Worker safety in factories and industrial plants became an issue in the late 19th century when more workers left their farms for jobs in cities.
Alice Hamilton, a young woman from a well-to-do family in Fort Wayne, Indiana, set her sights on becoming a doctor but shifted to pathology as she saw the new issues that were arising because of human exposure to chemicals in the workplace.
Industrial toxicology was a very new field of pathology, and Alice Hamilton quickly became known for her work in identifying workplace hazards. Workplace accidents, of course, could occur, but there was another unknown field involving the dangers of worker exposure to chemicals. For example, little was known about lead poisoning, or the dangers of working with mercury, phosphorous, and radium. Companies were also beginning to make artificial silk (viscose rayon), which proved to be a very toxic process. Hamilton studied it all.
Dr. Hamilton dedicated her life to finding answers to the issues that caused harm to people.
Table of contents
Early Years
Alice Hamilton (1869-1970) was one of five children born in Fort Wayne, Indiana. The Hamilton children were given a good education through home tutoring. Then all four of the girls (there was also a brother) were sent to a finishing school– Miss Porter’s Finishing School in Farmington, Connecticut.
Despite her genteel upbringing, Alice Hamilton was exposed to enough of the world that she aspired to be a doctor. However, her home schooling did not include the necessary math or science, nor did Miss Porter’s curriculum include these topics.
In this era, students usually went from high school directly into medical school, but Hamilton had hurdles to overcome. Her first challenge was persuading her father that this would be a good path for her. He finally agreed, and they found another tutor to fill in her gaps in math and science. When that was accomplished, she qualified for the University of Michigan Medical School, graduating in 1893.
Medical School
In medical school, Hamilton became fascinated by pathology. What made people sick? She decided she would study to be a research scientist instead of going into clinical practice.
One of Hamilton’s sisters was going to Europe to study classic literature. Hamilton knew that she could gain more education in bacteriology if she could enroll at a university in Europe. But neither she nor her sister were given easy access.
At universities in Frankfort and Berlin, they were turned away because of their gender. They then moved on to Munich and Leipzig where they were given limited access. At universities in both cities, Alice was permitted to attend lectures in bacteriology and pathology “if she made herself inconspicuous.”
She then returned to the United States where she became a researcher at Johns Hopkins Medical School, working under Simon Flexner, a young pathologist who went on to head Rockefeller Institute in New York City.
Hull House in Chicago
In 1897, she became professor of pathology at the short-lived Women’s Medical School at Northwestern University. She was then hired as a bacteriologist at Chicago’s Memorial Institute for Infectious Disease.
She also took up residence at Hull House, a settlement house for the poor in Chicago started by Jane Addams and Ellen Gates. This gave her an opportunity to live and work with immigrants, seeing whatever challenges they faced and helping them through it.
In Twenty Years at Hull House, Jane Addams writes of the conditions in the area: “schools [are] inadequate, sanitary legislation unenforced, street lighting bad, paving miserable…” And many houses in the area were not connected to Chicago’s rudimentary sewer system, so sewage in the streets was a frequent problem.
At Hull House, one of Dr. Hamilton’s main projects was establishing a “well baby” clinic. She saw that parents needed education and support so by providing opportunities for babies to be bathed at the clinic, it improved infant health by encouraging cleanliness, and it provided an opportunity to teach parents about how to care for their infants.
Typhoid Epidemic
In 1902, Chicago residents experienced a typhoid epidemic. Very little was understood about the spread of disease at that time. In the mid-19th century, British doctor John Snow had determined that cholera passed among people via contaminated water, but medical information of that sort traveled slowly. There was no reason for doctors to think that the spread of cholera might relate to how typhoid traveled.
As Dr. Hamilton watched typhoid ravage the families in her part of the city. She noted how the sewage in the neighborhoods attracted flies. She knew sewage harbored disease, and she concluded that the flies might transmit illnesses.
She gave speeches and wrote scientific papers on the topic. While her general theory proved to be true, the actual cause of this particular typhoid epidemic was later revealed to be primarily from a broken sewer pipe that contaminated drinking water. City maintenance workers did a temporary repair but hid the situation for as long as they could.
When the deception was revealed, Dr. Hamilton had enough authority to step in to see that Chicago’s Department of Health was reorganized.
“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 life experiences.”
Dr. Alice Hamilton on her life at Hull House
Industrial Dangers
In the late 19th century, there were few laws regulating safety in the workplace, yet public pressure was mounting. Because Dr. Hamilton was among the few experts in the field, she was called upon to address issues for the government.
In 1908, the governor of Illinois appointed her to the Illinois Commission on Occupational Diseases, and the group ran a groundbreaking study surveying industrial diseases in Illinois.
The federal government took notice and appointed her to be a special investigator for the Bureau of Labor (later called the Department of Labor) From 1911 to 1920, Hamilton served as a special investigator for that branch of the federal government.
Other industrial dangers arose from poor working environments. The Triangle Shirtwaist Factory Fire is an example of management showing complete disregard for worker safety.
The Dangers of Lead
Lead has been considered the “father of all metals,” and from ancient times forward, people have found helpful ways to use it. In America, the early colonies benefited from mining and forging lead. The metal had a low melting temperature which made it very adaptable. And because it did not corrode, it lasted a long time.
People were often exposed to lead, as it became a frequent additive to paint. This meant that lead-based paint was almost everywhere. In addition, lead was used in face powder, cigar wrappers, and the chemicals used to polish cut glass. Workers who manufactured products using lead found that workers often became ill.
In 1921, a new discovery led to a new and even more pervasive way to use lead. Engineers found that by creating tetraethyl lead gasoline, they could make high-power, high-compression combustion engines. But in the process of running the engine, the fumes from the gasoline released lead into the air. This meant people often breathed particles of lead in the air.
