Industrial Health and Safety

For the Encyclopedia of the Environment

February, 2003

Safety and health concerns about industrial workers are well known in literature. They have also been points of contention for organized labor and important threads within the overall area of environmental history. 

In literature, occupational disease has sometimes been portrayed with humor, as in Lewis Caroll’s “mad hatter”  who was  crazy because of mercury poisoning from making hats.  A more somber view has been taken by Charles Dickens, whose lead factory workers couldn’t get up off the bed, and Upton Sinclair’s  slaughterhouse workers, who lost fingers and, eventually, their short brutish lives in the Jungle. 

The burdens of work-created illness were shouldered entirely by workers and  families, rather than industry or taxpayers, until the middle 20th century. To this day, most workers injured on the job lose most of their income as a result of job injuries. Improving industrial health has long been a primary goal of organized labor.   

Historians have noted an overlap between occupational medicine and public health in many instances. For example, deaths of 17 workers in tetra-ethyl lead refineries in 1924-25 led to questions about the public health impact of leaded gasoline by scientists who were familiar with occupational impacts of lead poisoning. 

In the latter part of the 20th century, there has been a decrease in the number of worker fatalities on the job and the number of occupational diseases, such as black lung in coal miners and brown lung in textile mill workers. Even so, every day, an average of 9,000 workers have disabling injuries on the job, 16 workers die from a workplace injury, and 137 workers die from work-related diseases, according to the National Institute for Occupational Safety and Health. The toll comes at a financial cost of over $100 billion -- the equivalent health cost impact of all types of cancer.  

Ancient concerns

While many of the specific problems of industrial safety and health have only been recognized in the past 150 years, a duty to protect workers has long been acknowledged.  In Deuteronomy Chapter 22, we find the Biblical admonition: "When you build a new house, you shall make a parapet for [the] roof, so that you will not bring bloodguilt on your house if anyone falls from it.” 

A similar social concern is seen in ancient Greece and Rome. Plutarch (c.45-125 AD), for example, recommended that only criminal slaves be used in lead and mercury mines. It was not just, he said, to expose non-criminals to the poisons of the mines.

Mercury and lead were well known as poisons and Greek physicians appreciated their dangers.  Greek physician Hippocrates (about 460-370 BC) described severe attack of colic (stomach pain) in lead miners.  Around 200 BC, Greek physician Galen observed copper miners and noted dangers. Pedanius Dioscorides (c.40-90 AD) noted in his Materia Medica that eating lead would cause colic, parlysis and delierum. 

Romans were also well aware of the dangers of certain occupations.  Engineer Marcus Vitruvius Pollio noted in the 1st century BC that lead workers had pale gray complexions. “In casting,” Vitruvius noted,  “the lead receives the current of  air, [and] the fumes from it occupy the members of the body, and burning them thereon, rob the limbs of the virtues of the blood.”  Historian and scholar Pliny  (23-79 AD)  described workers using air bladders as masks to protect themselves from cinnabar (mercury) dust and vapors. 

(NOTE:  Despite some knowledge of industrial dangers, it was common practice in Ancient Rome to sweeten wine and grape pulp with sheets of lead. Most of the problem of lead poisoning in the upper classes could be attributed to this fondness for sweet foods, rather than to lead water pipes, according to modern day historian and toxicologist Jerome Nrigau).

Mining dangers known in early Europe

The dangers of mining and smelting metals were well known to workers in the European mining industries that were emerging the 11th and 12th centuries AD.  In part, concern about the dangers led to the establishment of the first  guilds. One of the first in Europe, for example, was founded among the silver miners of Goslar in the Harz Mountains of Germany in 1188. It was intended to help miners who became ill or to help their families if they died.

Knowledge about the dangers involved in mining expanded with the publication of De Re Metallica by Georgius Bauer, known as Agricola (1494-1556). The book concerned techniques of  mining and smelting iron, silver, lead, gold, mercury and other metals.  Parts of the book deal with occupational hazards. 

