SYMHC Classics: Alice Hamilton and Occupational Medicine

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Speaker 1: Happy Saturday. Dr Alice Hamilton's is going to come up in one of our forthcoming episodes, along with her groundbreaking work in the field of occupational medicine, specifically the dangers of workplace and environmental exposures to lead. So we are bringing our episode on her out as Today's Saturday Classic. This originally came out on May six, so enjoy. Welcome to Stuff You Missed in History Class, a production of I Heart Radio. Hello, and welcome to the podcast. I'm Holly Fry and I'm Tracy be Wilson and Tracy. Today's episode is going to delve into the start of the study of occupational disease and the woman behind that beginning. That's an important field, it is, and it's one of those interesting things that we see is so important today but a hundred years ago not so much. Well. Occupational health has also been affecting people for much, much, much longer than it has existed as a field. Like yes, and it is one of those things that even while I was researching this episode, I found myself going, why why didn't anybody study this? There's pretty obvious cause and effect for some of this stuff. One, yeah, but a number of previous episode topics are going to get mentioned as we uh go through this story. Yes, uh so. Dr Alice Hamilton's was a trailblazer in science and medicine and she dedicated her life to improving the workplace standards for laborers in an effort to reduce illnesses that came ardly from working with toxic chemicals. And this episode was requested by our listener Emily, who actually sent us a book to kickstart research, which is very kind and it's actually a really fun book, So thank you, Emily. So on February sixty nine. Alice Hamilton's was born in New York City. Her parents were Montgomery Hamilton's and Gertrude Pond. The family had really strong roots in Fort Wayne, Indiana. That was where her grandfather had been a land speculator and entrepreneur after immigrating from Ireland to the United States, and he had bought and sold a lot of property in Fort Wayne. Yeah, I read one account that basically said, like almost any piece of property you stand on in Fort Wayne today at some point passed through his hands in terms of ownership. Alice was born in New York because her mother, Gertrude, had wanted to go to have the baby at her family home, which was in New York, but when Alice was still very very tiny, she and her mother went back home to Fort Wayne to live on the property that they had there, which is a family called Old House. And the Old House itself had been built in eighteen forty, and Alice once described it as having been built quote for beauty, space, dignity, not for comfort and convenience. The family had staff, and so that inconvenience was borne by them, but Alice was very aware of the inherent wastefulness in building rooms so large that there had to be someone constantly tending to the fire errs, and having so many stories before running water that maids had to continually be carting water up flights of stairs. Montgomery, Gertrude and the children didn't live in Old House, although they spent a lot of their time there. They had a slightly smaller home on the same property called White House, and a home called Red House was where Alice's uncle lived. The one thing that Alice saw is a great benefit in those overly large homes was the ability to find some quiet space to be alone and get away from the bustle of a very large family. Alice and her sisters Edith, Margaret, and Norah, and her one baby brother, Arthur, who came along a little later, were home schooled by their parents. Gertrude Pond Hamilton's thought that the hours of public schools were unreasonable, and her father, Montgomery, thought that the subjects that they taught at those schools were far too boring for his children. Uh Edith incidentally went on to become a well known author and classicists, you mean recognize the name of Hamilton's and the sisters had all been born pretty closely, within six years of each other, and they were very very close to one another. Their brother, Arthur, who went by quint, was born much later, when Alice was seventeen. Alice described this upbringing, being taught at home and not really having friends outside of their family, as one that turned them all into bookworms eventually. Quote and since we saw so little of any children outside our own family, the people we met in books became real to us. But to be clear, there were other children around. Eleven cousins lived on the property where old house and the other home set, so sort of a giant family compound, kind of yes, uh, And it wasn't until Alice was a teenager of seventeen that she received any formal education when she attended Miss Porter's School in Farmington, Connecticut. And that was and still is a private preparatory school in Connecticut, and Alice's time there was the prelude to entering the University of Michigan Medical School. Alice thought that the school was awful, and she selected courses that would either be fairly easy. She already had a lot of linguistics education from her parents, so she took a lot of that, or she picked courses for which she could just memorize the needed information without really digesting and understanding it. But that meant that when