The deadliness of tetraethyl lead was confirmed in the summer of 1924—very shortly after the discovery was made. Workers engaged in producing the additive fell sick and died at several refineries in New Jersey and Ohio. Banner headlines greeted each new fatality until a total of 15 workers had lost their lives; many also suffered mental confusion from working there. Despite this, the industry continued manufacturing gasoline with lead for decades after.
While the manufacturing process was improved somewhat, it wasn’t until 1996 that lead-containing gasoline was fully phased out.
Challenges of These Studies
One of the difficulties in the field of industrial toxicology was that many of the industrial exposures took time before symptoms ensued. (The factories manufacturing tetraethyl gasoline were unusual in how quickly workers were sickened.) Most forms of lead poisoning were from chronic exposure. They symptoms could be debilitating, sometimes leading to death. Because these things did not occur instantly, it was harder for Hamilton and others to prove cause and effect.
And this lack of understanding caused other problems. No one thought about the importance of cleanliness for workers. It was very common for employees to finish at a factory and come home without changing clothes or washing their hands. This meant added exposure for the person as well as his or her family.
Many Other Toxic Substances
As Dr. Hamilton continued her government studies, she remained committed to sharing what she learned. In 1942, she wrote a book, “Exploring the Dangerous Trades.” She told her life story along with many warnings about the workplace.
Among those chemicals that were used a great deal in the early 20th century were phosphorus, mercury, and radium. Phosphorus was used in manufacturing matches and was known to cause “phossy jaw.” The victim’s jaw would become tender and abscesses could develop. Often the only solution was for part of the jaw to be removed surgically.
Mercury was used freely in the hat industry, and those workers often suffered brain damage. “Mad as a hatter” described the mental state of some of the workers.
There were also grave dangers in the watch industry. Consumers loved the fact that watches could have glow-in-the-dark numbers. But this involved using paint with radium. The young women in these jobs breathed radium in the workrooms, and many also licked the end of their paintbrushes to tighten up the brush point. This heightened their exposure, leading to illness and death. They became known as the “Radium Girls.”
Education and Confrontation
Dr. Hamilton knew that educating workers as to the dangers they faced in the workplace needed to be part of her job. She wrote articles and gave speeches, but also knew she had a duty to inform company presidents as to what was happening to their workers.
Because lead was such a major source of danger, Dr. Alice Hamilton finally found a way to confront Edward Cornish, the head of the National Lead Company. According to a booklet published by the American Chemical Society, she approached Cornish and presented to him 22 cases of serious illness among his workers.
He was indignant at first, but then went about making changes to reduce the fumes and dust exposure for workers.
Harvard Appointment
By 1919 Alice Hamilton was the acknowledged expert in the field of industrial medicine. Though Harvard University’s entire faculty was male, the medical school determined that they would create a department of industrial medicine with Hamilton as its leader.
Hamilton was to be given the title of assistant professor, but Harvard placed three qualifications on her appointment: Dr. Hamilton was not to use the Faculty Club; she would not be permitted to march in commencement processions with the rest of the faculty; and she would never be given football tickets, a “perk” available to the rest of the faculty.
She took the position and was never given a higher standing than assistant professor.
International Work
In 1924, she served a six-year term on the Health Committee of the League of Nations and was able to share her findings with an international audience.
At that time, the Soviet Union was advanced in the field of public health, and they had a facility dedicated to occupational illnesses. Dr. Hamilton was invited to Moscow to tour the facility.
More Studies in Toxicology
Though she maintained a full schedule of teaching responsibilities at Harvard, she insisted she be given time to return to live and work at Hull House for part of each year.
She continued to conduct her surveys of employment conditions within various industries and preferred to be in Chicago at Hull House while running those studies.
In addition to lead, mercury, radium, and the chemicals used in rayon, Dr. Hamilton added to her list of substances that needed to be studied: Carbon monoxide, certain dyes, benzene, and the chemicals used in storage batteries all came under her eye.
Tried to Help Whistle Blower
In 1933, Dr. Hamilton received an alarming telegram from what today would be described as a “whistle blower.” The anonymous writer wrote: “Rayon Factory Having Epidemic of Mental Cases.”
Rayon was one of the first semi-synthetic fabrics created. Working from wood pulp, chemicals (hydrogen sulfide and carbon disulfide) are added until the material becomes soft, shiny, and pliable. In the process, workrooms—usually lacking good ventilation— became almost instantly toxic. People fell ill quite rapidly from it.
Dr. Hamilton responded immediately to the telegram but could not gain access to the factory. A few weeks later, she met the company president at a social gathering. She discussed the telegram with him. He appeared concerned and assured her that she would be invited in just as soon as some remedial work was completed at the factory.
Despite continuing to express interest, she ultimately, she was never permitted in.
Never Gave Up
In 1934, she became 65, the mandatory retirement age for teachers at Harvard, Hamilton moved in with one of her sisters in Hadlyme, Connecticut, located in the southern portion of the state, just east of the Connecticut River.
From there, she avidly followed politics and social issues. She was pacifist and actively campaigned against McCarthyism.
Hamilton died in 1970 at the age of 101. She dedicated her life to making life better for other people and was active with both health-related and political causes.
While important progress was made during Dr. Alice Hamilton’s area, more work in industrial toxicology is needed.
Today when you hear “toxic workplace,” people are generally referring to a company with discriminatory, hostile attitudes toward their workers. But chemical hazards have not gone away. From miners suffering “black lung” to the factories making weed killers, unsafe workplaces abound. We need watch dogs paying attention to hazards of many types. Industrial toxicology is an important and growing field.
To read about a devastating industrial accident of another type, see “The Boston Molassacre.”