Agricola warned that heated rocks give off “fetid vapor” and said miners should not break rocks by fire inside a mine. He noted that mine dust could produce asthma and that if mine dust had “corrosive qualities” it “eats away the lungs and implants consumption...” Agricola noted that in some regions, for example the Carpathian mountains,  women have married as many as seven husbands, all of whom have been lost from premature death in mines.

Preventive measures he recommended included ventilation of mine shafts and the use of veils for miners to protect themselves from dust. 

Agricola also defended mining in general.  "The critics say ... that mining is a perilous occupation to pursue because the miners are sometimes killed by the pestilential air which they breathe;  sometimes their lungs rot away..." Agricola discounted these and other concerns. "Things like this rarely happen, and only insofar as workmen are careless," he wrote. The idea that workmen were to blame for occupational disease would be repeated into the mid-20th century.

 Beginnings of occupational medicine

Paracelsus, (1493 - 1541), also known as Aureolus Theophrastus Bombastus von Hohenheim,  wrote about the diseases of miners in a book published in 1567.  Educated as a physician, Paracelsus travelled throughout Europe and settled for a time in Basel, Switzerland, where he lectured on medicine. He was known for attempting to understand disease through direct observation rather than reliance on the theories of ancient physicians, but this approach put him in conflict with the medical authorities of the time.

Bernardino Ramazzini (1633-1714) is considered the “father” of occupational medicine. His reputation rests on a book,  De Morbis Artificum Diatriba,  first published in 1700, which examined the diseases and problems of 52 occupations.  As professor of   medicine at the university of  Modena, Italy, Ramazzini suggested that a doctor should take a medical history by asking the great questions recommended by Hyppocrates, but to those adding one more:  what is your occupation?

“Medicine, like jurisprudence, should make a contribution to the well being of workers and see to it that, so far as possible, they should exercise their callings without harm,” Ramazzini said. “So I for my part have done what I could and have not thought it unbecoming to make my way into the lowliest workshops and study the mysteries of the mechanic arts.”   

In describing occupational disease in the lead mines, Ramazzini noted that the skin of miners “is apt to bear the same color of  the metal” he said. Demons and ghosts are often found to disturb the miners.  At first tremors appear in the hands, soon they are paralyzed."

Mercury is the most cruel all poisons dealing death and destruction to miners, Ramazzini said, noting also that goldsmiths, especially those gilding silver and copper objects through a mercury process, were also very susceptible.   “Very few of them reach old age, and even when they do not die young their health is so terribly undermined they pray for death,” he said.  

Ramazzini’s book reflected an increasing concern for miners in some parts of Europe. One  of the first  programs of occupational medicine for protecting worker health was established  in the early 18th century in the mercury mines of  Idria (Idrija), in what is now Slovenia.  

Early industrial era observations

As new industries and chemicals began to be introduced in trade, new kinds of problems were observed by physicians and scientists. Benjamin Franklin, for instance, was concerned about lead poisoning in the printing trades and also published a paper on “dry gripes,” or stomach cramps, that he found came from drinking rum distilled in lead vessels. English doctor Percival Pott (1714-1788) linked a high frequency of nasal and scrotal cancer with the occupation of chimney sweep in 1775 and discovered the first occupational carcinogen.   And in 1779,  German physician Johann Peter Frank  (1745-1821), wrote A Complete System of  Medical Policy advocating governmental responsibility for clean water,  sewage systems, garbage disposal, food inspection and industrial health under an authoritative "medical police." 

A massive social shift from decentralized work in rural settings to centralized workplaces in factory towns took place across Europe in the early 19th century with tremendous consequences.

Workers who did not move to factory towns found they had no work, and some took to breaking steam powered looms in England’s Luddite rebellion of 1811 - 1816.   Those who did move found no infrastructure for dealing with clean water, sewage, trash, or even personal hygiene.  By the 1830s, the accumulating damage began to spark investigations and calls for reform. 

