History of Medicine

GET THE LEAD OUT!

Alice Hamilton and Industrial Toxins

(Thanks to Prof. Paul Blanc, Occupational Medicine Dept, UCSF, for help with this blog)

     A popular consumer item in the early 1900s was the cast iron, enameled bathtub. Probably few users knew how it was made.

     The tubs were first sandblasted to roughen the surfaces, bombarding workers with silica dust. The tub was then heated red-hot, to allow the enamel to spread evenly. Two men greeted the emerging red-hot tub, one handling a heavy apparatus that sprayed powdered enamel onto the tub, the other manipulating a turntable to expose it on all sides. Both men inhaled the enamel powder whirling around them, which contained about 20% lead.   

Alice Hamilton (from Wikipedia)

     The above description was rendered by Alice Hamilton, the founder of occupational medicine in the U.S. and a remarkable woman. Born into a fairly affluent family in Fort Wayne, Indiana, she and her four siblings were largely schooled at home. She attended medical school at the University of Michigan (14 of her class of 47 were women). Following an internship, study in Europe, and a year at Hopkins studying pathology she obtained a post teaching pathology at Northwestern Univ. Medical School. She chose to live at Hull House, a settlement house run by the future Nobel Peace prize winner Jane Addams in a poor area of Chicago. Here Hamilton encountered

Jane Addams (from Five Colleges &
Manuscript Collections)

impoverished immigrants ill with work-related diseases such as lead poisoning, carbon monoxide poisoning (steel workers), and silicosis. Having never been taught these disorders, she educated herself in the library.

     Her interest caught the attention of a sociologist, Charles Henderson, who had her appointed in 1908 to a new “Occupational Disease Commission”, formed to do research for a possible State insurance program. Hamilton was assigned to investigate lead poisoning, which led her to the tub factory. She documented the hazards of lead intoxication in this and several other areas, especially the lead smelting and paint industries. Company doctors under-diagnosed the disorders and no compensation was paid to sick workers.

    World War I brought a huge expansion in munitions manufacturing. TNT, picric acid, and fulminate of mercury (a detonator) were major products. Nitric acid was used almost universally to produce them. Hamilton, working for the Bureau of Labor Statistics, uncovered numerous problems. Nitric acid fumes damaged lungs, TNT caused liver damage and anemias, and fires and explosions occurred frequently. Workers were often unskilled and poorly trained. All of this Hamilton documented in a 1917 report. Soon after, she was appointed to the faculty at Harvard Medical School, the first woman on their faculty

     Next she investigated stone cutters. The recently invented air hammer produced 3000 strokes a minute, causing workers’ hands to become numb and bloodless and producing ever more silicate dust.

     Her work took her to mines, quarries, and factories. She investigated silicosis and poisoning from aniline dyes, carbon monoxide, mercury, and other toxicants. Her efforts culminated in the first American text of its kind, Industrial Poisonings in the United States, published in 1925 (available on line). She followed it  with Industrial Toxicology (1934). She was concerned over the occupational risks of tetraethyl lead in gasoline and advocated for the protection of workers made ill from painting radium on watch dials. Hamilton was well connected and highly influential in

Radium dial painters   (from Wikipedia)

improving industrial practices. To bring changes she tended to favor tactful persuasion by facts rather than blunt instruments, and supported legislation for worker compensation.

     Dr. Hamilton was a product of the Progressive Era. She was deeply involved in peace movements and social activism, though she was hesitant about an early equal rights amendment movement fearing it might lead to worsening work conditions for women. After WWI she helped in feeding programs in Europe. She visited the Soviet Union in 1924 and was saddened by its oppression and lack of freedom, though she generally favored socialism and was impressed by Russian attention to workers’ protection. She was a vocal anti-Fascist and personally assisted colleagues fleeing Europe. Her sister, Edith, was a classical scholar who authored The Greek Way and other works.

     Dr. Hamilton’s impact on industry practice was enormous. She has been honored by the establishment of the annual Alice Hamilton Lectureship at UCSF (http://oem.ucsf.edu/about/hamilton.html), the creation of the Alice Hamilton Award by the American Industrial Hygiene Association, and other lasting recognitions.

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 Sources:

Exploring the Dangerous Trades: The Autobiography of Alice Hamilton, 1943.

Alice Hamilton: A Life in Letters, by Barbara Sicherman, 1984.

Industrial Poisons in the United States, by Alice Hamilton, 1925