Radium-dial painters, mostly young working-class women, haunt the history of health physics. These young women with untreatable symptoms – whom the contemporary press and they themselves described as “the walking dead” – walk or more often hobble through Kate Moore’s book The Radium Girls. Their cases inspired the development of the field of radiation safety. The infamous photos of gross tumours overtaking the faces of pretty young women triggered a serious re-examination of the dangers of man-made radioactive isotopes in the 1920s, a time when merchants promoted radium as a miracle cure for whatever ails you. The case also led to the development of the first methods to detect radioactivity in living bodies. Indeed, the radium dial workers’ bodies became the raw material around which early health physicists created the notion of “permissible dose”.

Moore – a Sunday Times bestselling author – seeks to retrieve the life stories of the radium-dial painters in portraits of several dozen radium-dial workers who pursued lawsuits against watch companies in New Jersey and Illinois. In the 1910s and 1920s, the demand for glowing radium watch-faces grew yearly. Company managers advised their young female employees, paid by the piece, to work with paintbrushes, dipping the points in their mouth to sharpen them. Their counterpart painters in Germany used glass-pointed brushes that held their shape because scientists knew that radium was harmful. Moore shows that the US companies were aware that dipping brushes into one’s mouth was risky, but it was also the cheapest and fastest way to paint watch dials. As the desire for glow in the dark watches was insatiable during and after the First World War, the women painted and dipped all day long, rushing to keep up with the work.

The book makes for uncomfortable reading. Moore seeks to draw out the full effect of young lives painfully cut down in their prime. She swings between passages describing happy, pretty, dancing workers delighted to have cash in their pockets; to graphic details of the assault of radium accumulated in their bodies. The “girls” first started feeling aches and pains in their hips, knees and their jaws – their teeth wobbled painfully and when removed by dentists, the lesions did not heal. The young women developed anaemia, lost weight and felt chronically fatigued. As the ingested radium decayed, it broke down their bones into “honeycomb” configurations and ate into joints. Whole sections of the young women’s jaw bones gave way. Femurs snapped. Hip joints froze in place. Confused doctors treated the women, usually with casts and metal braces, measures that only increased their pain.

In the second half of The Radium Girls, Moore carefully replays the law suits against the Radium Dial Company in Ottawa, Illinois, and the US Radium Corporation in Orange, New Jersey. She shows the managers’ attempts to evade responsibility for damage, as they drew on a playbook of strategies deployed subsequently in the field of industrial hygiene. The radium-dial companies initially ignored their employees’ complaints of painful symptoms and the first early deaths. They claimed the women’s doses of radium were too low to cause problems, though male workers in labs and loading docks were provided leather aprons, gloves and a set of safety restrictions.

Glossing over the radium epidemic was easy. Until 1922 the industrial hygiene department at Harvard University was entirely funded by business, while regional public health offices bowed before the power of local industry. After several more young women died and many others became invalids, the rumours of the dangerous radium factories became a public-relations problem. When medical experts, hired by the companies themselves, ruled unexpectedly that radium poisoning could well be a factor, the reports were manipulated and hidden, and other more malleable specialists were found to vouch for radium’s supposed safety. As the lawsuits got under way, the companies courted public-health officials, lobbied for restricted workmen’s compensation laws, produced their own misleading public-health statements and did their best to sow confusion and stall legal rulings. As the years of court battles wore on, the plaintiffs increasingly had to turn over their bodies to use as evidence.

Moore spotlights Harrison Martland, the young and brash new chief medical examiner for Orange, New Jersey, who took the workers’ health complaints seriously. He collaborated to devise a way to ash the bones of a recently deceased radium worker and test the ash with an electrometer. These were the first measurements of radioactivity in the human body. Later, Martland came up with ways to count gamma rays coming from live patients and from radon in expired air from their lungs. Martland surmised that radium settling inside painters’ mouths produced bacteria that led to chronic infections and loss of teeth. He guessed that radium damaged blood-forming cells in bone marrow, leading to deadly anaemias. Radium, he reasoned, also settled in bones, made them brittle and produced sarcomas. He exhumed the body of a painter to make his point. The bone fragments, buried six years earlier, glowed in the dark grave.

At the time, toxicology demanded not just that statisticians show a significant increase in disease among radium-dial employees, but that the offending toxin be found in the bodies of the patients themselves. Martland’s measurements made a rare, lucid case in the history of what came to be known as “health physics”; radium known to be in the paint was also found in the workers’ bodies. Even with this clear-cut evidence, it took 14 years for the women to win their case in court.

Moore provides a happy ending for this story as she concludes that the “radium girls” drew attention to the dangers of the material, which spawned safe practices in the burgeoning Manhattan Project. She points to the Argonne Center for Human Radiobiology as a laboratory that promoted progress in radiation safety, with a “moral obligation to future generations”.

Unfortunately, I feel these are somewhat dubious claims. As the media attention about the dial-painters’ pain and death grew, scientists began to purposefully expose human subjects to man-made radioactive isotopes. Between 1931 and 1933, scientists at the Elgin State Hospital in Illinois injected half a dozen patients with 70 to 450 mg of radium-226. Later the Argonne lab located those patients, not to treat them, but to continue the experiment and measure retention of radium in their bodies. Scientists in the Manhattan Project began in 1943 to inject patients with the first micrograms of plutonium that they produced. In subsequent decades, the US Atomic Energy Commission funded hundreds of studies using human subjects exposed to internal and external radiation. Happy endings are nice, but I am not sure this sad tale deserves one.

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