In 1831, Charles Turner Thackrah, 1795 - 1833, a British physician, published The Effects of the Principle Arts, Trades and Professions. Thackrah not only made clinical observations about the incidence of disease in the trades, but he also had suggestions for improvements. He wrote that glazers, for example, should avoid dipping their hands into lead glaze mix, or even better, that something only slightly more expensive could be substituted. “Surely humanity  forbids that the health of workmen, and that of the poor at large, should  be sacrificed t o the saving of halfpence in the price of pots,” he said. “Evils are suffered to exist  even when the means of correction are known and easily applied. Thoughtlessness or apathy is the only obstacle to success."

About the same time in the 1830s, Parliamentary commissions began investigating outrageous working conditions common in England. Children were beaten into working 16 hour days in textile mills, for example, and were “stunted, diseased, deformed and degraded.” The resulting outrage  fueled two decades of social and environmental investigations and reform in England and across Europe.  The Royal Commission on the Employment of Children in the Mines reported  "cruel slaving revolting to humanity" and pushed for passage of the Mines Act of 1842, which prohibited all women and boys under age 13 from the mines.  The Factory and Workshops Acts, passed around this time and amended throughout the 19th century, would prohibit women from dangerous jobs such as lead and brass manufacturing and children under 11 from grinding metal.  Other subsequent related acts regulated specific occupational diseases, such as the 1875 bill preventing child employment of chimney sweeps or the 1883 Prevention of Lead Poisoning Act.

Reformers in the US were well aware that growing urban populations and a spreading industrial revolution was taking its toll.  In 1842, New York city physician John H. Griscom wrote 'The Sanitary Condition of the Laboring Population of New York City." He found a lack of sanitation, water and decent housing made it hard for workers and families to keep clean. 

Reform movements in the US and Europe were spurred by workers, but the US fight between labor and industry was particularly bitter. 

US versus European worker safety rates

One impediment to reform was the American myth of a higher standard of living and cleaner factories, which prevailed for many decades into the 20th century. However, in many industries, US workers fared worse than European counterparts.  

“For years we had the comfortable illusion that byssinosis [“brown lung” disease from cotton dust] was not a problem for US workers,” a Public Health Service brochure said in 1969. But a survey of of 230,000 textile workers had found rates from 12 to 30 percent in various plants.

US coal miners had an average of 3.4 deaths per thousand in the US between 1900 and 1906. This compared with 2.1 in Germany, 1.3 in Britain, 1.0 in Belgium and 0.9 in France. 

In 1921, US Public Health Service examined 1,800 pottery workers and found lead poisoning at least 13.5 percent. In comparison, British potters had less than one percent.   The US was also slow in legislating technological change for worker protection. White phosorous matches were well known to produce “phossy jaw,” a disfiguring necrotic condition of the face. They were banned in Europe in 1906, but not until 1931 in the US. Similarly, white lead paint was banned in Europe in 1922, but not in the US until much later.

Mine safety a serious problem

The fatality rate for coal and hard rock miners was the worst of all industries. It stood at 3.4 per thousand annually in 1900, dropping by the time of the Coal Mine Health and Safety Act of 1969 to about 1.75 and a late 20th century rate of 0.22 per thousand.  

The worst year on record was 1907, when over 906 coal miners died in 17 separate instances, including the worst mine disaster on record, Dec. 6, 1907, when 362 Fairmont Coal Co. workers died in explosions at  Monongah No. 6 and 8 in West Virginia.

Another mining disaster involved over 470 deaths and over 1500 injuries from silicosis in 1931-33 during the construction of the “Hawks Nest” hydroelectric tunnel for a Union Carbide power project near Gauley Bridge, West Virginia.  Officials on the job were aware that the thick silica dust was killing workers and did nothing. Racism was a factor, since most of the dead workers were African American or recent immigrants.

Other factory disasters spur legislation

The Triangle Shirtwaist Factory in New York City caught fire March 25, 1911, killing 146 women who were trapped without fire escapes. Public outrage was intense, esp after factory owners were acquitted under New York law. However, incident led NY state to establish Factory Investigating Commission which led to a nationwide era of reform in factory legislation between 1911 and 1914.  

