I SHALL ATTEMPT TO MAKE A survey of the history of factory hygiene, that is, of the hygiene of the plant and its installations as well as that of the work itself, especially of health safeguards in dangerous occupations, and also of the protection of miners.
I realize fully that some other aspects of working conditions, such as the protection of women and children, the regulation of working hours and wages, have always been of much greater importance for public health and labor protection, because they protect the greatest number of working people in the most effective way. However, being a physician and industrial hygienist, I wish to confine myself to my own field, the hygiene of work… . Accident prevention will also be treated, but since it is rather the concern of engineers it will be dealt with less thoroughly and without technical details… .
The methods developed for the control of health hazards (except accidents) may be divided in the following groups: the elimination of dangerous substances, the exclusion of especially endangered groups (women and children, and other groups by pre-examination and periodical examination), work turnover, shorter working hours (hygienic working day), personal precautions, and technical devices.
The elimination of dangerous substances and their replacement by others may be accomplished by laws and regulations or by voluntary action on the part of manufacturers. The supposition of both is that science has discovered substitutes adequate for the special purposes of the dangerous processes… .
Mercury seems to have been introduced in the production of mirrors in about 1500 in Venice… . In the middle of the 19th century there were many complaints, considerable research, and numerous regulations concerning the quick-silvering of mirrors… . The production of silver mirrors became cheaper than that of mercury mirrors when the price of silver went down. In the year 1889 the German government issued far-reaching rules for the use of mercury which made that process even more expensive… .
The desire to exclude from work persons who are especially sensitive to the hazards of that work is at the root of all the laws that protect women and children and also prevent their employment in dangerous trades. When an English law of 1833 prohibited employment of children under 9 years of age in textile factories and permitted children from 9 to thirteen to work no more than 9 hours a day, it became necessary—since reliable birth certificates were lacking—for a physician to testify that the individual was “of the ordinary strength and appearance” of a child that age. This was, I think, the first medical pre-examination for factory work required by law… .
The law presumes that in certain kinds of work all women and children, by their peculiarities, are more endangered than are male or adult persons. Consequently women and children are forbidden to engage in such work. The British Mines and Collieries Act of 1842 prohibited the employment underground of all females and of males under ten years of age. The British Factory and Workshop Act of 1878 prohibited the cleaning of moving machines by children, the employment of children and young persons in mercury mirror and white lead factories, and the work of young girls in certain parts of glassworks and brickworks. The regulation of May 7, 1898, prohibited the work of persons below the age of fifteen years in some divisions of the manufacture and decoration of earthenware and china. Sections 76 and 77 of the Factory and Workshop Act of 1901 likewise excluded women, young persons, or children from certain work… .
Other Persons Suspected of Being Especially Endangered. Exclusion from work—or from some types of work—also is indicated in the case of persons particularly sensitive to a substance because of certain bodily peculiarities and of persons who already have absorbed so much of a specific substance that curtailing the exposure seems necessary. The first group must be protected by medical pre-examination, the second group by periodical examination. These methods also have long been in use.
A regulation concerning factories making phosphorus matches, issued by the government of Lower Austria in 1846, made the following provision: “Such a factory must be visited by the health officer monthly and the workers, male and female, have to be examined, and, if one of them shows the slightest trace of a symptom attributable to the harmful influence of phosphorus, he must be eliminated from the work.” …
A German rule of 1892 stated that young workers may be employed in glassworks only if they obtain a certificate of fitness from a physician. The German regulation concerning lead paint factories (1903) orders examinations to be made twice a month by a physician, whose name is communicated to the factory inspector and the health officer. The management of the factory must keep a control book which contains the names, ages, and other such data on all workers, the beginning and termination of their employment, and a record of every illness… .
Thus we see that the trend of the development is to put the examinations as far as possible under governmental supervision. The reason is the same as that which caused the introduction of certifying surgeons in England: the impossibility of getting exact examinations and reports from physicians dependent on the manufacturer–or on the worker. I may add from my own experience that such examinations are reliably carried out only if efficient governmental supervision is exercised–perhaps with the exception of a few very large factories… .
