Industrial Diseases and Hazards. America's rise to industrial supremacy came at great human cost. Throughout the technological revolution that unfolded between the 1820s and World War I, mechanization and the harnessing of steam and then electric power, for all their benefits, also created new productive processes and new occupations that jeopardized the health of working men, women, and children. This revolution both generated novel acute and chronic diseases and increased the incidence of preexisting occupational disorders. In particular, the expansion of natural resource–based industries, like tanning and mining, fostered considerable morbidity.

Workplace hazards of all sorts sickened American employees during the era of industrialization. Among toxic chemicals, naturally occurring substances posed the greatest risk. A host of dangerous elements, including arsenic, mercury, phosphorus, and especially lead, poisoned employees across the nation. Cotton, silica, coal, and other vegetable and mineral dusts threatened the respiratory functioning of millions of workers. Bacteria and other biological agents attacked not only health‐care workers but also construction laborers and slaughterhouse employees. Among the common physical agents of disease, extremes of heat and cold and nonionizing radiation menaced outdoor workers, while noise deafened workers inside mills, foundries, and other manufacturing plants. Repetitive and strenuous movements strained workers' musculoskeletal systems. On the endless range of psychosocial stressors, the tensions of experimentation with the pace of new technology and the uncertainties surrounding devalued skills, arbitrary employer power, and a highly volatile business cycle all contributed to illness in the workforce.

Scientific recognition and public reporting of work‐related diseases were very limited prior to 1920. Against this pattern of disregard, the pioneering early twentieth‐century investigations by the Chicago physician Alice Hamilton (1869–1970), a resident of Jane Addams's Hull House, stand out as exceptional. Within working‐class culture, vernacular terms—“the jackhammer laugh,” “hatter's shakes,” “phossy jaw,” “brain strain,” “telegraphist's cramp”—reflected a widespread, if incomplete, understanding of industrial disease.

In the period commencing with World War I, a flood of synthetic chemicals transformed the working environment. Cracking petroleum, splitting coal‐tar molecules, and other chemical‐industry processes yielded substances to which human beings had never before been exposed. At the same time, increased resistance to infectious diseases meant that workers generally survived the long latent periods preceding the onset of cancer and other insidious chronic conditions. By the 1970s, federal officials estimated that work‐induced illness accounted for approximately 100,000 deaths per year and that approximately 2 million Americans were living with disabilies stemming from such maladies.

With countless new solvents, dyes, plastics, pesticides, and other synthetic chemicals producing toxicity, and with thousands of these substances exhibiting some carcinogenic potential, employees far beyond the chemical industry and, indeed, far beyond the manufacturing sector routinely encountered significant risks. Moreover, innovative materials and processes sometimes combined with older hazards, like asbestos and lead, to create dangerous new formulations. Mortality from asbestos‐related cancers in the last quarter of the twentieth century has been estimated at more than 200,000. Though the threat of some biohazards receded for workers in health‐care and other human services, the threat of others, such as hepatitis B virus, grew. Among the physical agents, radium, uranium, and other sources of ionizing radiation endangered diverse groups of employees. The rise of computers fostered hazards of repetitive motion and related ergonomic problems. The spread of so‐called scientific management split many jobs into fragments, leaving workers with neither control over nor fulfillment in their work. Combined with job insecurity, such powerlessness and alienation became a scientific‐managerial prescription for employee stress.

Clinical, toxicological, and epidemiological researchers clarified innumerable adverse effects of human‐made chemicals, often despite industry obstruction. Hamilton's Industrial Toxicology (1934) and Wilhelm Hueper's Occupational Tumors and Allied Diseases (1942) represented significant early breakthroughs in extending awareness of the scope of this problem. With the passage of the landmark Occupational Safety and Health Act in 1970, attention by public and private institutions to the full spectrum of workplace hazards accelerated. Unions and their allies pressed initiatives to give workers a right to know about the probability of occupational disease.

The late twentieth century witnessed the resurrection of a holistic perspective and a retreat from the long‐standing preoccupation with seeking a single, specific cause of work‐related ailments. Instead, the multifactorial nature of workers' afflictions, commonly involving both occupational and non‐occupational causes, was increasingly acknowledged, as were the varied, often indistinct, syndromes resulting from complex combinations of risk factors. Phenomena such as ergonomic disorders, stress‐induced disease, building‐related illness, multiple chemical sensitivities, and workers' hypertension challenged the single cause–singular effect paradigm.
See also Carson, Rachel; Consumer Movement; Factory System; Labor Movements.

Bibliography

David Rosner and Gerald Markowitz, eds., Dying for Work, 1987.
Ronald Bayer, ed., The Health and Safety of Workers, 1988.
David Rosner and and Gerald Markowitz , Deadly Dust, 1991.
Allard E. Dembe , Occupation and Disease, 1996.
Christopher C. Sellers , Hazards of the Job, 1997.
Alan Derickson , Black Lung, 1998.