Tetra Ethyl Lead was a gasoline additive designed by General Motors and Standard Oil to boost engine power. It was dangerous to make, and many workers in one new Standard plant near New York went “violently insane” in late October, 1924. At least 17 men died from severe lead poisoning in several plants. The incident drew attention to the larger issue of using a well known poison in a common article of commerce. Prominent occupational health advocate Alice Hamilton, like England’s  Charles Thackrah a century before, insisted that other gasoline additives would have the same effect without poisoning workers or the public, but a Public Health Service committee was pushed into approving leaded gasoline. Leaded gasoline was  banned in 1986, and Hamilton’s public health objections and ideas about alternatives were proven to be accurate. 

Radium dial painters of New Jersey developed cancer and other problems after working with radioactive watch dial paints that glowed in the dark.  At no time during their employment were the women warned about or protected from the radioactive paint.  Their employer, US Radium Corp., tried to forestall lawsuits in the late 1920s with phony medical examinations and inaccurate scientific reports. After a great deal of publicity, the women’s suit led to a negotiated 1928 court settlement and their medical bills were covered. Most died within a few years.  Both leaded gasoline and radium dial workplace dangers were diminished after Public Health Service expert conferences identified specific issues.

Major occupational diseases

Asbestos has been one of the leading causes of occupational death in the 20th century, with fatality rates still in the 3,000 per year range and continuing to rise as of 2000.  Asbestosis and asbestos-related lung cancers were diagnosed as early as 1899 and were considered preventable as early as the 1930s by British occupational health expert Thomas Legge. 

Occupational lung cancer is linked to inhaling carcinogens  such as asbestos, coal and petroleum-related compounds in the workplace. In 1998, about 17,315 lung cancer deaths will be attributable to occupational lung cancer, according to the American Lung Association.

Byssinosis (brown lung disease) is a chronic condition severely impairing lung functions. It is caused by dusts from hemp, flax, and cotton processing. Between 1979 and 1996, byssinosis caused  only 120 deaths, but an estimated 35,000 textile workers have been disabled.

Black lung disease, or coal workers' pneumoconiosis, is caused by the inhaling coal dust. An estimated 4.5 percent of coal miners are affected, according to the American Lung Association.  Between 1979 and 1996, 14,156 deaths were attributed to black lung disease.

Silicosis results from exposure to silica in mines, foundries, blasting operations, and manufacturing operations involving materials such as  stone, clay and glass.  Between 1979 and 1996, 2,694 deaths were attributed to silicosis. About 1.6 million workers may have been exposed to silica dust, while almost 60,000 may be suffering from some degree of silicosis, according to the American Lung Association.

Workers compensation laws

Before workers compensation acts were passed in Europe, England and various US states, injured workers had to present claims against employers to unsympathetic courts. Usually the claims were denied under common law theories that presumably treated workers and factory owners as equals.  A theory of  “contributory negligence” developed in the 1830s in England had it that if a fellow employee’s action caused an injury, a factory owner was not responsible. In most cases, even a manager would be considered a fellow employee. 

Workers compensation bills, which guaranteed wages and health benefits to workers who were injured on the job, were passed in Germany in 1884 and Britain in 1897. In the US, Maryland passed the first state worker compensation law in 1902. It was declared unconstitutional by a state court.

In the wake of the Triangle factory fire, New York passed a workers compensation act, but it too was struck down by state courts who said that imposing strict liability on the railroad would deprive it of property without due process.

Taking the workers  side against conservative judges, former president Teddy Roosevelt said these decisions “have been such as almost to bar the path to industrial, economic and social reform. By such decisions they add immensely  to the strength of the Socialist Party, they perpetuate misery, they increase  unrest and discontent.”  (quoted by Gersuny, 1981).   

