolproof safe environment, it will also be necessary to discover better ways to identify the earliest markers of disease. To do this, we must explore and explicate the basic mechanisms of disease through laboratory investigations as well as human observation and physiologic testing. The unique opportunity provided by the Generic Center program and highlighted in this diverse program over the next few days is that these efforts are being carried out in multiple disciplines concurrently. Also, there are periodic small and large gatherings such as this one where investigators have the chance to get together, formally present papers, and informally stimulate each other's progress towards disease prevention. To ignore the potential for this cross-cutting interaction would be a significant loss. To take full advantage of it is potentially revolutionary. I recently pulled out a book I hadn't read since I was an undergraduate. It specifically concerns the nature of intellectual ferment surrounding the development of the concept of a sun-centered rather than an earth-centered universe in the sixteenth century. The book is about more than developments in astronomy: it is a discussion of the nature of scientific revolutions. Scientific revolutions result from the brilliance, insight, and good fortune of the few superimposed on the evolutionary work of the many. They both cause and reflect significant itellectural and social ferment. For example, the revolutionary work of Copernicus in recognizing the limitations of the concept of an earth-centered universe reflected contemporaneous developments in optics, mathematics, physics, economics, and philosophy.