(a) Attitude toward diagnosis

86% of the men left mining because of pneumoconiosis. 7% had left because of ill health, and small percentages because of an accident or because their pit had closed, and had later been discovered to be suffering from pneumoconiosis. Nearly all the men, therefore, were faced with a situation in which their normal life was brought to an abrupt end. That is not to say, however, that all the men had not expected some such result. One in five said that they were not surprised to find that they had pneumoconiosis and had know that there was something of that nature wrong with them. On the other hand, 13% said that the diagnosis was a shock to them because it was totally unexpected.

Most of the men’s remarks about their reactions when they learned that they had pneumoconiosis referred to a general feeling of emotional upset, and not to specific problems. How strong the emotional upset can be is illustrated by the statement of man who said that although he had walked to the Doctor’s quite easily the shock of being told that he had silicosis was so great that his legs would not carry him home and he had to keep stopping on the way.

Interestingly enough, however, there was no association between expressions of shock and subsequent employment. The men who afterwards found employment said that they had been upset and worried no less frequently than those who did not find employment.

A direct question on particular problems which worried men at the time of certification brought more information. It must be remembered, however, that the question was one which could only be answered by men to whom certain problems stood out above others. Men who had a series of problems but did not think one stood out above others would, therefore, say ‘no’ to the question. In fact 42% said directly that they had no particular problems, but 31% spoke of financial difficulties, 13% fear of unemployment and 9% of their health. Quotations from answers to the question help to illustrate the reality behind these classifications. “With only 7/11 compensation , small dole, no job, with a wife and a small boy to keep, things didn’t look to good”. Again, “The upkeep of my family and home worried me since there didn’t seem to be much chance of finding a suitable job”. Finally, one ex-miner said he had wondered “How long I should continue to live. Would I always be able to get about. Was I finished?”

The men in the late X-ray category more often said that they were concerned about their health, and less often that they were worried about unemployment than men in the early X-ray category. These differences were significant. Again, the men who had never worked since leaving mining were significantly less concerned about employment, and more often concerned about their health, after certification, than the men who had found employment. This was associated, of course, with the fact that the older men and those in the later stages of pneumoconiosis were least often those who found work. It could be concluded that, in general, the men were more concerned with their emotional problems immediately after certification than they were with particular financial problems or with future employment, although these came to the forefront as they recovered their balance.

(b) Reaction to leaving mining

Some additional evidence on these points is given by the reaction of the men to leaving mining. 58% of the men said that they had been sorry to leave mining. 35% said they had been glad to leave mining, but a number of them were only glad to leave because they felt too ill and exhausted to continue. The older the men the greater was the proportion who were sorry to leave mining. Similarly, the men in the later stage of pneumoconiosis said they were too ill and exhausted to continue more frequently than those in the early stages of pneumoconiosis. The younger men and the fitter men were the least sorry to leave mining, therefore, and on both counts could be expected to find work more readily and adjust themselves more easily.

(c) Summary

After the initial shock and upset of diagnosis, the particular problems which faced men were those of money and employment. Many regretted leaving mining and found it difficult to adjust themselves to the idea of other work. The men who had been least frequently attached to mining and more frequently worried about further employment, and were ready to do anything, were those who later found work most frequently. Even so these men worked in a wider range of occupations than they had thought they would be able to do, at the time they were certified. The younger men and the men in the earlier stages of pneumoconiosis were consistently more worried about employment and more optimistic about what they could do than the older men and those in the later stages of pneumoconiosis.

From this evidence it seems that at least a prima facie case could he made out for an organisation which would help men over the difficult period of emotional readjustment they experience after certification and at the same time bring to their notice the wide range of jobs that have been done by men with pneumoconiosis and the possibilities of work in their neighbourhood. Such an organisation might do much to mitigate the air of hopelessness which many of the Survey’s interviewers thought overlay villages hard hit by pneumoconiosis, and need not, of course, be confined to the problems of men with pneumoconiosis, since men disabled in other ways must face many of the same difficulties.