"The decisions that a society makes can lead to workplace and environmental illness and injury. After some years working on the hazards related to exposures to silica and studying interventions to prevent them, the author assesses the results of her efforts. She succeeded in getting silica added to the list of substances regulated under the Massachusetts Toxics Use Reduction Act, though not easily. And she found some of the obstacles to doing so nonsensical or stubbornly resistant. The next step, she foresees, is leveraging that outcome to ban or limit the use of sand in blasting operations. But in the course of her work, she also has seen that interest in mitigating the dangers of silica, which is strong among medical and public health professionals who rightfully argue that nobody should be made ill today by this completely preventable problem, is tepid among the workers most affected by it. Although they understand the dangers of silica, it is not their main concern, and she understands why. In future work, she concludes, it may be more worthwhile to allow the community of workers to set the agenda and to help them achieve their goals. "

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