she decided to go into medicine, she was woefully lacking. She needed to take extra classes to get properly prepared for it. She had to take physics, chemistry, biology, and anatomy courses after she finished at Miss Porter's. Once those were complete, she enrolled at the University of Michigan. Even though this was decades after Elizabeth Blackwell became the first woman to graduate for medical school in the United States, it was still pretty unusual for a woman to pursue a career as a physician, but it turned out that Alice really loved both the freedom and the challenge of being on her own and learning so much about clinical and lab work. Eventually, she decided she wanted to do research instead of practice me uson and when she finished medical school in eight she worked as an intern in Minneapolis, Minnesota, at the Hospital for Women and Children, and after two months there, she moved to her next training position, this time at the New England Hospital for Women and Children, which is located near Boston. Her education continued after that. She studied in Leipzig and Munich over the course of a year. Because Germany was really where her chosen fields of bacteriology and pathology were most advanced. This was a tricky thing for her to negotiate because German schools were not open to women at that time. Alice and her sister Edith, who traveled to Germany with her, had to promise that they would be invisible to the male students. After gaining a solid level of knowledge in Europe, Alice came back to the United States to attend Johns Hopkins University for a year. Once all of that schooling was done, Hamilton made the switch in roles from student to educator, and she began teaching at the Northwestern Universities Women's Metal Cool School. In addition to her teaching, she also joined Chicago's Hull House and moved in there. That is the settlement house founded by Jane Adams that we discussed in our episode about Adams. Alice Hamilton has actually mentioned very briefly in that episode, and as part of her life at Hull House, Alice founded a well baby clinic for the community, and she also made the connection between typhoid spread and poor sewage disposal during the nineteen two epidemic in Chicago. Hull House made a big impact on Alice, and her ongoing work there really shaped her worldview. She once famously said of it quote, life in a settlement does several things to you. Among others, it teaches you that education and culture have little to do with real wisdom, the wisdom that comes from experiences. And it was during this work at Hull House and offering medical treatment and assistance to the poor families in the community, that Alice started to see firsthand just how closely linked disease was to poverty, and she started to realized just how dangerous working conditions were for the poor, who were often immigrants with little power to improve their workplaces or to move into less hazardous careers. In she wrote her first paper on the subject of occupational disease, and her works importance and her level of knowledge on the topic, we're pretty quickly acknowledged this is the time when workers in the United States were routinely handling toxic substances with little to no protection. We have talked on the podcast before about things like fossy jaw and mercury poisoning, and those were not uncommon among poor laborers, but in the United States there really wasn't any formal work being done to study these kinds of issues in the workplace. And we're going to talk about the next stage in Hamilton's career, which came because of the recognition that she achieved for that early work in studying occupational disease. But first we'll pause and have a little of sponsor break. In Alice Hamilton's was appointed to lead an Occupational Disease Commission which was formed by Illinois Governor Charles Deneen, and that commission was established to study industrial disease. It was the first of its kind in the United States, Lead, arsenic, carbon monoxide, brass, cyanides, and turpentine were all to be studied over the course of a year per the Governor's office, and Hamilton's, in addition to being the leader of this initiative, focused on lead in particular, and so she started researching the connection between industry and disease, pioneering the field of occupational epidemiology. She later wrote quote, it was while I was living in Hull House and working in bacteriological research that the opportunity came to me to investigate the dangerous trades of Illinois, not those where violent accidents occurred, but those with the less spectacular hazard of sickness from some industrial poison. It was a voyage of explor ration that we undertook our little group of physicians and student assistants, for nobody in Illinois knew even then where we should make our investigation beyond a few notorious led trades. American medical authorities had never taken industrial diseases seriously. The American Medical Associations had never held a meeting on the subject, and while European journals were full of articles on industrial poisoning, the number published in American medical journals up to nineteen ten could be counted on one's fingers, and the work on this project was extensive. Dr Hamilton's and her team spoke with laborers and pharmacists about factory conditions and instances of lead poisoning. They