The periodic examination not only offers the possibility of protecting men from serious illness by excluding them from dangerous work at the appearance of certain signs. It also permits the discovery of the dangerous spots by observing the frequency or the quick development of the first signs among workers at a given place or work. Thus it controls the efficiency of prophylactic measures and indicates the necessity for their improvement. Finally such examinations, in conjunction with examinations of the air, provide us with the time of true “allowable limits.”
SUMMARY
The information on industrial hygiene in antiquity is very scanty. It is true that many physicians since Hippocrates have told us something about occupational diseases, especially lead poisoning, and also about their treatment. But very little is said of their control, and some of what is said—for instance the advice of Pliny on protection in breathing—offers and inefficient method.
FIGURE 1—
Ludwig Teleky, circa 1920.
Source. BMJ Publishing Group (Baratt's Photo Press Ltd). Printed with permission.
During the Middle Ages nothing new was added, which is easily explained by the fact that all industrial activity was performed in small workshops. The mines were also small. There were only a few exceptions of larger workshops and mines. The low level of the natural sciences, of medicine, and technology made an efficient control impossible.
The first efforts to diminish industrial hazards by technical means we find in the mines, where without such installations the work had become impossible (Agricola).
Although the work of Ramazzini (1700) does not contain much about industrial hygiene, the works of some of his translators and revisers (Ackermann, Patissier) show great progress, seemingly due to the influence of the encyclopedists and the French Revolution. The beginning of the development of technology was also followed by an increasing number of prophylactic measures.
The economic evolution, which in England in the 18th century initiated the rise of capitalism and the use of machinery, created horrible conditions inside factories as well as outside in the workers’ districts. England, which had taken the lead in the development of industry, also took the lead in the corresponding labor protection and industrial hygiene.
In all countries the first labor laws were laws for the protection of children, sometimes embodying regulations related to measures of hygiene. The enactment of such laws was preceded by severe struggles between—on the one hand—manufacturers, the economic school of laissez faire, laissez aller, and the dogma of free enterprise without government interference and—on the other hand—the humanitarians (often from the class of manufacturers themselves), intelligent government officials, and the growing influence of the working class. These struggles finally resulted in the enforcement of protective laws and the appointment of special officials invested with the appropriate powers and finally the investment of governmental employees with the right to issue—under parliamentary control—regulations for hazardous industries.
The injuries to human life and health in the first ruthless years of industrialization were so evident that it did not at first require scientific research to show the necessity of improvements and to recognize the remedies. But very soon it proved necessary to investigate working conditions and their effect on human health. This was down by private individuals, scientists and physicians, and shortly thereafter in England by governmental councils and officials as well—particularly factory inspectors—appointed for the enforcement of early labor laws. A little later such investigations also were undertaken in the other European countries. Thus there developed in the third and especially in the fourth quarter of the 19th century a science of industrial hygiene. It developed further, using the methods available at that time in the medical, technical, and statistical sciences.
The growing realization that men are more important than economy, that the latter must serve the well-being of the people, that the prosperity of both employer and employed are interrelated—these and the increasing influence of the working class promoted the practical use of the scientific and technical knowledge acquired and spurred the hygienic sciences to proceed still further. When the most easily recognized evils had been at least partially removed, the recognition of others—and hence their control—could be achieved only by exact studies. Thus the science of industrial hygiene widened and deepened… .
The task remaining is first of all to put into more widespread practice all the measures discovered in these ways, to restrict dangers and control noxious substances, and to improve industrial health generally. Numerous laws—exact and detailed rules and regulations—are necessary, as well as their enforcement by highly qualified factory inspectors.
As far as it is possible to evaluate the situation from available statistics, we find a high incidence of accidents and occupational diseases at the beginning of state intervention, followed by a distinct decrease in consequence of this intervention. The better the governmental regulations and the more efficiently they are enforced, the greater has been the actual progress in eliminating accidents and diseases. These laws and regulations together with the officials for their enforcement, the factory inspectors, are the backbone of practical industrial hygiene in Europe and in several states of the United States… .
All of which shows that laws and regulations, thoroughly worked out, and enforced by well-trained inspectors, are indispensable to the practice of industrial hygiene. With these as a basis, it is important to have the cooperation of associations of experts, of trade unions, scientists and physicians.