I’d made a plan to go on a field trip to Wales as I had read in “Witnesses to Modern Biomedicine” by Tilli Tansey ( you can read more about it in Part 1 here ) that there had been lots of population based research in South Wales started by Archie Cochrane, the renowned epidemiologist, and largely carried out or supervised by Peter Elwood ( Director of the MRC Epidemiology Research Unit in South Wales ). He and his collegues carried out research into pneumoconiosis, glaucoma, dust diseases in flax, asbestos, steel and slate workers, with later work on iron deficiency anaemia, environmental lead, migraine, asthma, and two high-profile trials showing improved survival following a heart attack with regular use of aspirin and with consumption of a diet rich in oily fish.
I wanted to be able to capture a sense of going back in time as research had started in 1960 and the essence of Fieldwork seems to have had to change considerably over the last 50 years. My starting point was St Fagan’s near Cardiff; an open air museum which chronicles the historical lifestyle, culture and architecture of the Welsh people ( you can read my post about it here )
I had decided that I wanted to concentrate on 2 particular elements which were the research into Environmental Lead and early X-rays given to Welsh miners with potential occupational lung disease.
I took some copies of x-rays of lungs with lesions with me so that I could see how they appeared in the environment and also in the buildings. Somehow the fact that respiratory problems had crept up on, and grown, almost silently, with a community working for years in the mining industry felt very melancholy but a part I felt important to include.
I was also fascinated by the visual similarities between the capillaries in lungs and leafless trees, wattle and rib cages and the open doors of the ironworker’s houses at St Fagan’s. I thought they had echoes of lungs too; being at the centre of the buildings, like they are in the body, and like the lungs, letting in essential air. They also echoed of the old days of fieldworkers being able to knock on an open door and have a chat with locals which enabled them to discover some incredibly useful information.
( Witness Statement by Mrs Janie Hughes: Population-based Research )
Fieldwork has changed enormously because people distrust you nowadays, whereas, perhaps even 20 years ago, working in the Rhondda, in particular, was easy because everybody left their keys in their door and you just turned the key and shouted, ‘Can I come in?’ and they would say ‘Yes’, without even knowing who you were. In the early days, I think I am right in saying this, we didn’t even write to the people and say we were coming, we just cold-called, which we are not in favour of doing at present . Years ago people knew their neighbours, they knew lots about them, they knew the people across the road, they knew the people down the road. Nowadays no one wants to tell you anything about anybody, because they are always afraid of being accused of revealing things to agencies like the DSS (Department of Social Security), and so it’s a closed shop. You can rarely get any information from neighbours these days. You cannot call at the corner shop, or the post office, which is what I used to do a lot, to learn about people’s movements, that’s out now.
( Witness statement from Dr Philip D’Arcy Hart: Population-based Research )
We worked from a schoolroom, which was lent to us and did clinical examination of the miners, X-rays, some sort of respiratory disability tests, rather crude ones I have to say in retrospect, was all we could do, and history taking. There was no X-ray set-up there and we used a mobile van, Portable X-rays Limited, which trundled round the valleys, and it is amazing what beautiful X-rays they took for the period. We confirmed by X-rays and by post mortems that coalface workers who had not worked in hard rock did have serious, disabling lesions. And they did not look like classical silicosis. So this confirmed the suspicions that had been around…We were able to do that, not by following people along, of course, but by taking people who had been for different periods at Ammanford colliery, and matching them against the lesions they showed in their X-rays.
One of the interesting differences between the survey work I did in south Wales, and my later work in Belfast was the names. I don’t think we realised how difficult it was going to be when surveying miners in south Wales where so many men had names like Jenkins, Jones, Thomas, or Williams. Archie Cochrane solved this by ensuring that every man X-rayed was also photographed holding a board with his X-ray number and his name. When the unit returned four or five years later to re-X-ray that pit, it was possible to identify and radiograph the right Mr Jones. Of course, the miners all know each other by Jones ‘longtuff ’ or Jones ‘big nose’ or some phrase of that sort, but that wasn’t very useful to the survey team.One of the brilliant things about looking back into medical history is seeing how so much has been achieved in a relatively short space of time…the transition from a basic way of living, with no medical research and little help, to detailed investigation and a subsequent knowledge of environmental illnesses, and then offering practical solutions or choices, is really incredible. Whilst on my field trip I stayed at the most amazing traditional Welsh cottage, Ty Unnos, near Carmarthen which felt very inspirational and just the right place to create more images…( the blog post about my stay there is here )
Another branch of population based research which was carried out in Wales helped define problems occurring from Environmental Lead and this also really interested me.
( Witness Stement from Dr Peter Elwood: Population-based Research )
The MRC Epidemiology Unit conducted studies on environmental lead from 1976 to 1982 and chose three areas in Wales with different levels of traffic, from a rural area to a very heavily polluted area. The heavily polluted area was Port Talbot, where there’s a motorway, which is elevated above houses. Along this motorway we chose houses on the main road and houses with the motorway over above, and we did lead sampling in blood and lead air sampling, and confirmed that the lead levels were very, very high, and air lead levels were very high.
I was intrigued by the witness statement below about the high levels of lead in people’s blood where there was lead piping and then the subsequent drop in levels when the piping was replaced by copper pipes.
( witness statement from Dr Peter Elwood: Population-based Research )
The Welsh Office asked the MRC Epidemiology Unit to look at water lead. Some of the areas in Wales have a very acid surface water and old lead pipes. One or two studies had shown that the lead levels in the water were really quite high, higher than the WHO recommendation. We went to north Wales and did a number of surveys of water lead and blood lead, and estimated that the contribution that water was making to blood lead levels was quite substantial.
As a lover of classical history I was aware that the use of lead pipes in Roman times was extensive and I couldn’t understand why all the Roman’s hadn’t died of lead poisoning…I then discovered that, unlike today, there was a huge amount of calcium in the water during Roman times which formed a crust within the lead pipes, therefore unwittingly protecting the population from lead poisoning. I also discovered that the word ‘plumbing’ comes from the Latin word for lead ‘plumbum’ and that after the fall of Ancient Rome water supply and sanitation stagnated and even regressed for the next 1000 years!
I liked the idea of an image where copper pipes could be visible within nature; to show the beauty of a simple copper pipe which works to protect us and keep our water clean which is why I included lichen in the images which naturally only thrives in clean air.
Working on the image above then led me back to the x-ray…the images from the day before had felt quite bleak and now I felt that I wanted to breathe some new Welsh Spring life back into the lungs…
I had also been struck by the description of how beautiful the early x-rays had been so I wanted to embrace some more abstract images, making patterns from the x-ray; making them beautiful again.( Nb…I wouldn’t encourage anyone to pick or damage lichen as some are protected by law…the pieces here were found on the ground )
Next week I’ll be looking at the importance of hobbies, vocational passions…and laziness!
You can also find out more about The Modern Biomedicine Research Group funded by The Wellcome Trust, on their website here , their Facebook page here , their YouTube Channel here and their Twitter account here.