A GRIM LEGACY Though silicosis is still a serious occupational disease, it was even more prevalent at the beginning of the 20th century, when Alice Hamilton undertook her ground-breaking work to prevent silicosis in New England granite cutters. The industrial revolution introduced mechanical cutting tools that produced greater numbers of smaller particles than resulted from hammer-and-chisel work. In addition, the respirable particles produced during stone cutting and stone crushing were freshly fractured, which made them more potent agents of silicosis. When stone cutters used water to wet the stone, the incidence of silicosis was significantly reduced. The danger from RCS in ceramics, foundries, mining, and construction was slowly recognized. One of the most tragic occupational disasters involving RCS exposure occurred in the early nineteen-thirties during the construction of the Hawks Nest Tunnel under Gauley Mountain in West Virginia. Although original work plans called for ventilation and dust control measures, they were not used because of financial and political pressure to complete the work quickly. Hundreds of workers died within months of the project’s start, and others suffered the chronic progression of silicosis. The pattern of disease suggested that high exposures to RCS resulted in lung failure within several months, a relatively short time. Such rapid progression of disease is now called acute silicosis.