Alan Derickson

Alice Hamilton

The American physician Alice Hamilton (1869-1970) is recognized as the founder of industrial medicine in the United States. She was the first woman on the faculty of Harvard Medical School.

Alice Hamilton grew up in Fort Wayne, Ind., in an affluent home. Her parents entertained guests who discussed major topics of the day, and they stimulated the thinking of their children by raising doubts about society's religious and social assumptions. Hamilton attended Miss Porter's School in Farmington, Conn., and in 1893 graduated from the University of Michigan Medical School. She interned in the New England Hospital for Women in Boston. There she serviced working-class people, the usual clientele of the first women doctors (who were seldom employed by the upper classes).

In 1894 Dr. Hamilton studied bacteriology in Germany and returned to accept her first teaching position at the Women's Medical College of Northwestern University in Chicago, III. Another important factor in her life seems to have been her decision to live at Chicago's settlement house, Hull House. Here she came into close contact with notable social reformers (including the founder of Hull House and one of America's first social workers, Jane Addams) and with the sick from the streets and the mills of the city. For several years she was torn between the medical-social work around Hull House and an equally strong desire to devote herself to research at the McCormick Institute for Infectious Diseases.

Eventually Dr. Hamilton's social passion and scientific skills combined as she plunged into the research and activity to control health hazards in the dangerous trades of mining and factory work. Her first real chance came in 1910, when the governor of Illinois appointed her to a commission to investigate occupational diseases. She inspected mines and factories to identify hazardous jobs. After the Federal government asked her to make her research nationwide, she spent 12 years identifying lead, arsenic, and mercury poisons, aniline dyes, picric acid, dust, bad ventilation, and other health hazards. On the basis of her research she was expected to present the needed antidotes and safeguards.

Always an outspoken feminist, Dr. Hamilton must have been excited to accept an invitation in 1919 to be the first woman to join the faculty of the Harvard Medical School. In 1935 she retired from Harvard but not from her national and international efforts to prevent industry from poisoning the earth. She was one of the first to warn of the lethal nature of atomic radiation.

Further Reading

The best book on Alice Hamilton is her autobiography, Exploring the Dangerous Trades (1943). For general background see George Rosen, A History of Public Health (1958). □

HAMILTON, ALICE

Alice Hamilton was born in New York City in 1869, and died in Hadlyme, Connecticut, in 1970. She graduated from the University of Michigan's medical school in 1893 and pursued postgraduate study in pathology and bacteriology in Germany as well as Johns Hopkins University. In 1897, a position as professor of pathology at the Women's Medical School of Northwestern University brought her to Hull House, located in Chicago, where she remained for the next twenty-two years. Hull House was a hotbed for social reform during the turn of the twentieth century, and Hamilton participated in activities designed to ameliorate urban poverty—from teaching basket weaving to starting an infant health clinic.

In 1908, Hamilton's work at Hull House led to an appointment on the Illinois Commission on Occupational Diseases. The commission lacked any in-depth study on which to recommend legislation and Hamilton was asked to conduct a nine-month survey on the prevalence of industrial diseases in the state. Her survey combined laboratory findings with an extensive investigation of hospital records, inspections of industrial plants, and the testimonials from workers and their families. While she studied a number of dangers, she focused on lead poisoning and was able to connect the disease with specific occupations. Her seminal study, the [Illinois] Report of Commission on Occupational Diseases; To His Excellency Governor Charles S. Deneen (1911), demonstrated that the majority of Illinois' industrial workers faced life-threatening hazards at their jobs. The state responded by immediately passing a law that established occupational safety standards.

Considered the leading authority on industrial toxicology, Hamilton worked as a special investigation for the U.S. Bureau of Labor from 1911 to 1920. She also became an assistant professor of industrial medicine at Harvard from 1919 to 1935, and wrote the first American textbook on the subject, Industrial Poisons in the United States (1925).

Jennifer Koslow

(see also: Lead; Occupational Disease )

Bibliography

Hamilton, A. (1943). Exploring the Dangerous Trades. Boston: Little, Brown.

Sicherman, B. (1984). Alice Hamilton: A Life in Letters. Cambridge, MA: Harvard University Press.

—— (1991). "Working It Out: Gender, Profession, and Reform in the Career of Alice Hamilton." In Gender, Class, Race, and Reform in the Progressive Era, eds. N. Frankel and N. S. Dye. Lexington: University of Kentucky Press.

Alice Hamilton 1869–1970, American toxicologist, physician, and educator, b. New York City, M.D. Univ. of Michigan, 1893; she continued her studies in Germany. A pioneer in industrial diseases and hygiene, she joined the faculty of Harvard Medical School in 1919 and became emeritus professor of industrial medicine in 1935. Her services as an outstanding authority on industrial conditions, ailments, and poisons were eagerly sought by political and government agencies. She worked with the state of Illinois, the U.S. Dept. of Commerce, and the health committee of the League of Nations. Her publications include Industrial Poisoning in the United States (1925), Industrial Toxicology (1934), and Exploring the Dangerous Trades, an autobiography (1943).