also reviewed medical records and hospitals, and they went to factories to see for themselves what the conditions were like. And, as you might suspect, this line of investigation was not exactly welcomed by some of the people in power in the industries that she wanted to research. In her autobiography, she describes some of the attitudes about illness and injury that she encountered. Quote, as I look back, some striking pictures come to me of that anarchic period. One is the picture of the works manager of a big white lead plant, a gentleman of breeding and something of a philanthropist. He is looking at me indignantly and exclaiming, why that sounds as if you think that when a man gets lead poisoning in my plant, I ought to be held responsible. Another is that of a Hungarian woman at Hull House telling me of a terrible accident and a steel mill on the South Shore in which her husband had been injured. He and the other victims were being held in communicado and the company hospital. No one was allowed to see them. She knew nothing except that her husband was not dead. Yeah, she has a lot of accounts. If you read her autobiography, there are many similar stories that she witnessed. A lot of Hamilton's writing on the issues she was researching at this time mentions the various people who were ignorant and indifferent in allowing danger of circumstances to continue to be the norm in factories, from the owners to the foreman, to the company doctors, and even the workers. She wrote quote, the employers could, if they wished, shut their eyes to the dangers their workmen faced, for nobody held them responsible, while the workers accepted the risks with fatalistic submissiveness as part of the price one must pay for being poor. She also cataloged the various excuses she was given by employers and her investigations about illness and disease among their workers. Some took racist positions, claiming that the various immigrant groups were filthy and never washed. Others claimed that various illnesses weren't the result of anything related to their work, but were caused by alcoholism among the employees. She wrote, quote, there is no form of industrial poisoning which I have not heard some man attribute to whiskey. Even though Hamilton's and her colleagues had been appointed to a commission by the governor, they didn't have any actual authority to just walk into ants and start asking questions. And there was also no real set of guidelines or procedure for how they should do this work. So they simply started looking for themselves for places that would fall under the umbrella of their mandate, and then they would just ask to enter and look around and speak with someone in authority. And Alice does mention in her writing that she was always greeted with kindness, and then in some cases foreman or factory owners already had their own worries about employee health, and they were actually really glad to have someone helping them figure out the problem. This commission wasn't intended to be a whistleblowing operation, though Alice wasn't supposed to identify any of the factories and her reports by name or give details that could identify them, and she submitted the reports in the manner that was requested. She wasn't completely comfortable with that, though. She worried that people weren't being helped in a direct way while government agencies reviewed the findings of the report. So she started a habit of telling the men in charge of the factories where she found concern exactly what she felt was wrong. She gave these men her own recommendations for the simple steps they might take to improve conditions, and later she wrote about how surprised she was that this informal quote primitive method actually worked. In one case, she had visited a white lead works that was open with the intent of being safe, but then there hadn't been a protocol in place to remove waste materials from production, and there were piles of it around the factory, and she spoke to the manager, but he was not very enthused about being told what to do. The plant owner wasn't really an option. He was elderly and not really actively involved in running the factory. But then she remembered that she actually knew the owner's daughter. The two women had gone to school together, and so by reaching out through that channel, Alice was able to explain to her former schoolmate problems going on in the lead works and encourage a little bit of change, and that worked. The factory not only changed its operating procedures to include removal of the waste products on a regular basis. Leadership actually asked Alice to stop by periodically and inspect things for them and just touch base. And she continued to develop relationships both through these kinds of ways and with managers and foremen as often as possible so that she could keep their discussions about safety cordial. And she continued to leverage any other means she could to enact change in ways that her government work couldn't really do. Ultimately, though the report that Alice compiled with her colleagues did have significant impact. It made a clear case showing that illnesses were often the result of on the job conditions. In nineteen eleven, the state of Illinois pass legislation that required three things of employers. One they had to follow new safety guidelines to minimize