Factory inspection and worker safety

Reforms in Britain during the 1840s led to a series of Factory Acts and amendments designed to end child labor, bring women into safer occupations and limit workday hours.  The 1867 Factories and Workshops Act , for example, excluded boys under 13 from the coal mines and glass factories. Women’s employment was also curtailed. Other subsequent related acts regulated specific occupational diseases, such as the 1875 bill preventing child employment of chimney sweeps (on the 100th anniversary of Percival Pott’s treatise on cancer among chimney sweeps). 

Between 1890 and 1920, most US states enacted workplace safety laws, but they  were primarily cosmetic and sometimes struck down by reactionary courts. An Illinois  law limiting women’s employment to eight hours was struck down in 1895 by state courts.  When employers did violate weak laws, they were not penalized but were simply asked to stop violating them. In many states factory inspections were voluntary. Some states enforced tougher laws in response to disasters, such as in New York following the 1911 Triangle Shirtwaist fire, but most did not.

The New Deal of the 1930s brought the National Labor Relations Act (Wagner Act)  which guaranteed a right to form unions and bargain collectively; and the 1936 Walsh Healey Act which set safety and health requirements for government contractors. Safety standards were adopted from panels of government advisors (the ACGIH). A 1947 bill guaranteed a right to walk off the job if workers believed it was unsafe, but attempts to pass an act requiring occupational safety and health standards across the board were defeated in the 1950s and 1960s.  Organized labor noted work injury and illness rates increasing during this time, with annual fatalities around 14,500. 

In 1970 Congress passed a comprehensive Occupational Safety and Health Act with requirements for record keeping, complaint procedures, federal inspections, and regulatory hearings with judicial enforcement.  Professional standards for occupational medicine were also included.

Critics say OSHA’s impact has been slight enough to be debatable, but some studies suggest that OSHA has managed to limit exposure in newly regulated areas such as asbestos, vinyl chloride, lead and cotton dust.   

Meanwhile, in 1977, The Federal Mine Safety and Health Act  consolidated all federal  mining industry regulations into a single administration and in 1990, the Mine Safety and Health Administration (MSHA) began programs to help eliminate specific health hazards, such as black lung disease and silicosis. 

Conclusion

Government regulation and worker compensation lawsuits probably led to the decline of the occupational fatality rate from 7.46 to 4.25 per 100,000 workers annually between 1980 and 1995 in the US, although similar statistics concerning occupational disease are more difficult to isolate.  It seems clear that without regulation, industry would not have acquired any sense of social responsibility on its own. 

This is all the more evident when we consider the looming international challenge of industrial safety and health laws in developing nations. Over one million work-related deaths occur each year, according to International Labor Organization estimates. The fatality rate is twice to four times that of developing nations, while hundreds of millions of workers suffer from workplace accidents and occupational exposure to hazardous substances worldwide. Only ten percent of workers in the developing world are likely to have workers compensation coverage. 

Labor organizations and international environmental organizations have made industrial health and safety a 21st century issue for the developing world. 

Illustrations and charts: 

Mine Safety fatality rates:

 http://www.cdc.gov/niosh/mining/data/images/hist11-00.gif 

Mine disasters in history

http://www.cdc.gov/niosh/mining/data/gt_disaster.html

Worker health chartbook

http://www2.cdc.gov/chartbook/chap2/chartbk2.htm

Web Sites

The International Labor Organization

http://www.ilo.org/

The National Institute for Occupational Safety and Health

http://www.cdc.gov/niosh/homepage.html

National Safety Council

http://www.nationalsafetycouncil.org/

Recommended Books

Jacqueline Karnell Corn, Response to Occupational Health Hazards: A Historical Perspective (New York: Van Nostrand Reinhold, 1992).

Carl Gersuny, Work Hazards and Industrial Conflict (Providence, RI: New England Press, 1981)

David Rosner and Gerald Markowitz, Dying for Work (Indianapolis, IN:  Indiana University Press, 1987).

Donald Hunter, The Diseases of the Occupations, (London: Hodder and Stoughton, 1976). 

Daniel M. Berman, Death on the Job: Occupational Health and Safety Struggles in the United States (New York: Monthly Review Press, 1998).