Occupational Diseases through the Industrial Revolution

Despite the recent concern, however, attention to the worksite as a source of disease is not new. Even the ancients recognized that certain occupations pre­sented special risks of disease and injury.

The Industrial Revolution fundamentally changed the methods of production and work relationships throughout the world. The factory system, which displaced workers from their land and homes, cre­ated new dangers. In addition to accidents caused by machinery, a faster pace of production, and long hours, new diseases plagued the working classes. Because England was the first industrial nation, English reformers and physicians quantified, mea­sured, and documented the effects of industrialism and urbanization on the lives of the English working classes. Edwin Chadwick, Thomas Percival, and Wil­liam Farr were among a group of Benthamites, To­ries, and social reformers who sought to use statisti­cal and quantitative analyses to impose order and expose the horrible working and living conditions that were closely linked to the development of the factory system.

The growing European socialist movements inter­preted the disintegration of workers’ health as confir­mation of the unacceptable social costs of industrial capitalism. In the mid-nineteenth century, Freder­ick Engels wrote his classic treatise, The Condition of the Working-Class in England. In this work he devoted two chapters to the conditions of work in a variety of industries, specifically noting the effects of these conditions on the health of workers. He was especially concerned with the impact of child labor on the health of children pointing to its relationship with child mortality and disablement:

In the manufacture of glass, too, work occurs which seems little injurious to men but cannot be endured by children. The hard labor, the irregularity of the hours, the frequent night-work, and especially the great heat of the working place (100 to 190 Fahrenheit), engender in children gen­eral debility and disease, stunted growth, and especially affections of the eye, bowel complaint, and rheumatic and bronchial affections.

By the mid-nineteenth century, physicians, sani­tary and social reformers, and radicals recognized a wide variety of occupational diseases that afflicted industrial populations. The medical literature was filled with articles about dust diseases and heavy­metal poisonings closely linked to the high tempera­ture, poor ventilation, and bad lighting of the early factories. Consonant with much medical theory that associated disease with the social and moral environ­ment of different populations, the medical literature noted the explicit relationship between disease and the work environment. Health was understood to be a reflection of the balance between people and nature. Disease was seen as a reflection of the imbalance between humans and the unnatural environments that they created for themselves. Cities, factories, slums, and other manifestations of industrialism were creating this imbalance. Hence, physicians and public health workers writing about treatments, diagnoses, and cures for disease often framed their arguments in the personal, moral, and social terms that infused medical theory. For example, throughout most of the nineteenth century, impure air, “mias­mas,” and dust were considered sources of disease; industrial dust was seen as the source of one form of “phthisis” or consumption, a chronic condition that affected broad cross sections of western European and U.S. populations. Popular and medical opinion coin­cided in that both used the terms phthisis and con­sumption to denote a set of symptoms of diverse social origins. The symptoms of wasting away, coughing, spitting, and weakening appeared in victims from various classes and social strata. The root of a worker’s disease could be found by looking at a host of variables including race, ethnicity, personal charac­teristics, home life, and work.

By the last third of the nineteenth century, how­ever, the growing acceptance of germ theory moved the medical and public health communities away from this social explanation of disease. This was illustrated most directly by the effect of Robert Koch’s discovery of the tubercle bacillus on the his­tory of industrial lung disease. By the time of Koch’s discovery in 1882 an enormous literature about the effect of dust on the health of workers had developed, especially in Europe. But with the discovery of the bacillus, the study of its relation to industry ceased, according to Ludwig Teleky (1948), a noted indus­trial physician and author of the first modern his­tory of industrial hygiene. In Europe, researchers “mocked at all those ‘curiosities’ of quartz lungs, coal lungs, and iron lungs, ‘all of which belong in a cabi­net of curiosities.’ ” Until the beginning of the twenti­eth century all consumption or phthisis came to be understood as tuberculosis, caused by a specific or­ganism and spread like other infectious diseases.