the risk of occupational disease. Two, if they employed workers in so called dangerous trades, they had to provide monthly health screening for those employees. And three, they had to report any illnesses to the Department of Factory inspection. In nineteen eleven, after her work with the State of Illinois Commission concluded, Alice Hamilton was asked to serve as a special investigator for the Federal Department of Labor Bureau of Labor Statistics because of the reputation she had earned for her work at the state level, and she served in that role for almost a decade and continued her study and investigation of lead in industry, as well as rubber, viscoast, rayon, and other substances. Hamilton's continued to break barriers in her career, and we will get to another of those right after we pause for one of the sponsors that keeps us going. During World War One, Hamilton's turned her attentions to the industries associated with war for investigation. She studied factories where munitions were made, and she submitted reports outlining the dangers of the various chemicals involved and how those dangers might be addressed for worker safety. Many safety procedures were established because of the work she did during those years. She also commented at one point that she felt like because the government was so quick to act on those recommendations, it kind of gave her work a level of credibility that it hadn't really had before. Nearing the end of her work in the Bureau of Labor Statistics, Hamilton's was offered a position teaching at Harvard Medical School as an assistant professor of Industrial Medicine. That made her the first woman on the faculty there, and there's some irony in that appointment. The school wasn't accepting women as students at the time. When she was interviewed on the subject, Alice Hamilton was always quick to point out that she shouldn't have been the first woman on the faculty and she was I was like, yes, I am uh. We should have been doing this before. Uh. And despite the attention that her groundbreaking position gained the school, she was denied a number of benefits that were available to other faculty members. For example, she wasn't allowed into the faculty club, and she wasn't allowed to participate in the commencement procession, and she would not receive any football tickets. Those were all benefits that any other faculty member would have had. But as part of her hiring negotiation, Dr Hamilton's wanted to teach only one semester each year, and that way the remainder of the year would be spent on her work at Hull House and on her ongoing research into toxicology. Alice was appointed to the League of Nations Health Committee that made her the only woman chosen for it. That same year, she was invited to the Soviet Union to offer her expertise on the management and treatment of occupational disease. There, Hamilton's continued to use her various positions to work not just for the betterment of occupational health, but also for social reform and healthcare. Her work with impoverished communities continued to drive her efforts, including work in epidemic disease, infant mortality reduction, and addiction, and she also advocated for family planning at a time when that was not a very welcome topic because she saw how much women in impoverished communities really didn't have education on the matter, and also in some cases their health was put at risk by having pregnancy after pregnancy, after pregnancy. She also worked in the interest of women's labor rights, even when that position stood in opposition to legislation that was introduced for equal rights. Hamilton was concerned that the wording of bills introduced for equality in the workplace would diminish protections for women in the workplace, so she became an advocate for women in labor industries like textile mills, food packaging and processing plants, as well as hospitality. In nineteen fifty two, she became an advocate for the Equal Rights Amendment once she felt that equality legislation wouldn't diminish protections for women at work, and part of the reason she was so adamant about those protections was that she had collected data that showed that there were ways in which women were more vulnerable than men when it came to certain issues of industrial poisoning. Her research indicated that women were more susceptible, particularly to lead poisoning, and all industrial poisonings had the added complication of potentially causing birth defects and or sterility. In she wrote the first text on toxicology, titled Industrial Poisons in the United States. Nine years later, in nineteen thirty four, she wrote another text book, Industrial Toxicology. The year after Industrial Toxicology was first published, Hamilton's time at Harvard ended because she reached mandatory retirement age in the sixteen years that she was there. She was never promoted beyond the title of assistant professor, and instead had been employed on a series of three year contracts that renewed over and over. After leaving Harvard, Hamilton's, who was sixty six at the time, hadn't actually retired from her life's work. She moved to Haadline, Connecticut with her sister Margaret, who, like all four of the Hamilton's sisters, had not married, and Alice continued to consult on the topic of toxicology in industrial settings, including acting as an advisor to New York State Industrial Commissioner Francis Perkins. Even outside of consulting, Dr Hamilton's stayed busy. In nineteen forty three, she wrote her autobiography, Exploring the Dangerous Trades. She revised her textbook Industrial Toxicology in nineteen forty nine when she was eighty and as Joseph McCarthy stirred up the Second Red Scare in the u s and the late forties and early fifties, she spoke out against it. At that point she was in her eighties. That activism continued into her nineties, when she wrote to President Kennedy to urge him to get American troops out of Vietnam. On February nineteen sixty nine. Hamilton's celebrated her one birthday the following year. She died on September twenty, nineteen seventy, after having a stroke. Three months after her death, on December nineteen seventy, the Occupational Safety and Health Act of nineteen seventy became law. It's opening paragraph reads, an Act to assure safe and healthful working conditions for working men and women, by authorizing enforcement of the standards developed into the Act, by assisting and encouraging the States and their efforts to assure safe and healthiple working conditions, by providing for research, information, education, and training in the field of occupational safety and health, and for other purposes. Yes, so that was kind of the culmination of her life's work, and she just missed seeing it happened by a few months. Today, the Centers for Disease Control and Prevention give out the Alice B. Hamilton's Awards for Occupational Safety and Health, and on her birthday in ven the National Institute for Occupational Safety and Health Ridge Avenue Facility in Cincinnati, Ohio was dedicated to her memory and named the Alice Hamilton's Laboratory. For Occupational Safety and Health. In two thousand to the American Chemical Society designated Alice Hamilton's and her work in industrial medicine a National Historic Chemical Landmark. And to close, I wanted to offer up a fairly famous quote from Dr Allis Hamilton's autobiography, and it reads, quote I chose medicine not because I was scientifically minded, for I was deeply ignorant of science. I chose it because as a doctor, I could go anywhere I pleased, too far off lands or to city slums, and be quite sure I could be of use anywhere. That's such a great sentiment, it is, And it's like her heaps me too. Uh. One of the things that I think is really interesting about her story is that it's sort of it shows how when there's progress in some field, it's not like there's a switch that gets flipped where everything is fixed now, like the Radium girls were after this, and like I think she was part of some of the investigation of that, and like that was well after Illinois had passed laws related to this. Like it's it's an example of sort of the trajectory of things that that take a while. And of course there are plenty of occupational issues that still exists today. Yeah. In her autobiography, which we mentioned was written in the forties, there's a funny moment where she talks about how like to her, it's almost amusing that people started using like the the safety first wording, when she's like, when I started doing this, that would have been like an athema. Nobody would have said those words. So she was seeing the progress and could appreciate her impact even if she did not get to see that the OSHA law UM finally signed into reality. That law is older than I thought it was. Yeah. Yeah, And it's one of those things I think people don't always know, like the origin point for OSHA, Like we used that acronym as a word all the time, But when you really think about, like someone had to go and investigate all of these things into TRUM and that there was a very clear link between some of the work that was happening and some of the illnesses that were resulting, uh and document all of it so that there could be a clear case made. And it was largely uh, you know, her instigating it in the United States at least, there was, as we mentioned, uh, stuff going on in other parts of the globe where they had already begun that kind of research. But Alice Hilton sure love her. I also noticed, in case anyone's curious, when you look at by agraphies of her, Uh, she isn't very often addressed as Dr Alice Hamilton's and I think that's because she didn't go into practice as a medical doctor but instead took this research route. But she did finish medical school and wasn't mp D, So we kind of switched a little bit and included it periodically just to remind people. Um, but I don't think she went by Dr Hamilton's on the regular in her day to day life. Thanks so much for joining us on this Saturday. Since this episode is out of the archive, if you heard an email address or a Facebook U r L or something similar over the course of the show, that could be obsolete. Now. Our current email address is History Podcast at I heart radio dot com. Our old health stuff works email address no longer works, and you can find us all over social media at missed in History. And you can subscribe to our show on Apple Podcasts, Google podcast, the I Heart Radio app, and wherever else you listen to podcasts. Stuff you miss in History Class is a production of I heart Radio. For more podcasts from I heart Radio, visit the iHeart Radio app, Apple Podcasts, or wherever you listen to your favorite shows. H